Beta-thalssaemia major (BTM) is a rare disease that encompasses a vast range of endocrinological complications, despite of the improvement of treatment protocols. The aim of this study was to identify the clinical and hematological parameters associated with osteoporosis, a frequent complication found in beta-thalassaemia patients.
Patients with BTM were evaluated in the Endocrinology Department of Elias Hospital between February 2004 and March 2016. Only patients who provided written informed consent were included in the study. A complete physical and hormonal evaluation was performed on all patients, and data regarding treatment of hematological disease were collected. The bone density was evaluated using dual energy X-ray absortiometry (DXA).
Forty-nine patients were included in the study (median age 28.37 years; range 1247). We found that 35 patients (71.4%) had osteoporosis documented using DXA, 16 of them (45.7%) had fragility fractures caused by decreased BMD.
Patients with osteoporosis were older (median age 31.51 vs 20.5 years, P=0.05) and started the iron chelation therapy at an older age compared with subjects without this condition (105.72 months vs 63.58 months, P<0.05). Although the levels of serum ferritin were higher in patients with osteoporosis (1062 vs 777 ng/ml), the difference did not reached statistical significance. Hypogonadism was significantly more frequently found in patients with osteoporosis (30 pts, 85.7% vs 5 pts, 14.3%) in comparison to patients without osteoporosis (P=0.014). The risk of developing osteoporosis was six times greater in hypogonadal study subjects.
Our data show that osteoporosis is a highly prevalent complication among Romanian β-thalasaemia patients, its presence being associated with older age, delayed initiation of iron chelation therapy and the presence of hypogonadism.
20 - 23 May 2017
European Society of Endocrinology