PREVALENCE OF OSTEOPOROSIS AMONG THALASSEMIC CHILDREN IN SULAIMANI

Authors

  • Adnan M Hasan Department of Pediatrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Taha A Qaradaghi Sulaimani Internal Medicine Teaching Hospital, Rheumatology Section, Sulaimani Health Directorate, Kurdistan Region, Iraq.
  • Mohammed M Alghabsha Sulaimani Pediatric Teaching Hospital, Sulaimani Health Directorate, Kurdistan Region, Iraq.

DOI:

https://doi.org/10.17656/jsmc.10127

Keywords:

Osteoporosis, Thalassemic children, Sulaimani

Abstract

Background 

Thalassaemia is a group of hereditary disorders and it is the most prevalent monogenetic disease in the world. Osteopenia and osteoporosis are frequent among beta-thalassaemia major patients caused by multiple factors interfere with bone remodeling.

Objective

To assess the prevalence of osteoporosis among thalassemic children and identify factors contributed to osteoporosis in Sulaimani city\Iraq. 

Patients and Methods

A cross sectional study carried out in Shaheed Dr. Hemin Hospital (Internal Teaching Hospital) in Sulaimani for period from the 1st of January to the 30th of August, 2015 on a sample of 100 patients with thalassaemia. The data were collected with direct interview and filling of a questionnaire. Selected patients were known cases of Beta thalassaemia registered in Thalassaemia center. Some information was taken from the patients and/or their parents; other information was taken from the patients files in Thalassaemia department and DXA department.

Results

Mean age of thalassemic patients was 13.4±3.2 years. Osteoporosis was represent in 44 of thalassemic patients and osteopenia was represent in 47 patients. A significant association between osteoporosis and thalassemic patients with age 13-18 years (p=0.009).A significant association was observed between osteoporosis and weekly intake of dairy products (p=0.03), and weekly intake of eggs by thalassemic patients (p=0.001).

Conclusion

Osteoporosis prevalence in thalassaemic patients in Sulaimani was lower than the reported prevalence in previous researches in Iraq and other countries.

References

Weatherall DJ, Clegg JB. The Thalassaemia Syndromes.4th edition, 2001. Blackwell scientific Publications, Oxford.UK, 2349-2353. DOI: https://doi.org/10.1002/9780470696705

Eleftheriou A, Angastiniotis M, Soteriades ES, Englezos P. The Thalassaemia International Federation (TIF): A Global Public Health Paradigm. Available from: http://www.thalassaemia.org.

Hashemieh M, Azarkeivan A, Radfar M, Saneifard H, Hosseini-Zijoud S, Noghabaei G et al . Prevalence of Osteoporosis among Thalassemia Patients from Zafar Adult Thalassemia Clinic, Iran. IJBC. 2014; 6 (3):143-148.

Voskaridou E, Terpos E. New insights into the pathophysiology and management of osteoporosis in patients with beta thalassaemia. Br J Haematol. 2004; 127(2):127-39.

Di Stefano M, Chiabotto P, Roggia C. Bone mass and metabolism in thalassemic children and adolescents treated with different iron-chelating drugs. Journal of Bone and Mineral Metabolism 2004; 22 (1): 53–57. DOI: https://doi.org/10.1007/s00774-003-0449-z

Voskaridou E, Terpos E. New insights into the pathophysiology and management of osteoporosis in patients with β thalassaemia. British Journal of Haematology 2004; 127 (2): 127–139. DOI: https://doi.org/10.1111/j.1365-2141.2004.05143.x

Skordis N, Efstathiou E, Kyriakou A, Toumba M. Hormonal dysregulation and bones in thalassaemia—an overview. Pediatric Endocrinology Reviews 2008; 6 (1): 107–115.

Olivieri NF, Koren G, Harris J. Growth failure and bony changes induced by deferoxamine. American Journal of Pediatric Hematology/Oncology 2000; 14 (1): 48–56. DOI: https://doi.org/10.1097/00043426-199221000-00007

Cefalu CA. Is bone mineral density predictive of fracture risk reduction? Current medical research and opinion 2004; 20(3):341-9. DOI: https://doi.org/10.1185/030079903125003062

Angelopoulos NG, Katounda E, Rombopoulos G, Goula A, Kaltzidou V, Kaltsas D, et al. Evaluation of bone mineral density of the lumbar spine in patients with beta-thalassemia major with dual-energy x-ray absorptiometry and quantitative computed tomography: a comparison study. J PediatrHematolOncol 2006; 28(2):73-8. DOI: https://doi.org/10.1097/01.mph.0000199587.76055.21

Carmina E, Di Fede G, Napoli N, Renda G, Vitale G, Lo Pinto C, et al. Hypogonadism and hormone replacement therapy on bone mass of adult women with thalassemia major. Calcif Tissue Int. 2004; 74(1):68-71. DOI: https://doi.org/10.1007/s00223-002-1044-3

Al-Khero KN, Salih MM. Bone mineral density in beta thalassemia syndrome in Mosul city. Ann Coll Med Mosul 2013; 39 (2): 160-165. DOI: https://doi.org/10.33899/mmed.2013.81272

AL Jadir SM, Jalal MZ, AL Ghreer MF, AL Hamdani MS, AL Omaree WR. Osteoporosis in Iraqi patients with thalassemia. Arthritis Research & Therapy. 2012; 14(1):P4. DOI: https://doi.org/10.1186/ar3605

Bielinski BK, Darbyshire P, Mathers L, Boivin CM, Shaw NJ. Bone density in the Asian thalassaemic population: a cross-sectional review. ActaPaediatr. 2001; 90(11):1262-1266. DOI: https://doi.org/10.1111/j.1651-2227.2001.tb01572.x

Saffari F, Mahyar A, Jalilolgadr S. Endocrine and metabolic disorders in beta-thalassemiamajor patients. Caspian J Intern Med. 2012; 3(3):466-472.

Abdulwahid DA, Hassan MK. α and β -Thalassemia intermedia in Basra, Southern Iraq. Hemoglobin 2013; 37(6):553-63. DOI: https://doi.org/10.3109/03630269.2013.825841

Al-Badry BJ, Al-Tamemi MB Prevalence of anti-HBV antibodies in multi-transfused patients with thalassemia at ThiQar province. J.Thi-Qar Sci. 2014; 4 (3): 14-17.

Shawky RM, Kamal TM. Thalassemia intermedia: An overview. The Egyptian Journal of Medical Human Genetics 2012; 13: 245–255. DOI: https://doi.org/10.1016/j.ejmhg.2012.03.006

Aessopos A, Kati M, Farmakis D. Heart disease in thalassemia intermedia: a review of the underlying pathophysiology. Haematologica 2007; 92(5):658–665. DOI: https://doi.org/10.3324/haematol.10915

Al-Hakeim HK, Al-Madani T, Mahammad MMR, Kateb DA, Nassir SA, Kareem S. Study of Some Biochemical Parameters in Iraqi Male Children with Thalassemia. IBN AL- HAITHAM J. FO R PURE & APPL. SC I VO L. 2009; 22 (4).

Ardalan FA, Osquei MR, Toosi MN, Irvanloo G. Synergic effect of chronic hepatitis C infection and beta thalassemia major with marked hepatic iron overload on liver fibrosis: a retrospective cross-sectional study. BMC Gastroenterology. 2004; 4:17. DOI: https://doi.org/10.1186/1471-230X-4-17

Salih AM. Prospective Study of Total Splenectomy Among Thalassemic Major Patients Attending Azadi-Teaching Hospital in Kirkuk City During Three Years Study From 2008- 2011. Journal of Kirkuk medical college 2013; 1 (1): 1-8. DOI: https://doi.org/10.32894/kjms.2013.169484

Basanagoudar PL, Gil SS, Dhillon MS, Marwaha RK. Fractures in Transfusion Dependent Beta Thalassemia – An Indian Study. Singapore Med J 2001; 42(5): 196-199.

Shah N, Mishra A, Chauhan D, Vora C, Shah NR. Study on effectiveness of transfusion program in thalassemia major patients receiving multiple blood transfusions at a transfusion centre in Western India. Asian Journal of Transfusion Science. 2010; 4(2):94-98. DOI: https://doi.org/10.4103/0973-6247.67029

Fung EB, Xu Y, Trachtenberg F, et al. Inadequate Dietary Intake in Patients with Thalassemia. Journal of the Academy of Nutrition and Dietetics. 2012; 112(7):980-990. DOI: https://doi.org/10.1016/j.jand.2012.01.017

Fung EB, Harmatz P, Milet M, et al. Morbidity and mortality in chronically transfused subjects with thalassemia or sickle cell disease: a report from the multicenter study of iron overload. Am J Hematol.2007; 82(4):255–265. DOI: https://doi.org/10.1002/ajh.20809

Fung EB. Nutritional deficiencies in patients with thalassemia. Ann NY Acad Sci. 2010; 1202:188–196. DOI: https://doi.org/10.1111/j.1749-6632.2010.05578.x

Fung EB, Xu Y, Kwiatkowski J, et al. Relationship between chronic transfusion therapy and body composition in subjects with thalassemia. J Pediatr. 2010; 157(4):641–647. DOI: https://doi.org/10.1016/j.jpeds.2010.04.064

Claster S, Wood JC, Noetzli L, et al. Nutritional deficiencies in iron overloaded patients with hemoglobinopathies. Am J Hematol. 2009; 84(6):344–348. DOI: https://doi.org/10.1002/ajh.21416

Liungman P. Vaccination of immunocompromised patients. Clinical Microbiology and Infection 2012 European Society of Clinical Microbiology and Infectious Diseases, CMI, 18 (5): 93–99. DOI: https://doi.org/10.1111/j.1469-0691.2012.03971.x

Bashir FY, Sadoon OA. Serum ferritin level in transfusion dependent β--thalassaemia patients in Mosul. Ann. Coll. Med. Mosul 2010; 36 (1 & 2): 72-78. DOI: https://doi.org/10.33899/mmed.2010.8922

Published

2017-11-01

How to Cite

1.
Hasan A, Qaradaghi T, Alghabsha M. PREVALENCE OF OSTEOPOROSIS AMONG THALASSEMIC CHILDREN IN SULAIMANI. JSMC [Internet]. 2017 Nov. 1 [cited 2024 Jun. 21];7(3):249-62. Available from: https://jsmc.univsul.edu.iq/index.php/jsmc/article/view/jsmc-10127

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