Association of Bone Health in Children with Thalassemia: A Case-Control Study
DOI:
https://doi.org/10.36283/ziun-pjmd14-3/031Keywords:
Bone Mineral Density, Osteopenia, Osteoporosis, Thalassemia, Vitamin DAbstract
Background: Children with transfusion dependent thalassemia (TDT) often experience a range of bone-related issues. This study was done to assess bone health in children with TDT by evaluating bone mineral density (BMD) and related biochemical markers.
Methods: This case-control study was conducted at the hematology department of the Children’s Hospital and Institute of Child Health, Multan, from September 2024 to February 2025. Children aged 5–16 years with TDT, receiving regular transfusions and chelation for at least one year, were enrolled as cases, while age- and gender-matched healthy children served as controls. A total of 90 participants (45 per group) were recruited using non-probability consecutive sampling. Bone health was evaluated by dual-energy X-ray absorptiometry and relevant laboratory investigations. Data were analyzed in IBM-SPSS Statistics version 26.0, applying an independent sample t-test or chi-square test, with p<0.05 considered statistically significant.
Results: of 90 children, 46 (51.1%) were boys, while the mean age was 10.80±3.11 years. TDT children showed significantly lower lumbar spine Z-scores (-1.90±0.60 vs. -0.76±0.47, p<0.001) and femoral neck Z-scores (-1.83±0.56 vs. -0.81±0.40, p<0.001). Osteoporosis was present in 9 (20%) children, and 36 (80%) had osteopenia. TDT children had lower vitamin D (10.54±3.93 ng/ml vs. 20.93±7.54 ng/ml, p<0.001), calcium, and phosphorus levels, but higher alkaline phosphatase and parathyroid hormone levels (p<0.001).
Conclusion: Children with TDT have significantly lower BMD, with a high prevalence of osteopenia and osteoporosis. Vitamin D deficiency, lower serum calcium and phosphorus levels, and increased bone turnover were key contributors to poor bone health in TDT patients.
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