Bone Density And Osteocalcin in B-Thalassaemia

Pathological fractures had been reported in homozygous thalassemicpatients. These fractures had been attributed to osteoporosis. Previous studieshave shown that iron overload results in disturbance of function of mostendocrine glands including parathyroid gland.Disturbance of calcium metabolism was supposed to be either due to:- defective parathonnone hormone secretion.or - defective hydroxylation ofvitamin D in the liver.So this study was carried out to study the problem of bone disease inthalassemic patientsThe present study was conducted on 40 thalassemic children agedbetween 4 and 22 years and 20 age and sex watched normal children.-.. Additionally, history taking, thorough clinical examinations, and laboratoryinvestigations was performed serum calcium,phosphorus, alkalinephosphatase, iron, ferritin, parathonnone hormone and osteocalcin.Furthermore, bone density was measured by dual energy x-ray absorptiometryon lumber spine.from the present study it was found that thalassemic patients had<-significantly lower serum calcium level and low bone density than the controlgroup. Correlation study was done and revealed that serum ferritin which isconsidered as an indicator of severity of the condition was negativelycorrelated with calcium level. This finding was supposed to be the result ofcellular damage of parathyroid gland resulting from hemosiderosis.’-i In addition, the thalassemic patients with serum ferritin> 1000 ng/mlhad lower bone density than the thalassemic patients with serum ferritin <1000 ng/ml indicating that the higher the serum ferritin level the more liability.ee~3E_=_eE._e5E.ITill ~~~~~~~~}to osteoporosis. Regular chelation therapy was found to be partially protective ....._to the thalassemic patients against the risk of hypoparatyroidism. Thisobservation was concluded from the results of this study which shows thatpatients on regular desferal therapy shows higher bone density than those onirregular desferal therapy.