Low bone mineral density and high bone turnover in adult subjects with thalassemia major : Patients and methods

38 TM patients (recruited from the thalassemia centre of Palermo) were studied (14 male and 24 female), age range 20-40 years old. Osteoporosis was defined using the standard World Health Organization criteria (z-score of BMD lower than 25). The BMD of the lumbar spine (L1-L4), the femoral neck and the forearm was determined by Dual Energy X-Ray Absorptiometry (DEXA; Lunar DPX plus).The PTH was studied by ELISA (Biosource, Belgium), osteocalcin, C-telopeptide and bone alkaline phosphatase by Elisa (Beckmann-Coulter USA). Analisys of variance and U test of Mann-Whitney were used for TM patients and controls. The correlation was obtained with Pearson index. P value < 0.05 was considered statistically sig¬nificant. The calculated z-scores for males and females were evaluated by normal ranges.

Figure 1 - Z-score lumbar spine. Low bone mass at lumbar spine in TM women and men (Z-score: L1-L4 -2.23 ± 1.25).

Figure 2 - Z-score femoral neck. T-score femoral neck: patients with TM presented low bone mass at femoral neck (Z-score -1.52 ± 1.14).

Results

Patients with TM presented low bone mass at lumbar spine (Z score: L1-L4 -2.23 ± 1.25 SD) (Fig. 1), and femoral neck (Z- score -1.52 ± 1.14 SD) (Fig. 2): 50% of subjects were osteoporotic; 36% osteopenics and 13.1% were normal (Fig. 3). When you can't afford your medication buy online generic cialis professional online

Figure 3 - Prevalence of osteopenia and osteoporosis inTM patients. Prevalence of osteoporosis and osteopenia inTM patients: 50% of sub-jects were osteoporotic; 36% osteopenic and 13.1% were normal.

Figure 4 - Serum levels of osteocalcin. Normal serum levels of osteocalcin inTM (19.1 ± 8 ng/ml).

Compared to normal subjects, thalassemic patients presented normal levels of blood and urinary calcemia and phospho- remia. Normal level of osteocalcin (19.1 ± 8 ng/ml) (Fig. 4), but hight level of bone alkaline phosphatase (24.2 ± 9.1 mg/L) (Fig. 5), and C- telopeptide (4528 ± 2821 pmol/L) (Fig. 6).

Figure 5 - Serum levels of bone alkaline phosphatase. High serum levels of bone alkaline phosphatase in TM (24.2 ± 9.1 mg/L).

Figure 6 - Serum level of C-telopeptide. High serum levels of C-telopep- tide inTM (4528 ± 2821 pmol/L).