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Bone Metabolism Markers in Thalassemia Major-Induced Osteoporosis: Results from a Cross-Sectional Observational Study

[ Vol. 19 , Issue. 5 ]

Author(s):

Athanasios N. Tsartsalis*, George I. Lambrou, Dimitrios N. Tsartsalis, Ioannis Papassotiriou, Eugenia Vlachou, Evaggelos Terpos, George P. Chrousos, Christina Kanaka-Gantenbein and Antonis Kattamis   Pages 335 - 341 ( 7 )

Abstract:


Background: Thalassemia major (TM) patients eventually face many new health conditions, including endocrinopathies and low bone mineral density, usually observed in the aging general population.

Objective: The aim of the current study was to evaluate biomarkers of bone remodeling in TM patients and to compare them with both osteoporotic and healthy population, in order to investigate new therapeutic paths.

Method: Sixty-four patients with TM (32 men and 32 women) participated in the study. The patients were evaluated with dual-energy X-ray absorptiometry (DXA) of the lumbar spine and femoral neck and with markers of bone remodeling including receptor activator of nuclear factor kappa-Β ligand (RANKL), osteoprotegerin (OPG), C-terminal telopeptide (CTX), and sclerostin. Results were compared with those from 12 postmenopausal women with osteoporosis and 12 women with normal bone mineral density.

Results: The statistical analysis of the biochemical markers of bone metabolism revealed overall significant differences between the three groups only for RANKL and OPG/RANKL (p=0.049 and p=0.009). RANKL was higher and OPG/RANKL was lower in TM patients compared to osteoporosis group.

Conclusion: Patients with TM do not have a higher probability of suffering from osteoporosis from the general population. However, some markers of osteoclast activity differ between patients with TM and osteoporosis, indicating possibly differences in terms of anti-osteoporotic treatment. The lack of significant differences among the three groups in regards to the levels of CTX and sclerostin may indicate the potential efficacy of the current osteoporotic treatment also for TM patients.

Keywords:

Osteoporosis, Thalassemia Major, sclerostin, RANKL, OPG, endocrinopathies, bone metabolism.

Affiliation:

Naval Hospital of Athens, Department of Endocrinology Diabetes and Metabolism, Dinokratous 70, 11521, Athens , First Department of Pediatrics, National and Kapodistrian University of Athens, Choremeio Research Laboratory, Thivon & Levadeias 8, 11527, Goudi, Athens, Department of Clinical Physiology, Linköping University, Linköping, SE-58183 Linköping, Department of Clinical Biochemistry, “Aghia Sophia” Children’s Hospital, Thivon, 115 27 Athens, Department of Nursery, School of Health Sciences, University of West Attica, Ag. Spydironos 28, 12243, Aigaleo, Athens, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, “Alexandra” General Hospital, Lourou 12, 11527, Athens , First Department of Pediatrics, National and Kapodistrian University of Athens, Choremeio Research Laboratory, Thivon & Levadeias 8, 11527, Goudi, Athens, First Department of Pediatrics, National and Kapodistrian University of Athens, Choremeio Research Laboratory, Thivon & Levadeias 8, 11527, Goudi, Athens, Hematology/Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, Thivon & Levadeias, 11527, Goudi, Athens



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