Dual-Energy X-Ray Absorptiometry (DEXA) Scan and Biochemical Evaluation of Bone Mineral Density in Beta-Thalassemia Major

Abstract

Objective: To assess whether or not BMD Z-score differs between children and older beta- thalassemia major patients as well as the relationship of serum ferritin, serum calcium, and vitamin D with bone mineral density. 

Study Design: Cross sectional study 
Place and Duration of Study: This study was conducted at the Al-Karama Teaching Hospitals ̓ Thalassemia Care Center Baghdad between 1st October 2024 to 31st May 2025. 

Methods: This study was comprised 50 beta-thalassemia major patients equal or less than 15 years old, and 50 beta thalassemia major patients over 15 years’ old were enrolled. All patients underwent a medical examination, assessment of bone mineral density of lumbar spine by DEXA scan and a blood test to determine serum ferritin, serum calcium, and vitamin D levels. 

Results: There were 24 (48%) patients normal, 18 (36%) patients had osteoporosis, and 8 (16%) patients had osteopenia in those under the age of 15 years while there were 22 (44%) patients with osteopenia followed by 14 (28%) patients with osteoporosis and 14 (28%) patients normal in patients over 15 years bone mineral density (BTM). The mean osteopathy score in those patients were 16.63, 24.43 and 16.97 as normal, osteopenia, and osteoporosis, respectively with significant difference between the two groups. There is no significant association between serum ferritin and BMD Z-score. Vitamin D levels exhibited substantial variations with BMD Z-score. 

Conclusion:  Osteopathy was prevalent among beta-thalassemia major patients. In this study, the most common causes of osteoporosis and osteopenia were ageing, poor nutrition, calcium and vitamin D inadequacy.