Bone density unveiled: Investigating the effects of beta-thalassemia major on growing children and adolescents.

OBJECTIVE

To evaluate bone mineral density in children and adolescents with beta-thalassemia major.

METHODS

The retrospective, cross-sectional, descriptive study was conducted from October 30 to November 15, 2024, at Peshawar General Hospital, Peshawar, Pakistan, and comprised data from January to August 2024 of paediatric betathalassemia major patients aged 2-18 years. Bone mineral density and Z-scores were evaluated using dual-energy X-ray absorptiometry scans of the lumbar spine, proximal femur and distal radius. Data was analysed using SPSS 25.

RESULTS

Of the 281 patients with mean age 6.92±3.74 years, 176(62.6%) were boys and 105(37.4%) were girls. The mean bone mineral density for proximal femur was 0.59±0.14g/cm², for lumbar spine 0.53±0.14g/cm²and for distal radius 0.35±0.09g/cm². Corresponding Z-scores were -0.41±1.81, -0.48±1.79 and -2.99±1.97 respectively. Low bone mass prevalence was 36(18.9%) at proximal femur, 43(16.4%) at lumbar spine, and 76(62.3%) at distal radius. Age negatively correlated with Z-scores at proximal femur (r=-0.27, p=0.001) and distal radius (r=-0.19, p=0.03). Male subjects had higher bone mineral density and Z-scores at the proximal femur than females(p=0.04).

CONCLUSION

The reduction was significant in bone mineral density, particularly at the distal radius, in paediatric patients with beta-thalassemia major. The negative correlation between age and bone mineral density underscored the importance of early and continuous bone health monitoring in such patients.