Skip to main content
Erschienen in: Archives of Osteoporosis 1/2020

01.12.2020 | Original Article

Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran

verfasst von: Mohammadreza Bordbar, Gholamhossein Ranjbar Omrani, Sezaneh Haghpanah, Forough Saki, Mehran Karimi, Omidreza Zekavat

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

Summary

Despite the significant improvements in the management of thalassemia, there are growing concerns regarding their long-term complications. We showed that low bone mass is one of the most prevalent complications among these patients. Insufficient physical activity and hypogonadism are the main possible associated factors followed by DM and insufficient sun exposure.

Purpose

Despite the significant improvements in the management of transfusion-dependent thalassemia (TDT), there are growing concerns regarding their long-term complications.

Methods

This cross-sectional study included 615 TDT patients who were registered and followed in a comprehensive thalassemia clinic in Southern Iran. We measured serum biochemical tests and bone mineral density in all patients. We recorded physical activity and sun exposure subjectively, and an endocrinologist visited and examined all the patients. A group of age- and gender-matched healthy volunteers participated in the study as the control group.

Results

The mean age of the studied population was 28.4 ± 7.7 years, and 55.8% were female. The prevalence of vitamin D deficiency was 45.6% and 54.4% in TDT patients and the control group. A portion of TDT patients suffered from different endocrinopathies, which included hypogonadism (49.8%), diabetes mellitus (17.2%), hypoparathyroidism (14.6%), and hypothyroidism (6.3%). The prevalence of low bone mass in patients with TDT was 48.3 and 74.6% in the femoral and lumbar bones, respectively. Low physical activity, insufficient sun exposure, diabetes mellitus, and hypogonadism were associated with low bone mass.

Conclusion

Low bone mass is highly prevalent among TDT patients in Southern Iran. Insufficient physical activity and hypogonadism are the main possible associated factors, followed by DM and insufficient sun exposure.
Literatur
1.
Zurück zum Zitat Bordbar M, Haghpanah S, Zekavat OR, Saki F, Bazrafshan A, Bozorgi H (2019) Effect of different iron chelation regimens on bone mass in transfusion-dependent thalassemia patients. Expert Rev Hematol 12(11):997–1003PubMed Bordbar M, Haghpanah S, Zekavat OR, Saki F, Bazrafshan A, Bozorgi H (2019) Effect of different iron chelation regimens on bone mass in transfusion-dependent thalassemia patients. Expert Rev Hematol 12(11):997–1003PubMed
2.
Zurück zum Zitat Gaudio A, Morabito N, Catalano A, Rapisarda R, Xourafa A, Lasco A (2019) Pathogenesis of thalassemia major-associated osteoporosis: a review with insights from clinical experience. J Clin Res Pediatr Endocrinol 11(2):110–117PubMedPubMedCentral Gaudio A, Morabito N, Catalano A, Rapisarda R, Xourafa A, Lasco A (2019) Pathogenesis of thalassemia major-associated osteoporosis: a review with insights from clinical experience. J Clin Res Pediatr Endocrinol 11(2):110–117PubMedPubMedCentral
3.
Zurück zum Zitat Bordbar M, Bozorgi H, Saki F, Haghpanah S, Karimi M, Bazrafshan A, Zekavat OR (2019) Prevalence of endocrine disorders and their associated factors in transfusion-dependent thalassemia patients: a historical cohort study in Southern Iran. J Endocrinol Investig 42(12):1467–1476 Bordbar M, Bozorgi H, Saki F, Haghpanah S, Karimi M, Bazrafshan A, Zekavat OR (2019) Prevalence of endocrine disorders and their associated factors in transfusion-dependent thalassemia patients: a historical cohort study in Southern Iran. J Endocrinol Investig 42(12):1467–1476
4.
Zurück zum Zitat De Sanctis V, Soliman AT, El-Hakim I, Christou S, Mariannis D, Karimi M et al (2019) Marital status and paternity in patients with transfusion-dependent thalassemia (TDT) and non transfusion-dependent thalassemia (NTDT): an ICET - a survey in different countries. Acta Biomed 90(3):225–237PubMedPubMedCentral De Sanctis V, Soliman AT, El-Hakim I, Christou S, Mariannis D, Karimi M et al (2019) Marital status and paternity in patients with transfusion-dependent thalassemia (TDT) and non transfusion-dependent thalassemia (NTDT): an ICET - a survey in different countries. Acta Biomed 90(3):225–237PubMedPubMedCentral
5.
Zurück zum Zitat Dede AD, Trovas G, Chronopoulos E, Triantafyllopoulos IK, Dontas I, Papaioannou N, Tournis S (2016) Thalassemia-associated osteoporosis: a systematic review on treatment and brief overview of the disease. Osteoporos Int 27(12):3409–3425PubMed Dede AD, Trovas G, Chronopoulos E, Triantafyllopoulos IK, Dontas I, Papaioannou N, Tournis S (2016) Thalassemia-associated osteoporosis: a systematic review on treatment and brief overview of the disease. Osteoporos Int 27(12):3409–3425PubMed
6.
Zurück zum Zitat Voskaridou E, Terpos E (2004) New insights into the pathophysiology and management of osteoporosis in patients with beta thalassaemia. Br J Haematol 127(2):127–139PubMed Voskaridou E, Terpos E (2004) New insights into the pathophysiology and management of osteoporosis in patients with beta thalassaemia. Br J Haematol 127(2):127–139PubMed
7.
Zurück zum Zitat De Sanctis V, Soliman AT, Canatan D, Tzoulis P, Daar S, Di Maio S et al (2019) An ICET-a survey on occult and emerging endocrine complications in patients with beta-thalassemia major: conclusions and recommendations. Acta Biomed 89(4):481–489PubMed De Sanctis V, Soliman AT, Canatan D, Tzoulis P, Daar S, Di Maio S et al (2019) An ICET-a survey on occult and emerging endocrine complications in patients with beta-thalassemia major: conclusions and recommendations. Acta Biomed 89(4):481–489PubMed
8.
Zurück zum Zitat Tzoulis P, Ang AL, Shah FT, Berovic M, Prescott E, Jones R, Barnard M (2014) Prevalence of low bone mass and vitamin D deficiency in beta-thalassemia major. Hemoglobin. 38(3):173–178PubMed Tzoulis P, Ang AL, Shah FT, Berovic M, Prescott E, Jones R, Barnard M (2014) Prevalence of low bone mass and vitamin D deficiency in beta-thalassemia major. Hemoglobin. 38(3):173–178PubMed
9.
Zurück zum Zitat Anapliotou ML, Kastanias IT, Psara P, Evangelou EA, Liparaki M, Dimitriou P (1995) The contribution of hypogonadism to the development of osteoporosis in thalassaemia major: new therapeutic approaches. Clin Endocrinol 42(3):279–287 Anapliotou ML, Kastanias IT, Psara P, Evangelou EA, Liparaki M, Dimitriou P (1995) The contribution of hypogonadism to the development of osteoporosis in thalassaemia major: new therapeutic approaches. Clin Endocrinol 42(3):279–287
10.
Zurück zum Zitat Chatterjee R, Katz M (2000) Reversible hypogonadotrophic hypogonadism in sexually infantile male thalassaemic patients with transfusional iron overload. Clin Endocrinol 53(1):33–42 Chatterjee R, Katz M (2000) Reversible hypogonadotrophic hypogonadism in sexually infantile male thalassaemic patients with transfusional iron overload. Clin Endocrinol 53(1):33–42
11.
Zurück zum Zitat Scacchi M, Danesi L, Cattaneo A, Valassi E, Pecori Giraldi F, Argento C et al (2008) Bone demineralization in adult thalassaemic patients: contribution of GH and IGF-I at different skeletal sites. Clin Endocrinol 69(2):202–207 Scacchi M, Danesi L, Cattaneo A, Valassi E, Pecori Giraldi F, Argento C et al (2008) Bone demineralization in adult thalassaemic patients: contribution of GH and IGF-I at different skeletal sites. Clin Endocrinol 69(2):202–207
12.
Zurück zum Zitat Lasco A, Morabito N, Gaudio A, Crisafulli A, Meo A, Denuzzo G, Frisina N (2002) Osteoporosis and beta-thalassemia major: role of the IGF-I/IGFBP-III axis. J Endocrinol Investig 25(4):338–344 Lasco A, Morabito N, Gaudio A, Crisafulli A, Meo A, Denuzzo G, Frisina N (2002) Osteoporosis and beta-thalassemia major: role of the IGF-I/IGFBP-III axis. J Endocrinol Investig 25(4):338–344
13.
Zurück zum Zitat De Sanctis V, Soliman AT, Canatan D, Elsedfy H, Karimi M, Daar S et al (2018) An ICET- a survey on hypoparathyroidism in patients with thalassaemia major and intermedia: a preliminary report. Acta Biomed 88(4):435–444PubMed De Sanctis V, Soliman AT, Canatan D, Elsedfy H, Karimi M, Daar S et al (2018) An ICET- a survey on hypoparathyroidism in patients with thalassaemia major and intermedia: a preliminary report. Acta Biomed 88(4):435–444PubMed
14.
Zurück zum Zitat Voskaridou E, Terpos E (2008) Pathogenesis and management of osteoporosis in thalassemia. Pediatr Endocrinol Rev 6(Suppl 1):86–93PubMed Voskaridou E, Terpos E (2008) Pathogenesis and management of osteoporosis in thalassemia. Pediatr Endocrinol Rev 6(Suppl 1):86–93PubMed
15.
Zurück zum Zitat Skordis N, Efstathiou E, Kyriakou A, Toumba M (2008) Hormonal dysregulation and bones in thalassaemia--an overview. Pediatr Endocrinol Rev 6(Suppl 1):107–115PubMed Skordis N, Efstathiou E, Kyriakou A, Toumba M (2008) Hormonal dysregulation and bones in thalassaemia--an overview. Pediatr Endocrinol Rev 6(Suppl 1):107–115PubMed
16.
Zurück zum Zitat De Sanctis V, Pinamonti A, Di Palma A, Sprocati M, Atti G, Gamberini MR et al (1996) Growth and development in thalassaemia major patients with severe bone lesions due to desferrioxamine. Eur J Pediatr 155(5):368–372PubMed De Sanctis V, Pinamonti A, Di Palma A, Sprocati M, Atti G, Gamberini MR et al (1996) Growth and development in thalassaemia major patients with severe bone lesions due to desferrioxamine. Eur J Pediatr 155(5):368–372PubMed
17.
Zurück zum Zitat Terpos E, Voskaridou E (2010) Treatment options for thalassemia patients with osteoporosis. Ann N Y Acad Sci 1202:237–243PubMed Terpos E, Voskaridou E (2010) Treatment options for thalassemia patients with osteoporosis. Ann N Y Acad Sci 1202:237–243PubMed
18.
Zurück zum Zitat Johanson NA (1990) Musculoskeletal problems in hemoglobinopathy. Orthop Clin North Am 21(1):191–198PubMed Johanson NA (1990) Musculoskeletal problems in hemoglobinopathy. Orthop Clin North Am 21(1):191–198PubMed
19.
Zurück zum Zitat Origa R, Fiumana E, Gamberini MR, Armari S, Mottes M, Sangalli A et al (2005) Osteoporosis in beta-thalassemia: clinical and genetic aspects. Ann N Y Acad Sci 1054:451–456PubMed Origa R, Fiumana E, Gamberini MR, Armari S, Mottes M, Sangalli A et al (2005) Osteoporosis in beta-thalassemia: clinical and genetic aspects. Ann N Y Acad Sci 1054:451–456PubMed
20.
Zurück zum Zitat Al-Agha AE, Bawahab NS, Nagadi SA, Alghamdi SA, Felemban DA, Milyani AA (2020) Endocrinopathies complicating transfusion-dependent hemoglobinopathy. Saudi Med J 41(2):138–143PubMed Al-Agha AE, Bawahab NS, Nagadi SA, Alghamdi SA, Felemban DA, Milyani AA (2020) Endocrinopathies complicating transfusion-dependent hemoglobinopathy. Saudi Med J 41(2):138–143PubMed
21.
Zurück zum Zitat Abbasi S, Asl JF, Zadeh LM, Mirdoraghi M (2018) Measurement bone mineral density (BMD) of patients with beta thalassemia. Data Brief 19:1021–1024PubMedPubMedCentral Abbasi S, Asl JF, Zadeh LM, Mirdoraghi M (2018) Measurement bone mineral density (BMD) of patients with beta thalassemia. Data Brief 19:1021–1024PubMedPubMedCentral
22.
Zurück zum Zitat Larijani B, Moayyeri A, Keshtkar AA, Hossein-Nezhad A, Soltani A, Bahrami A, Omrani GH, Rajabian R, Nabipour I (2006) Peak bone mass of Iranian population: the Iranian Multicenter Osteoporosis Study. J Clin Densitom 9(3):367–374PubMed Larijani B, Moayyeri A, Keshtkar AA, Hossein-Nezhad A, Soltani A, Bahrami A, Omrani GH, Rajabian R, Nabipour I (2006) Peak bone mass of Iranian population: the Iranian Multicenter Osteoporosis Study. J Clin Densitom 9(3):367–374PubMed
23.
Zurück zum Zitat Pellegrino F, Zatelli MC, Bondanelli M, Carnevale A, Cittanti C, Fortini M, Gamberini MR, Giganti M, Ambrosio MR (2019) Dual-energy X-ray absorptiometry pitfalls in thalassemia major. Endocrine. 12:1–4 Pellegrino F, Zatelli MC, Bondanelli M, Carnevale A, Cittanti C, Fortini M, Gamberini MR, Giganti M, Ambrosio MR (2019) Dual-energy X-ray absorptiometry pitfalls in thalassemia major. Endocrine. 12:1–4
24.
Zurück zum Zitat Bozzola M, Bozzola E, Montalbano C, Stamati FA, Ferrara P, Villani A (2018) Delayed puberty versus hypogonadism: a challenge for the pediatrician. Ann Pediatr Endocrinol Metab 23(2):57–61PubMedPubMedCentral Bozzola M, Bozzola E, Montalbano C, Stamati FA, Ferrara P, Villani A (2018) Delayed puberty versus hypogonadism: a challenge for the pediatrician. Ann Pediatr Endocrinol Metab 23(2):57–61PubMedPubMedCentral
25.
Zurück zum Zitat Kennel KA, Drake MT, Hurley DL (2010) Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc 85(8):752–757 quiz 7-8PubMedPubMedCentral Kennel KA, Drake MT, Hurley DL (2010) Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc 85(8):752–757 quiz 7-8PubMedPubMedCentral
26.
Zurück zum Zitat Baldini M, Forti S, Orsatti A, Ulivieri FM, Airaghi L, Zanaboni L, Cappellini MD (2014) Bone disease in adult patients with beta-thalassaemia major: a case-control study. Intern Emerg Med 9(1):59–63PubMed Baldini M, Forti S, Orsatti A, Ulivieri FM, Airaghi L, Zanaboni L, Cappellini MD (2014) Bone disease in adult patients with beta-thalassaemia major: a case-control study. Intern Emerg Med 9(1):59–63PubMed
27.
Zurück zum Zitat Karimi M, Ghiam AF, Hashemi A, Alinejad S, Soweid M, Kashef S (2007) Bone mineral density in beta-thalassemia major and intermedia. Indian Pediatr 44(1):29–32PubMed Karimi M, Ghiam AF, Hashemi A, Alinejad S, Soweid M, Kashef S (2007) Bone mineral density in beta-thalassemia major and intermedia. Indian Pediatr 44(1):29–32PubMed
28.
Zurück zum Zitat Valizadeh N, Farrokhi F, Alinejad V, Said Mardani S, Valizadeh N, Hejazi S et al (2014) Bone density in transfusion dependent thalassemia patients in Urmia, Iran. Iran J Ped Hematol Oncol 4(2):68–71PubMedPubMedCentral Valizadeh N, Farrokhi F, Alinejad V, Said Mardani S, Valizadeh N, Hejazi S et al (2014) Bone density in transfusion dependent thalassemia patients in Urmia, Iran. Iran J Ped Hematol Oncol 4(2):68–71PubMedPubMedCentral
29.
Zurück zum Zitat Meena MC, Hemal A, Satija M, Arora SK, Bano S (2015) Comparison of bone mineral density in thalassemia major patients with healthy controls. Adv Hematol 2015:648349PubMedPubMedCentral Meena MC, Hemal A, Satija M, Arora SK, Bano S (2015) Comparison of bone mineral density in thalassemia major patients with healthy controls. Adv Hematol 2015:648349PubMedPubMedCentral
30.
Zurück zum Zitat Naithani R, Seth T, Tandon N, Chandra J, Pati H, Saxena R, Choudhry VP (2018) Fractures and low bone mineral density in patients with beta thalassemia major. Indian J Hematol Blood Transfus 34(1):163–165PubMed Naithani R, Seth T, Tandon N, Chandra J, Pati H, Saxena R, Choudhry VP (2018) Fractures and low bone mineral density in patients with beta thalassemia major. Indian J Hematol Blood Transfus 34(1):163–165PubMed
31.
Zurück zum Zitat Aslan I, Canatan D, Balta N, Kacar G, Dorak C, Ozsancak A et al (2012) Bone mineral density in thalassemia major patients from Antalya, Turkey. Int J Endocrinol 2012:573298PubMedPubMedCentral Aslan I, Canatan D, Balta N, Kacar G, Dorak C, Ozsancak A et al (2012) Bone mineral density in thalassemia major patients from Antalya, Turkey. Int J Endocrinol 2012:573298PubMedPubMedCentral
32.
Zurück zum Zitat Benigno V, Bertelloni S, Baroncelli GI, Bertacca L, Di Peri S, Cuccia L et al (2003) Effects of thalassemia major on bone mineral density in late adolescence. J Pediatr Endocrinol Metab 16(Suppl 2):337–342PubMed Benigno V, Bertelloni S, Baroncelli GI, Bertacca L, Di Peri S, Cuccia L et al (2003) Effects of thalassemia major on bone mineral density in late adolescence. J Pediatr Endocrinol Metab 16(Suppl 2):337–342PubMed
33.
Zurück zum Zitat Vogiatzi MG, Macklin EA, Fung EB, Cheung AM, Vichinsky E, Olivieri N, Kirby M, Kwiatkowski JL, Cunningham M, Holm IA, Lane J, Schneider R, Fleisher M, Grady RW, Peterson CC, Giardina PJ, for the Thalassemia Clinical Research Network (2009) Bone disease in thalassemia: a frequent and still unresolved problem. J Bone Miner Res 24(3):543–557PubMed Vogiatzi MG, Macklin EA, Fung EB, Cheung AM, Vichinsky E, Olivieri N, Kirby M, Kwiatkowski JL, Cunningham M, Holm IA, Lane J, Schneider R, Fleisher M, Grady RW, Peterson CC, Giardina PJ, for the Thalassemia Clinical Research Network (2009) Bone disease in thalassemia: a frequent and still unresolved problem. J Bone Miner Res 24(3):543–557PubMed
34.
Zurück zum Zitat Mohkam M, Shamsian BS, Gharib A, Nariman S, Arzanian MT (2008) Early markers of renal dysfunction in patients with beta-thalassemia major. Pediatr Nephrol 23(6):971–976PubMed Mohkam M, Shamsian BS, Gharib A, Nariman S, Arzanian MT (2008) Early markers of renal dysfunction in patients with beta-thalassemia major. Pediatr Nephrol 23(6):971–976PubMed
35.
Zurück zum Zitat Chan YL, Pang LM, Chik KW, Cheng JC, Li CK (2002) Patterns of bone diseases in transfusion-dependent homozygous thalassaemia major: predominance of osteoporosis and desferrioxamine-induced bone dysplasia. Pediatr Radiol 32(7):492–497PubMed Chan YL, Pang LM, Chik KW, Cheng JC, Li CK (2002) Patterns of bone diseases in transfusion-dependent homozygous thalassaemia major: predominance of osteoporosis and desferrioxamine-induced bone dysplasia. Pediatr Radiol 32(7):492–497PubMed
36.
Zurück zum Zitat Fung EB, Xu Y, Kwiatkowski JL, Vogiatzi MG, Neufeld E, Olivieri N et al (2010) Relationship between chronic transfusion therapy and body composition in subjects with thalassemia. J Pediatr 157(4):641–647 7 e1-2PubMedPubMedCentral Fung EB, Xu Y, Kwiatkowski JL, Vogiatzi MG, Neufeld E, Olivieri N et al (2010) Relationship between chronic transfusion therapy and body composition in subjects with thalassemia. J Pediatr 157(4):641–647 7 e1-2PubMedPubMedCentral
37.
Zurück zum Zitat Baldini M, Forti S, Marcon A, Ulivieri FM, Orsatti A, Tampieri B, Airaghi L, Zanaboni L, Cappellini MD (2010) Endocrine and bone disease in appropriately treated adult patients with beta-thalassemia major. Ann Hematol 89(12):1207–1213PubMed Baldini M, Forti S, Marcon A, Ulivieri FM, Orsatti A, Tampieri B, Airaghi L, Zanaboni L, Cappellini MD (2010) Endocrine and bone disease in appropriately treated adult patients with beta-thalassemia major. Ann Hematol 89(12):1207–1213PubMed
38.
Zurück zum Zitat Trachtenberg F, Foote D, Martin M, Carson S, Coates T, Beams O et al (2010) Pain as an emergent issue in thalassemia. Am J Hematol 85(5):367–370PubMedPubMedCentral Trachtenberg F, Foote D, Martin M, Carson S, Coates T, Beams O et al (2010) Pain as an emergent issue in thalassemia. Am J Hematol 85(5):367–370PubMedPubMedCentral
39.
Zurück zum Zitat Dede AD, Tournis S, Dontas I, Trovas G (2014) Type 2 diabetes mellitus and fracture risk. Metabolism. 63(12):1480–1490PubMed Dede AD, Tournis S, Dontas I, Trovas G (2014) Type 2 diabetes mellitus and fracture risk. Metabolism. 63(12):1480–1490PubMed
40.
Zurück zum Zitat Vogiatzi MG, Macklin EA, Fung EB, Vichinsky E, Olivieri N, Kwiatkowski J, Cohen A, Neufeld E, Giardina PJ (2006) prevalence of fractures among the thalassemia syndromes in North America. Bone. 38(4):571–575PubMed Vogiatzi MG, Macklin EA, Fung EB, Vichinsky E, Olivieri N, Kwiatkowski J, Cohen A, Neufeld E, Giardina PJ (2006) prevalence of fractures among the thalassemia syndromes in North America. Bone. 38(4):571–575PubMed
41.
Zurück zum Zitat Hamann C, Kirschner S, Gunther KP, Hofbauer LC (2012) Bone, sweet bone--osteoporotic fractures in diabetes mellitus. Nat Rev Endocrinol 8(5):297–305PubMed Hamann C, Kirschner S, Gunther KP, Hofbauer LC (2012) Bone, sweet bone--osteoporotic fractures in diabetes mellitus. Nat Rev Endocrinol 8(5):297–305PubMed
42.
Zurück zum Zitat Leidig-Bruckner G, Ziegler R (2001) Diabetes mellitus a risk for osteoporosis? Exp Clin Endocrinol Diabetes 109(Suppl 2):S493–S514PubMed Leidig-Bruckner G, Ziegler R (2001) Diabetes mellitus a risk for osteoporosis? Exp Clin Endocrinol Diabetes 109(Suppl 2):S493–S514PubMed
43.
Zurück zum Zitat Hofbauer LC, Brueck CC, Singh SK, Dobnig H (2007) Osteoporosis in patients with diabetes mellitus. J Bone Miner Res 22(9):1317–1328PubMed Hofbauer LC, Brueck CC, Singh SK, Dobnig H (2007) Osteoporosis in patients with diabetes mellitus. J Bone Miner Res 22(9):1317–1328PubMed
44.
Zurück zum Zitat Polat HB, Beyazal MS (2018) The effect of cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in postmenopausal women. Arch Osteoporos 13(1):61PubMed Polat HB, Beyazal MS (2018) The effect of cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in postmenopausal women. Arch Osteoporos 13(1):61PubMed
45.
Zurück zum Zitat Baschant U, Rauner M, Balaian E, Weidner H, Roetto A, Platzbecker U, Hofbauer LC (2016) Wnt5a is a key target for the pro-osteogenic effects of iron chelation on osteoblast progenitors. Haematologica. 101(12):1499–1507PubMedPubMedCentral Baschant U, Rauner M, Balaian E, Weidner H, Roetto A, Platzbecker U, Hofbauer LC (2016) Wnt5a is a key target for the pro-osteogenic effects of iron chelation on osteoblast progenitors. Haematologica. 101(12):1499–1507PubMedPubMedCentral
46.
Zurück zum Zitat Momeni A, Rapp S, Donneys A, Buchman SR, Wan DC (2016) Clinical use of deferoxamine in distraction osteogenesis of irradiated bone. J Craniofac Surg 27(4):880–882PubMedPubMedCentral Momeni A, Rapp S, Donneys A, Buchman SR, Wan DC (2016) Clinical use of deferoxamine in distraction osteogenesis of irradiated bone. J Craniofac Surg 27(4):880–882PubMedPubMedCentral
47.
Zurück zum Zitat Wong P, Fuller PJ, Gillespie MT, Kartsogiannis V, Kerr PG, Doery JC et al (2014) Thalassemia bone disease: a 19-year longitudinal analysis. J Bone Miner Res 29(11):2468–2473PubMed Wong P, Fuller PJ, Gillespie MT, Kartsogiannis V, Kerr PG, Doery JC et al (2014) Thalassemia bone disease: a 19-year longitudinal analysis. J Bone Miner Res 29(11):2468–2473PubMed
48.
Zurück zum Zitat Fung EB, Harmatz PR, Milet M, Coates TD, Thompson AA, Ranalli M, Mignaca R, Scher C, Giardina P, Robertson S, Neumayr L, Vichinsky EP, Multi-Center Iron Overload Study Group (2008) Fracture prevalence and relationship to endocrinopathy in iron overloaded patients with sickle cell disease and thalassemia. Bone. 43(1):162–168PubMedPubMedCentral Fung EB, Harmatz PR, Milet M, Coates TD, Thompson AA, Ranalli M, Mignaca R, Scher C, Giardina P, Robertson S, Neumayr L, Vichinsky EP, Multi-Center Iron Overload Study Group (2008) Fracture prevalence and relationship to endocrinopathy in iron overloaded patients with sickle cell disease and thalassemia. Bone. 43(1):162–168PubMedPubMedCentral
Metadaten
Titel
Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran
verfasst von
Mohammadreza Bordbar
Gholamhossein Ranjbar Omrani
Sezaneh Haghpanah
Forough Saki
Mehran Karimi
Omidreza Zekavat
Publikationsdatum
01.12.2020
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1/2020
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-020-00811-7

Weitere Artikel der Ausgabe 1/2020

Archives of Osteoporosis 1/2020 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.