Document Detail


Low bone mineral density in adolescents with beta-thalassemia.
MedLine Citation:
PMID:  16339698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The pervasiveness of low bone mass (LBM) in beta-thalassemia (Thal) patients (pts) is escalating as the average life expectancy of these pts increases. Adolescence is a period of substantial bone accrual, which is crucial for future bone strength. Studies of LBM are prevalent among adults with Thal. However, limited information exists about bone accrual and LBM in adolescents with the disease. Thirty-one pts with beta-Thal (26 Thal major [TM], 5 Thal intermedia [TI]), aged 9-20 years (mean: 15.3 years), 14 males and 17 females, underwent measurement of spinal bone mineral density (BMD) by DEXA (Lunar, Prodigy). Height, weight, body mass index, and Tanner stage were assessed at the time of the BMD measurement. A total of 16.1% of the patients had normal bone mass (Z > or = -1), 22.6% had reduced bone mass (Z = -1 to -2), and 61.3% had low bone mass (Z < or = -2). BMD Z correlated with height and weight Z scores. Some 53.9% of subjects had normal gonadal function and 46.1% had induced puberty with gonadal steroids. BMD Z significantly worsened with age (P < .0001). However, there was no difference in the LBM prevalence between subjects with normal versus those with induced puberty: BMD Z was -2 or less in 71.4% of subjects with normal puberty versus 66.7% in those with induced puberty. Our results indicate a high prevalence of LBM among adolescents with Thal regardless of adequate transfusion and chelation regimens. Bone accrual was found to be suboptimal in adolescents with normal or induced puberty. Thus, calcium and vitamin D supplementation with antiresorptive therapies should be evaluated in the adolescent Thal pt with close monitoring of growth and sexual development.
Authors:
Maria G Vogiatzi; Karen A Autio; Jeffrey E Mait; Robert Schneider; Martin Lesser; Patricia J Giardina
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1054     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2005  
Date Detail:
Created Date:  2005-12-12     Completed Date:  2006-07-13     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  462-6     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, New York-Presbyterian Hospital / Weill Medical College of Cornell University, New York, New York 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anthropometry
Blood Transfusion
Bone Density*
Bone Diseases, Metabolic / epidemiology,  etiology*
Chelation Therapy
Child
Combined Modality Therapy
Deferoxamine / therapeutic use
Disease Progression
Endocrine System Diseases / drug therapy,  epidemiology,  etiology
Female
Gonadal Steroid Hormones / therapeutic use
Human Growth Hormone / therapeutic use
Humans
Hypogonadism / drug therapy,  epidemiology,  etiology
Iron Chelating Agents / therapeutic use
Male
Osteoporosis / epidemiology,  etiology*
Prevalence
Puberty, Delayed / drug therapy,  epidemiology,  etiology
Spine / chemistry
beta-Thalassemia / complications*
Grant Support
ID/Acronym/Agency:
5H46 MC00085//PHS HHS; M01-RR06020/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Gonadal Steroid Hormones; 0/Iron Chelating Agents; 12629-01-5/Human Growth Hormone; 70-51-9/Deferoxamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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