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Repeated blood transfusions in thalassemia patients is followed by endocrinopathies as diabetes, hypothyroidism, hypogonadism, hypoparathyroidism, and disorders in calcium and vitamin D homeostasis. The aimof this study was to evaluate the association of beta-thalassemia patientsendocrinopathies and osteoporosis. Serum level of some factors related tothe function of gonads, thyroid, adrenal, and pancreas along with serumlevels of calcium, phosphate, albumin, vitamin D, and iron were measured.Bone marrow density was tested via dual-energy x-ray absorptiometry(DXA densitometry). In this study, 56 patients with major thalassemia wereinvestigated. Paraclinical analysis indicated osteopenia in 17 (30.4%) andosteoporosis in 39 patients (69.6%) in addition to other types of endocrinedisorders, such as hypogonadism in 29 (51.8%), hypothyroidism in 13(23.2%), hypoparathyroidism in 1 (1.8%), hypocortisolism in 2 (3.6%), anddiabetes in 9 (16.1%) patients. Endocrinopathies had no significant relationship with osteoporosis and osteopenia in men. However, hypogonadismhad a significant relationship with osteoporosis and osteopenia in womenwith thalassemia. Estradiol level was lower in women with osteoporosisin comparison with women with osteopenia. Ferritin levels had neitherassociation with osteoporosis nor with LH levels (P>0.05). Secondary hypogonadism disorders are the main causes of osteoporosis and osteopeniain female beta-thalassemia patients.
[1] Galanello, R., Origa, R., 2010. Beta-thalassemia. Orphanet Journal of Rare Diseases. 5(1), 11.
[2] Mishra, A.K., Tiwari, A., 2013. Iron overload in beta thalassaemia major and intermedia patients. Maedica. 8(4), 328.
[3] Porter, J.B., 2005. Monitoring and treatment of iron overload: state of the art and new approaches. Seminars in Hematology. 42(2 Suppl 1), S14-18.
[4] Andrews, N.C., 1999. Disorders of iron metabolism. New England Journal of Medicine. 341(26), 1986- 1995.
[5] Chern, J.P., Lin, K.H., Tsai, W.Y., et al., 2003. Hypogonadotropic hypogonadism and hematologic phenotype in patients with transfusion-dependent beta-thalassemia. Journal of Pediatric Hematology /Oncology. 25(11), 880-884.
[6] Giardina, P.J., Grady, R.W., 1995. Chelation therapy in beta-thalassemia: the benefits and limitations of desferrioxamine. Seminars in hematology. 32(4), 304-312.
[7] De Virgillis, S., Congia, M., Frau, F., et al., 1988. Deferoxamine-induced growth retardation in patients with thalassemia major. The Journal of Pediatrics. 113(4), 661-669.
[8] Bielinski, B.K., Darbyshire, P., Mathers, L., et al., 2001. Bone density in the Asian thalassaemic population: a cross-sectional review. Acta Paediatrica. 90(11), 1262-1266.
[9] Haidar, R., Musallam, K.M., Taher, A.T., 2011. Bone disease and skeletal complications in patients with β thalassemia major. Bone. 48(3), 425-432.
[10] Root, A.W., Diamond, F.B., 2002. Calcium metabolism, normal homeostasis and disorders of calcium metabolism in the child and adolescent. Sperling MA, editor. Pediatric endocrinology. 2nd ed. Philadelphia: Saunders. pp. 65-110.
[11] Soliman, A., De Sanctis, V., Yassin, M., 2013. Vitamin D status in thalassemia major: an update. Mediterranean Journal of Hematology and Infectious Diseases. 5(1).
[12] Blake, G.M., Fogelman, I., 2007. The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgraduate Medical Journal. 83(982), 509-517.
[13] Altrichter, S., Boodstein, N., Maurer, M., 2009. Matrix metalloproteinase‐9: a novel biomarker for monitoring disease activity in patients with chronic urticaria patients? Allergy. 64(4), 652-656.
[14] Vogiatzi, M.G., Macklin, E.A., Fung, E.B., et al., 2009. Bone disease in thalassemia: a frequent and still unresolved problem. Journal of Bone and Mineral Research. 24(3), 543-557.
[15] Anapliotou, M.L., Kastanias, I.T., Psara, P., et al., 1995. The contribution of hypogonadism to the development of osteoporosis in thalassaemia major: new therapeutic approaches. Clinical Endocrinology. 42(3), 279-287.
[16] Benigno, V., Bertelloni, S., Baroncelli, G.I., et al.,2003. Effects of thalassemia major on bone mineral density in late adolescence. Journal of Pediatric Endocrinology & Metabolism. 16(Suppl 2), 337-342.
[17] Voskaridou, E., Terpos, E., 2008. Pathogenesis and management of osteoporosis in thalassemia. Pediatric Endocrinology Reviews: PER. 6, 86-93.
[18] Rothman, M.S., Wierman, M.E., 2008. Female hypogonadism: evaluation of the hypothalamic–pituitary– ovarian axis. Pituitary. 11(2), 163.
[19] Emerit, J., Beaumont, C., Trivin, F., 2001. Iron metabolism, free radicals, and oxidative injury. Biomedicine & Pharmacotherapy. 55(6), 333-339.
[20] Okman-Kilic, T., 2015. Conference proceedings. Estrogen Deficiency and Osteoporosis.
[21] Srisukh, S., Ongphiphadhanakul, B., Bunnag, P., 2016. Hypogonadism in thalassemia major patients. Journal of Clinical & Translational Endocrinology. 5, 42-45.
[22] Wang, L., Li, Q., Duan, X.L., et al., 2005. Effects of extracellular iron concentration on calcium absorption and relationship between Ca2+ and cell apoptosis in Caco-2 cells. World Journal of Gastroenterology: WJG. 11(19), 2916.
[23] Sahota, O., 2000. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age and Ageing. 29(4), 301-304.
[24] Rodrıguez-Martınez, M.A., Garcıa-Cohen, E.C., 2002. Role of Ca2+ and vitamin D in the prevention and treatment of osteoporosis. Pharmacology & therapeutics. 93(1), 37-49.
[25] Mills, E.G., Yang, L., Nielsen, M.F., et al., 2021. The Relationship between Bone and Reproductive Hormones beyond Estrogens and Androgens. Endocrine Review. 42(6), 691-719.
[26] Wang, J., Zhang, W., Yu, C., et al., 2015. Follicle-stimulating hormone increases the risk of postmenopausal osteoporosis by stimulating osteoclast differentiation. PLoS One. 10(8), e0134986.
[27] Liu, Z., Ye, F., Zhang, H., et al., 2013. The association between the levels of serum ferritin and sex hormones in a large scale of Chinese male population. PloS one. 8(10), e75908.
[28] Berge, L.N., Bønaa, K.H., Nordøy, A., 1994. Serum ferritin, sex hormones, and cardiovascular risk factors in healthy women. Arteriosclerosis and Thrombosis: A Journal of Vascular Biology. 14(6), 857-861.
[29] Xu, Z.R., Wang, A.H., Wu, X.P., et al., 2009. Relationship of age-related concentrations of serum FSH and LH with bone mineral density, prevalence of osteoporosis in native Chinese women. Clinica Chimica Acta. 400(1-2).
[30] Dhanwal, D.K., 2011. Thyroid disorders and bone mineral metabolism. Indian Journal of Endocrinology and Metabolism. 15(Suppl2), S107.
[31] Ahn, H.Y., 2018. Effects of Abnormal Thyroid Function Status to Bone Metabolism. International Journal of Thyroidology. 11(1), 21-25.
[32] Hung, C.L., Yeh, C.C., Sung, P.S., et al., 2018. Is Partial or Total Thyroidectomy Associated with Risk of Long-Term Osteoporosis: A Nationwide Population-Based Study. World Journal of Surgery. 14, 1-8.
[33] Kim, C.W., Hong, S., Oh, S.H., et al., 2015. Change of bone mineral density and biochemical markers of bone turnover in patients on suppressive levothyroxine therapy for differentiated thyroid carcinoma. Journal of Bone Metabolism. 22, 135–141.
[34] Kozai, M., Yamamoto, H., Ishiguro, M., et al., 2013. Thyroid hormones decrease plasma 1α, 25-dihydroxyvitamin D levels through transcriptional repression of the renal 25-hydroxyvitamin D3 1α-hydroxylase gene (CYP27B1). Endocrinology. 154(2), 609-622.
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