1. ¹Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
2. ²Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

Correspondence: Dr TF Leung, Department of Paediatrics, 6/F, Prince of Wales Hospital, Shatin, Hong Kong. E-mail: leung2142@cuhk.edu.hk

Received 18 November 2004; Accepted 28 April 2005; Published online 20 June 2005.

Abstract

Osteoporosis and osteopenia affect up to half of patients with thalassaemia major (TM). We investigate the effects of acquired factors and BMT on bone mineral density (BMD) in these patients. In all, 53 patients on regular transfusion (BT group) and 33 patients at 5.71.9 years post transplant (BMT group) were recruited. BMD was measured by dual energy X-ray absorptiometry. Serum concentrations of osteocalcin, bone-specific alkaline phosphatase (ALP), beta-crossLap and urinary cross-linking deoxypyridinoline (DPD) were measured by chemiluminescence and enzyme immunoassay, respectively. Severe BMD deficit (Z-score <-2.5) at spine and hip were noted in 62 and 35% of BT group. Serum osteocalcin (=-0.463; P=0.006) was predictive of spine BMD, whereas age (=-0.843; P=0.007) and urine DPD (=-0.439; P=0.037) were associated with hip BMD in BT group. Among BMT patients, post transplant duration (=0.450; P=0.009) and serum bone-specific ALP (=-0.495; P=0.013) were associated with spine BMD. Severe BMD deficit was less common among BMT than BT patients (6 vs 35%; P=0.036). The mean (s.d.) osteocalcin levels in BMT and BT groups were 96.4 (72.7) g/l and 68.9 (40.3) g/l, respectively (P=0.037). In conclusion, severe BMD deficit is common in Chinese TM patients and BMT may reverse BMD deficit in these patients.