1. ¹Division of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
2. ²Hematology and Bone Marrow Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

Correspondence: Dr MO Premaor, Division of Internal Medicine, Hospital de Clínicas de Porto Alegre, Sala 700 Rua Ramiro Barcellos 2350/700—Porto Alegre, RS 90035-903, Brazil. E-mail: mop21@cam.ac.uk

Received 10 December 2008; Revised 19 February 2009; Accepted 25 February 2009; Published online 13 April 2009.

Abstract

Post-BMT subjects have an increased bone fracture risk. Additionally, several factors were associated with osteopenia and osteoporosis in these individuals. We aimed to identify other factors associated with osteopenia and osteoporosis in allogeneic post-BMT subjects. We conducted a cross-sectional study with 47 allogeneic post- BMT subjects. Serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone, ferritin, vitamin B₁₂, insulin, glucose, cholesterol and triglyceride levels were measured. Insulin resistance and secretion were estimated through the homeostatic model assessment for insulin resistance (HOMA-IR) and homeostatic model assessment for -cell function (HOMA-B), respectively. A bone densitometry (BMD) was also obtained. The median time after BMT was 47.7 (12–115) months. Osteoporosis was identified in 17.0% of the subjects and osteopenia in 19.7%. The mean serum ferritin (P=0.002), insulin (P<0.0001), glucose (P=0.003) and triglyceride (P=0.018) levels were higher in individuals with osteopenia/osteoporosis. HOMA-IR (P<0.0001) and HOMA-B (P<0.0001) were increased in post-BMT subjects with osteopenia/osteoporosis. There was no other factor associated with the outcome. After adjustments ferritin, serum 25(OH)D and HOMA-IR remained independently associated with osteopenia/osteoporosis; however triglycerides no longer were. In conclusion, in the present study, low serum 25(OH)D levels, high serum ferritin levels and insulin resistance were associated with osteopenia/osteoporosis in post-BMT subjects.