Prevalence of osteoporosis & osteopenia in transfusion-dependent thalassemia in Sulaimaniyah city, Iraq

Background and objectives: Although blood transfusion and iron chelation increase the lifespan of thalassemic patients, these patients face many complications, including osteoporosis and osteopenia. Thus, we aimed to determine prevalence rates of osteoporosis/osteopenia using Dual Energy X-Ray Absorptiometry in transfusion-dependent thalassemia patients and its relationship with chelation agents and body mass index. Methods: This retrospective study included 150 patients with transfusion-dependent thalassemia in the Thalassemia and Congenital Blood Disorders Center, Sulaimaniyah, Iraq, from December 2021 to July 2022. The participant’s information was collected from the hospital database, including sociodemographic characteristics, bone mineral density status, and the number of items used for chelation. A Dual Energy X-Ray Absorptiometry bone scan was used to check the bone mineral density. Results: The mean age of patients was 19.59±7.59, body mass index was 21.23±18.13, and most (53.3%) were females. Dual Energy X-Ray Absorptiometry results showed that 53.3% of the patients had osteopenia, 21.3% had osteoporosis, 36.7% had average bone mineral density, and 6.7% had low bone mineral density for age. In addition, there was a significant difference between the frequencies of bone density disorders in patients who used one chelating agent (46.4%) versus two chelating agents (85%) (P?0.001). Also, there was a significant difference between the incidence of bone density disorders with low and average body mass index (78%) in comparison with overweight and obese patients (8%) (P?0.001). Conclusions: There is a high prevalence of osteoporosis and osteopenia in transfusion-dependent thalassemia patients, which are more prone to trauma and bone fracture.