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Abstract：
UNASSIGNED: A common complication of thalassemia is secondary osteoporosis. This study aimed to assess the prevalence and factors associated with low BMD in thalassemic patients.
UNASSIGNED: This is a cross-sectional study. Eligible patients were males aged within 18-49 years or premenopausal women diagnosed with thalassemia in Chiang Mai University Hospital between July 2021 and July 2022. The diagnosis of low BMD by dual-energy x-ray absorptiometry (DXA) was defined as a Z-score of -2.0 SD or lower in either the lumbar spine or femoral neck. Clinical factors associated with low BMD were analyzed using a logistic regression model.
UNASSIGNED: Prevalence of low BMD was 62.4% from 210 patients with a mean age of 29.7 ± 7.6 years. The predominant clinical characteristics of low BMD thalassemia patients were being female, transfusion-dependent (TDT) and a history of splenectomy. From multivariable analysis, the independent variables associated with low BMD were transfusion dependency (odds ratio, OR 2.36; 95%CI 1.28 to 4.38; p=0.006) and body mass index (BMI) (OR 0.71; 95%CI 0.61 to 0.82; p<0.001). Among patients with low BMD, we observed a correlation between a Z-score with low IGF-1 levels (β=-0.42; 95% CI -0.83 to -0.01; p=0.040), serum phosphate levels (β=0.40; 95% CI 0.07 to 0.73; p=0.016) and hypogonadism (β=-0.48, 95% CI -0.91 to -0.04, p=0.031).
UNASSIGNED: This study found a prevalence of low BMD in 62.4% of subjects. Factors associated with low BMD were TDT and BMI. Within the low BMD subgroup, hypogonadism, serum phosphate and low serum IGF-1 levels were associated with a lower Z-score.
UNASSIGNED: This is a cross-sectional study. Eligible patients were males aged within 18-49 years or premenopausal women diagnosed with thalassemia in Chiang Mai University Hospital between July 2021 and July 2022. The diagnosis of low BMD by dual-energy x-ray absorptiometry (DXA) was defined as a Z-score of -2.0 SD or lower in either the lumbar spine or femoral neck. Clinical factors associated with low BMD were analyzed using a logistic regression model.
UNASSIGNED: Prevalence of low BMD was 62.4% from 210 patients with a mean age of 29.7 ± 7.6 years. The predominant clinical characteristics of low BMD thalassemia patients were being female, transfusion-dependent (TDT) and a history of splenectomy. From multivariable analysis, the independent variables associated with low BMD were transfusion dependency (odds ratio, OR 2.36; 95%CI 1.28 to 4.38; p=0.006) and body mass index (BMI) (OR 0.71; 95%CI 0.61 to 0.82; p<0.001). Among patients with low BMD, we observed a correlation between a Z-score with low IGF-1 levels (β=-0.42; 95% CI -0.83 to -0.01; p=0.040), serum phosphate levels (β=0.40; 95% CI 0.07 to 0.73; p=0.016) and hypogonadism (β=-0.48, 95% CI -0.91 to -0.04, p=0.031).
UNASSIGNED: This study found a prevalence of low BMD in 62.4% of subjects. Factors associated with low BMD were TDT and BMI. Within the low BMD subgroup, hypogonadism, serum phosphate and low serum IGF-1 levels were associated with a lower Z-score.
摘要：
■地中海贫血的常见并发症是继发性骨质疏松症。本研究旨在评估地中海贫血患者低骨密度的患病率和相关因素。
■这是一项横断面研究。符合条件的患者为年龄在18-49岁之间的男性或2021年7月至2022年7月在清迈大学医院诊断为地中海贫血的绝经前女性。通过双能X射线吸收法（DXA）诊断低BMD的定义为腰椎或股骨颈的Z评分为-2.0SD或更低。使用逻辑回归模型分析与低BMD相关的临床因素。
■210例患者的低骨密度患病率为62.4%，平均年龄为29.7±7.6岁。低骨密度地中海贫血患者的主要临床特征是女性，输血依赖性（TDT）和脾切除术史。根据多变量分析，与低骨密度相关的独立变量是输血依赖性(比值比，OR2.36；95CI1.28至4.38；p=0.006）和体重指数（BMI）（OR0.71；95CI0.61至0.82；p<0.001）。在低BMD患者中，我们观察到Z评分与低IGF-1水平之间的相关性（β=-0.42;95％CI-0.83至-0.01;p=0.040），血清磷酸盐水平（β=0.40；95％CI0.07至0.73；p=0.016）和性腺功能减退（β=-0.48，95％CI-0.91至-0.04，p=0.031）。
■这项研究发现，62.4％的受试者普遍存在低BMD。与低骨密度相关的因素是TDT和BMI。在低BMD亚组中，性腺功能减退,血清磷酸盐和低血清IGF-1水平与较低的Z评分相关.
■这是一项横断面研究。符合条件的患者为年龄在18-49岁之间的男性或2021年7月至2022年7月在清迈大学医院诊断为地中海贫血的绝经前女性。通过双能X射线吸收法（DXA）诊断低BMD的定义为腰椎或股骨颈的Z评分为-2.0SD或更低。使用逻辑回归模型分析与低BMD相关的临床因素。
■210例患者的低骨密度患病率为62.4%，平均年龄为29.7±7.6岁。低骨密度地中海贫血患者的主要临床特征是女性，输血依赖性（TDT）和脾切除术史。根据多变量分析，与低骨密度相关的独立变量是输血依赖性(比值比，OR2.36；95CI1.28至4.38；p=0.006）和体重指数（BMI）（OR0.71；95CI0.61至0.82；p<0.001）。在低BMD患者中，我们观察到Z评分与低IGF-1水平之间的相关性（β=-0.42;95％CI-0.83至-0.01;p=0.040），血清磷酸盐水平（β=0.40；95％CI0.07至0.73；p=0.016）和性腺功能减退（β=-0.48，95％CI-0.91至-0.04，p=0.031）。
■这项研究发现，62.4％的受试者普遍存在低BMD。与低骨密度相关的因素是TDT和BMI。在低BMD亚组中，性腺功能减退,血清磷酸盐和低血清IGF-1水平与较低的Z评分相关.
