背景:维生素D的合成缺陷导致慢性内分泌疾病引起的钙稳态改变,导致骨代谢性疾病。这项研究旨在确定钙的水平,维生素D,和甲状旁腺激素(PTH)在儿童β-地中海贫血。
方法:在本病例对照研究中,纳入36名接受铁螯合治疗的重型β-地中海贫血儿童。对于对照组,选择年龄和性别相匹配的36例。地中海贫血儿童对细胞体积(PCV)的要求各不相同,平均PCV要求为78.57±49.07。这项研究在政府医学院儿科进行了六个月,那格浦尔,印度。通过免疫测定测定血清PTH水平,和血清维生素D水平使用电化学发光技术进行评估。其他检查检查肝功能,血清铁蛋白,钙,磷,和全血细胞计数。学生的t检验,Mann-Whitney,采用卡方检验进行统计分析。
结果:与对照组(10.4±1.21g/dL)相比,病例组的平均血红蛋白水平明显降低(5.62±1.9g/dL)(p<0.001)。病例组平均血清铁蛋白水平(3073±1262.24ng/mL)明显高于对照组(58.37±29.67ng/mL)(p<0.001)。与对照组的5.6%相比,80.6%的病例有维生素D缺乏,72.2%的病例与2.8%的对照有PTH缺陷,两者均显示统计学上的显着差异(p<0.001)。病例组和对照组的血清总钙平均水平(8.51±0.84mg/dL)存在显着差异,维生素D(15.23±10.07ng/mL),和PTH(14.66±19.86pg/mL)(9.13±0.6mg/dL,p=0.05;34.94±9.57ng/mL,p<0.001;32.08±12.42pg/mL,p<0.001;分别)。
结论:生长障碍可能是由于血清钙显著降低,维生素D,β-地中海贫血患儿的PTH水平。这些异常可能是由过量的铁和不足的营养支持引起的,突出了治疗方法的相关性。
BACKGROUND: A defective synthesis of vitamin D contributes to alterations in calcium homeostasis due to chronic endocrinopathies, leading to metabolic bone diseases. This
study aimed to ascertain the levels of calcium, vitamin D, and parathyroid hormone (PTH) in children with β-thalassemia.
METHODS: In this case-control
study, 36 children with major β-thalassemia receiving iron chelation therapy were included. For the control group, 36 cases matched for age and sex were selected. The packed cell volume (PCV) requirements varied among the thalassemic children, with an average PCV requirement of 78.57±49.07. The
study was conducted for six months in the Department of Pediatrics at the Government Medical College, Nagpur, India. Serum PTH levels were determined by immunoassay, and serum vitamin D levels were assessed using electrochemiluminescence technique. Additional tests looked at liver function, serum ferritin, calcium, phosphorus, and complete blood count. The student\'s t-test, Mann-Whitney, and chi-square tests were used for statistical analysis.
RESULTS: In comparison to the control group (10.4±1.21 g/dL), the case group\'s mean hemoglobin level was considerably lower (5.62±1.9 g/dL) (p<0.001). The mean serum ferritin level in the cases was notably higher (3073±1262.24 ng/mL) compared to the control group\'s level (58.37±29.67 ng/mL) (p<0.001). A total of 80.6% of cases compared to 5.6% of controls had vitamin D deficiency, and 72.2% of cases compared to 2.8% of controls had PTH deficit, both of which showed statistically significant differences (p<0.001). Significant differences were observed between the case and control groups for the mean levels of total serum calcium (8.51±0.84 mg/dL), vitamin D (15.23±10.07 ng/mL), and PTH (14.66±19.86 pg/mL) (9.13±0.6 mg/dL, p=0.05; 34.94±9.57 ng/mL, p<0.001; 32.08±12.42 pg/mL, p<0.001; respectively).
CONCLUSIONS: Growth failure may result from the markedly reduced serum calcium, vitamin D, and PTH levels in children with β-thalassemia. The relevance of treatment approaches is highlighted by the possibility that these anomalies are caused by excessive iron and inadequate nutritional support.