Bone resorption markers and bone forming cytokines in thalassemia major patients

الملخص EN

Hypothesis: osteoporosis represents an important cause of morbidity in thalassemia major (TM) patients.

The cause is multifactorial ; including defective vitamin D metabolism and iron intoxication.

The pathogenesis is not completely clarified, especially the mechanism by which cytokines affect skeletal bones.

Osteoprotegrin / RANK system has been recently introduced in the pathogenesis of post-menopausal osteoporosis and other bone diseases.

Objective : to investigate the relationship between vitamin D, as a bone resumption marker and the new bone cytokine (osteoprotegrin) and their implication on bone mineral density (BMD).

Methodology : Twenty-five TM patients and 10 healthy controls were included in the study.

They were subjected to full history and clinical examination.

Body mass index was assessed.

Serum 25 (OH) 2 Vitamin D was estimated.

Bone resumption markers (Deoxypyridinoline and pyridinoline cross links) were assessed.

Osteoprotegrin serum level was measured and BMD was assessed with DEXA.

Results : serum 25 (OH)2 Vitamin D was significantly reduced in patients than controls.

Bone resumption markers (DpD, pyD) showed a highly statistical significant increase than controls.

Also, serum osteoprotegrin was reduced than controls.

Moreover, there was a negative correlation between the levels of PyD, DpD and osteoprotegrin.

Again, TM patients had lower bone mineral density and Tanner staging than controls.

Conclusion : TM osteoporosis is a major problem that is a real challenging issue.

Osteoprotegrin / RANK system has got a direct role which needs further investigation.