ABSTRACT
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 resorption 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 resorption 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 resorption 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