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Dexa-Scan assessment for bone mass density evaluation in ^-thalassemia subjects
Section 5. Physiology
Pano Genti,
MSc., PhD Student at Sport Sciences Research Institute, Department of Physical Activity Health and Recreation Research, Sports University of Tirana, Albania E-mail: [email protected] Dhimitraq Prifti, Prof. Assoc. Dr., Faculty of Movement Sciences, Deparment of Sport Medicine, Sports University of Tirana, Albania.
Dexa-Scan assessment for bone mass density evaluation in ^-thalassemia subjects
Abstract: Beta thalassemia is one of the most common genetic disorders in the world. According Albanian Ministry of Health, in Albania are approximately 300 thousand thalassemic carries (8-9 % of the population) and around 80 new cases of thalassemia every year. Mostly the subjects are children and youth. A total of 25 patients (17 female & 8 male) 18 years old and over, have been selected and devided into 2 groups (control group 15 subjects and intervention group 10 subjects). After DEXA-scan examination the authors a physical activity intervention program (based on vibrating platforms will be held for 3-6 months). BMD of lumbar spine and right femoral neck is measured using DEXA-Scan method (GE Healthcare Lunar DPX NT-151392) to evaluate the bone mass density. Results show that all patients have low bone mass density which was expected for this category. All patients should be screened periodically for bone mass density in order for them to have comparative data's to prevent further problems. Further research is needed to identify risk factors and means of prevention.
Keywords: Beta thalassemia, Bone mass density, Dexa-scan.
Introduction correlated with poor school performances and physi-
Beta thalassemia is one of the most common ge- cal or social restrictions for the severity and chronic-netic disorders in the world. Thalassemic subject have ity of the disease, and not with age, sex, ferritin level, high levels of iron in their blood due to frequent blood brainstem auditory, visual and somatosensory evoked transfusin (every 3 weeks) causing them bone mass potentials, or motor and sensory nerve conduc-density low levels including even osteoporosis. Thal- tion velocity Economou [1]; Zafeiriou [3]. Accord-assemic children have been described to show im- ing Albanian Ministry of Health, in Albania are ap-paired abstract reasoning, deficits of language, atten- proximately 300 000 thalassemic carries (8-9 % of the tion, memory, constructional/visual spatial skills, population). There are around 80 new cases of thal-and executive functions, all of which are more prom- assemia every year. Mostly the subjects are children inent in hemosiderotic subjects Monastero [2]. In and youth. One ofthe main problems for thalassemic most children, low intelligence quotient appears to be subjects is the impairment of bone mass density due
Section 5. Physiology
to fruquen blood transfusions and essesive calcium amount. According World Health Organization, Definition ofOsteoporosis and Osteopenia for Caucasian Women is: Normal = T-score at or above -1.0 SD; Osteopenia = T-score between -1.0 and -2.S SD; Osteoporosis = T-score at or below -2.5 SD; (WHO definitions only apply when a young healthy caucasian. Women reference database is used to determine T-scores). Statistically 68 % ofrepeat scans fall within l SD (± 0.010 g/cm2 for AP Spine L1-L4).
Objectives
Main objective of this study was to evaluate the bone mass density parameters and level of calcification in thalassemia subjects.
Methodology
Bone mass density (BMD) of lumbar spine and right femoral neck have been measured using DEXA Scan (Lunar DPX NT+151392)
Results
DEXA-scan results presented in the tables 1-4.
Table 1. - Results of DEXA-scan measurements of 15 subjects (control group) with P-Thalassemia. Ancillary Results [AP Spine] BDT (Bone Density Trend)
Subject Nr: Age & Gender: Male (M); Female (F) Region BMD (g/cm2) Young Adult T-score Age Matched Z-score
1 17 (M) L1-L4 0.622 -5.0 -3.6
2 18 (F) L1-L4 0.741 -3.7 -3.2
3 18 (F) L1-L4 0.938 -2.0 -1.2
4 18 (M) L1-L4 0.794 -3.5 -2.7
5 20 (F) L1-L4 0.743 -3.6 -3.3
6 21 (F) L1-L4 0.793 -3.2 -2.9
7 21 (M) L1-L4 0.551 -5.6 -4.5
8 21 (F) L1-L4 0.731 -4.1 -3.1
9 22 (F) L1-L4 0.672 -4.2 -3.5
10 22 (F) L1-L4 0.914 -2.2 -1.9
11 22 (F) L1-L4 1.021 -1.3 -1.1
12 22 (M) L1-L4 1.131 -0.7 0.2
13 23 (M) L1-L4 0.980 -2.0 -1.1
14 27 (F) L1-L4 1.002 -1.5 -0.7
15 30 (M) L1-L4 0.808 -3.4 -3.0
Average 21.733333 0.8294 -3.06667 -2.3733333
Table 2. - Results of DXA scan measurements of 15 subjects (control group) with P-Thalassemia for Left Femur Bone Density Trend (Total)
Subject Nr. Age & Gender: Male (M); Female (F) Region BMD Young Adult Age Matched
T-score Z-score
1 17 (M) Total 0.811 -2.0 -1.2
2 18 (F) Total 0.929 -0.6 -0.3
3 18 (F) Total 0.948 -0.5 0.1
4 18 (M) Total 0.695 -2.8 -2.3
5 20 (F) Total 0.814 -1.5 -1.3
6 21 (F) Total 0.813 -1.5 -1.4
7 21 (M) Total 0.819 -2.0 -1.3
8 21 (F) Total 0.794 -2.1 -1.6
9 22 (F) Total 0.590 -3.2 -2.8
10 22 (F) Total 0.749 -2.1 -1.9
11 22 (F) Total 0.973 -0.3 -0.2
12 22 (M) Total 0.924 -1.2 -0.7
13 23 (M) Total 0.878 -1.5 -1.0
14 27 (F) Total 0.807 -1.6 -1.0
15 30 (M) Total 0.707 -2.7 -2.4
Average 0.816733 -1.70667 -1.28667
Dexa-Scan assessment for bone mass density evaluation in ß-thalassemia subjects
Table 3. - Results of DEXA-scan measurements of 10 subjects (intervention group) with ß-Thalassemia. Ancillary Results [AP Spine] BDT (Bone Density Trend)
Subjects Nr. Age & Gender: Male (M); Female (F) Region BMD (g/cm2) Young Adult T-score Age Matched Z-score
1 18 (F) L1-L4 1.044 -1.1 -0.9
2 21 (F) L1-L4 0.947 -1.9 -1.5
3 19 (F) L1-L4 0.962 -1.8 -1.6
4 19 (F) L1-L4 0.907 -2.3 -1.8
5 21 (F) L1-L4 1.002 -1.5 -1.6
6 21 (F) L1-L4 0.899 -2.3 -1.8
7 28 (F) L1-L4 0.795 -3.2 -2.9
8 20 (F) L1-L4 0.916 -2.2 -1.7
9 18 (F) L1-L4 0.858 -2.7 -2.5
10 30 (F) L1-L4 0.868 -2.6 -2.1
Average 21.3 0.920 -2.16 -1.84
Table 4. - Results of DXA scan measurements of 15 subjects (control group) with P-Thalassemia for Left Femur Bone Density Trend (Total)
Subject Nr. Age & Gender: Male (M); Female (F) Region BMD Young Adult Age Matched
T-score Z-score
1 18 (F) Total 0.873 -1.1 -1.0
2 21 (F) Total 0.771 -1.9 -1.6
3 19 (F) Total 0.881 -1.0 -0.9
4 19 (F) Total 0.888 -1.0 -0.7
5 21 (F) Total 0.992 -0.1 -0.2
6 21 (F) Total 0.995 -0.8 -1.4
7 28 (F) Total 0.825 -1.5 -1.1
8 20 (F) Total 0.649 -2.8 -2.6
9 18 (F) Total 0.994 -0.1 0.2
10 30 (F) Total 0.893 -0.9 -0.8
11 21.3 Total 0.791 -1.8 -1.3
Average 21.3 0.868364 -1.18182 -1.03636
Conclusions: Based on the Dexa-scan results, we can say that beta-thalassemia subjects have serious problems regarding bone mass density especially on the lumbar region BMD (g/cm2) L1-L4 region; 0.8294 in the control group and 0.92 in the intervention group. Also left-femur bone density are very low BMD; 0.816733
in the control group and 0.868364 in the intervention group.
Recommendations: All patients should be screened periodically for bone mass density in order for them to have comparative data's to prevent further problems. Further research is needed to identify risk factors and means of prevention.
References:
1. Economou M., Zafeiriou D. I., Kontopoulos E., Gompakis N., Koussi A., Perifanis V., Athanasiou-Metaxa M. Neurophysiology and intellectual evaluation ofbeta-thalassemia patients.//Brain Dev. - 2006. - 28: 14-18.
2. Monastero R., Monastero G., Ciaccio C., Padovani A., Camarda R. Cognitive deficits in beta-thalassemia major.//Acta Neurol Scand. - 2000. - 102: 162-168.
3. Zafeiriou D. I., Economu M., Athanasiou-Metaxa M. Neurological complications in beta-thalassemia.// Brain Dev. - 2006. - 28: 477-81.
4. WHO, World Health Organization. Definition of Osteoporosis and Osteopenia for Caucasian Wome.
