An In-Depth Analysis of Variable Dynamics Influencing Bone Mineral Density in Transfusion-Dependent Thalassemia Patients
- PMID: 40224693
- PMCID: PMC11992274
- DOI: 10.1007/s12288-024-01864-1
An In-Depth Analysis of Variable Dynamics Influencing Bone Mineral Density in Transfusion-Dependent Thalassemia Patients
Abstract
The survival of patients with transfusion-dependent thalassemia has increased with optimal blood transfusion. In adult patients with thalassemia, iron toxicity due to repeated blood transfusion is the main contributing factor causing decreased bone density and leads to mechanical disruption in the bone structure. This study aimed to analyze the variables affecting bone mineral density (BMD) in patients with thalassemia major. We enrolled patients with transfusion-dependent thalassemia who visited the Hasan Sadikin Hospital Bandung outpatient clinic. Participants underwent anthropometric measurement, laboratory, and BMD examination. Bivariate analysis was performed to determine the correlation between clinical data and BMD by Pearson or Rank-Spearman depending on data distribution. Multivariate analysis was performed to determine the most influential variables using linear regression analysis. p < 0.05 was considered statistically significant. Overall, 59 participants were included. BMD was significantly correlated with body mass index (BMI), sex, average pre-transfusion hemoglobin level, blood transfusion volume, and vitamin D, with coefficient r values of 0.47, 0.34, - 0.27, and - 0.28 (p < 0.05), respectively. BMI was the variable that most influenced BMD, with 0.39 coefficient value, an adjusted coefficient value of 0.32 (0.01-0.04), and p = 0.04. Receiver operating characteristic analysis showed BMI had the highest area under the curve (AUC) in all examination areas, especially in the hip area, with 0.800 AUC. 77.8% sensitivity, and 71.7% specificity. BMD was correlated with BMI, sex, average pre-transfusion hemoglobin level, blood transfusion volume, and vitamin D, with BMI being the most influential factor affecting BMD.
Supplementary information: The online version contains supplementary material available at 10.1007/s12288-024-01864-1.
Keywords: Blood transfusion volume; Body mass index; Dual X-ray absorptiometry; NTX-1; Transfusion-dependent beta.
© Indian Society of Hematology and Blood Transfusion 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Conflict of interest statement
Conflict of interestAndri Reza Rahmadi, Febi Ramdhani Rachman, Evan Susandi, Sumartini Dewi, Laniyati Hamijoyo, Dimmy Prasetya, Indra Wijaya, Mohammad Ghozali, Suthat Fucharoen, Ramdan Panigoro declare that they have no conflict of interest.
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