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Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort
OBJECTIVE: To delineate the prevalence and associated risk factors of low BMD, osteoporosis/bone fragility and fracture in transfusion‐dependent thalassemia (TDT) in the Chinese population in Hong Kong. DESIGN, PATIENTS AND MEASUREMENTS: A retrospective cohort study design was employed. Patients of...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258995/ https://www.ncbi.nlm.nih.gov/pubmed/35490138 http://dx.doi.org/10.1002/edm2.340 |
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author | Lee, Samantha Lai Ka Wong, Raymond Siu Ming Li, Chi Kong Leung, Wing Kwan |
author_facet | Lee, Samantha Lai Ka Wong, Raymond Siu Ming Li, Chi Kong Leung, Wing Kwan |
author_sort | Lee, Samantha Lai Ka |
collection | PubMed |
description | OBJECTIVE: To delineate the prevalence and associated risk factors of low BMD, osteoporosis/bone fragility and fracture in transfusion‐dependent thalassemia (TDT) in the Chinese population in Hong Kong. DESIGN, PATIENTS AND MEASUREMENTS: A retrospective cohort study design was employed. Patients of TDT who had serial Hologic dual‐energy X‐ray absorptiometry (DXA) from 2010 to 2016 and received regular transfusion for at least 5 years were recruited. Clinical and biochemical data, from 5 years before the first DXA scan, were retrieved from the electronic record system of the Hospital Authority, till 30 June 2020. Low bone mineral density and osteoporosis/bone fragility are defined by the ISCD 2019 position guidelines. RESULTS: Seventy‐seven patients were included in the analysis. The fracture prevalence of TDT among the Chinese population in Hong Kong was 15.58%. Up to 55.84% of patients had low bone mineral density, and 5.19% patients had osteoporosis/bone fragility state. The median age at first fracture was 31.73 years (range 24.06–44.18 years). In the regression analysis, a higher log(10) transformation of average ferritin levels over 5 years before the first DXA scan was significantly associated with fracture occurrence regardless of bisphosphonate treatment (OR 310.73, 95% CI 3.99–24183.89, p = .010). Mean average ferritin level over 5 years was 6695.5 ± 2365.7 pmol/L (fracture group) versus 4350.7 ± 3103.2 pmol/L (non‐fracture group), p = .016. Hip and spine BMD Z‐score did not have statistically significant association with fracture occurrence. CONCLUSION: Iron overloading plays an important role in adverse bone health in TDT. Dual X‐ray densitometry is insufficient in predicting fracture risk. |
format | Online Article Text |
id | pubmed-9258995 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92589952022-07-11 Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort Lee, Samantha Lai Ka Wong, Raymond Siu Ming Li, Chi Kong Leung, Wing Kwan Endocrinol Diabetes Metab Research Articles OBJECTIVE: To delineate the prevalence and associated risk factors of low BMD, osteoporosis/bone fragility and fracture in transfusion‐dependent thalassemia (TDT) in the Chinese population in Hong Kong. DESIGN, PATIENTS AND MEASUREMENTS: A retrospective cohort study design was employed. Patients of TDT who had serial Hologic dual‐energy X‐ray absorptiometry (DXA) from 2010 to 2016 and received regular transfusion for at least 5 years were recruited. Clinical and biochemical data, from 5 years before the first DXA scan, were retrieved from the electronic record system of the Hospital Authority, till 30 June 2020. Low bone mineral density and osteoporosis/bone fragility are defined by the ISCD 2019 position guidelines. RESULTS: Seventy‐seven patients were included in the analysis. The fracture prevalence of TDT among the Chinese population in Hong Kong was 15.58%. Up to 55.84% of patients had low bone mineral density, and 5.19% patients had osteoporosis/bone fragility state. The median age at first fracture was 31.73 years (range 24.06–44.18 years). In the regression analysis, a higher log(10) transformation of average ferritin levels over 5 years before the first DXA scan was significantly associated with fracture occurrence regardless of bisphosphonate treatment (OR 310.73, 95% CI 3.99–24183.89, p = .010). Mean average ferritin level over 5 years was 6695.5 ± 2365.7 pmol/L (fracture group) versus 4350.7 ± 3103.2 pmol/L (non‐fracture group), p = .016. Hip and spine BMD Z‐score did not have statistically significant association with fracture occurrence. CONCLUSION: Iron overloading plays an important role in adverse bone health in TDT. Dual X‐ray densitometry is insufficient in predicting fracture risk. John Wiley and Sons Inc. 2022-04-30 /pmc/articles/PMC9258995/ /pubmed/35490138 http://dx.doi.org/10.1002/edm2.340 Text en © 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Lee, Samantha Lai Ka Wong, Raymond Siu Ming Li, Chi Kong Leung, Wing Kwan Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort |
title | Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort |
title_full | Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort |
title_fullStr | Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort |
title_full_unstemmed | Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort |
title_short | Prevalence and risk factors of fractures in transfusion dependent thalassemia – A Hong Kong Chinese population cohort |
title_sort | prevalence and risk factors of fractures in transfusion dependent thalassemia – a hong kong chinese population cohort |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258995/ https://www.ncbi.nlm.nih.gov/pubmed/35490138 http://dx.doi.org/10.1002/edm2.340 |
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