The Association between Calcium and Vitamin D Intake and Bone Mineral Density in β Thalassemia Major Patients

Publish Year: 1397
نوع سند: مقاله کنفرانسی
زبان: English
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AMSMED19_068

تاریخ نمایه سازی: 1 دی 1397

Abstract:

Background and Objectives: Thalassemia is a hereditary anemia with high prevalence in Iran. Reduction in bone density and the occurrence of osteoporosis in thalassemia major patients due to the iron overload, caused by constant blood transfusion and the use of iron chelators, is inevitable. Our aim is to determine the status of calcium and vitamin D intake and its effect on bone density in these patients. Materials and Methods: 184 β-thalassemia major male and female from Zafar Thalssemia Clinic who met our inclusion criteria were recruited to this study. This study was approved by the Ethics Committee of Iran University of Medical Sciences (IR.IUMS.REC.95-09-132-24951). Demographic characteristics, dietary intake, and physical activity of the last year were evaluated using personal information, Food Frequency Questionnaire, and International Physical Activity Questionnaire respectively. Bone mineral density (lumbar spine and femoral neck) was measured using DXA densitometry. Statistical analysis was performed using SPSS 21 software. Findings: 64.28% of our participants used Desferrioxamine, 19.04% Deferasirox, and 16.66% used Deferiprone as iron chelating drug. Also 45.23% of the patients had gone through splenectomy. 89.02% of our patients had low physical activity and they were blood-transfused at least once a month. Regarding our main outcomes, dietary intake of calcium and vitamin D in thalassemia patients were lower than the recommended standard values (P= 0.016 and P= 0.023 respectively). Lumbar spine’s bone mineral density was positively associated with calcium (P= 0.002) and vitamin D (P= 0.001) intake. The same significant correlation was found between the femoral neck’s bone mineral density and calcium intake (P= 0.023). Vitamin D intake on the other hand, was not significantly associated with femoral neck’s bone mineral density. Conclusion: Low calcium and vitamin D dietary intake are dramatically related to low bone mineral density in β-thalassemia major patients. Although several factors contribute to the osteoporosis and the reduction of bone mineral density in these patients, the importance of nutritional status and food consumption is undeniable as it is changeable and more cost-effective, and with proper interventions, including teaching healthy eating to the patients and administration of calcium and vitamin D supplements, the severity of these bone complications can be delayed or reduced.

Authors

Zohreh Sajadi Hezaveh

Student Research Committee, Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

Farzad Shidfar

Correspondence to Dr Farzad Shidfar, Department of Nutrition, School of Health, Iran University of Medical Sciences, Tehran, Iran