ASSESSMENT OF THE NUTRITIONAL STATUS, BONE MINERALIZATION AND ANTHROPOMETRICS OF CHILDREN WITH THALASSEMIA MAJOR

Abstract

Objective: Children with thalassemia major are prone to growth failure and micronutrient deficiency. In this study, we aimed to evaluate nutritional status, anthropometrics, bone mineralization defects in regularly transfused patients. Methodology: We analyzed the data obtained by evaluating laboratory tests, anthropometric measures, and bone mineral density. Results: Twenty-nine patients (62% male, 38% female) with mean age 12.26±4.74 years, mean pre-transfusion hemoglobin 8.64±1.01 g/dl, mean serum ferritin 1158.6±556.8 ng/ml were included. Vitamin D (72.4%), selenium (72.4%), folate (37.9%) deficiencies were the most frequent ones. In 17.2% hypocalcemia, 3.5% hypomagnesemia, in 10.3 % decreased ceruloplasmin were observed. Folate was higher between 2≤ and<6 years (p:0.028). Ceruloplasmin was higher between 6≤ and<10 years (p:0.018). Selenium was significantly higher in patients with ferritin ≥1500 (p=0.008). No significant ferritin-related differences were found in other micronutrients (p>0.05)For body mass index (BMI) 31% were under the 5th percentile, none was over the 95th percentile. For height, 24.5%, for weight 20.7% were under the 3rd, none was over 97th percentile. BMI of patients 10≤age≤18 years old was significantly higher (p=0.001). Anthropometric percentiles did not differ significantly in terms of mean serum ferritin and micronutrient levels. Hypoparathyroidism was observed in 13.8%, hypothyroidism in 3.5% of the patients. Low bone density was detected in 14.8% (2 osteopenic, 2 osteoporotic) patients. Bone mineral density did not differ significantly in terms of ferritin and micronutrient levels. Conclusions: Nutritional support and prevention of deficiencies are important to minimize the burden of complications, to increase the life expectancy and quality in TM patients.