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

Abstract

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. We analyzed the data obtained by evaluating laboratory tests, anthropometric measures, and bone mineral density. 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. Nutritional support and prevention of deficiencies are important to minimize the burden of complications, to increase the life expectancy and quality in TM patients.