Oxidative Criteria And Somebone Turnover Markers In Beta-Thalassemic Patients

Abstract

Bone disease in beta-thalassemic patients has multifactorial etiology;increased iron stores and per-oxidative stress are involved factors.This study aimed to investigate the relationship between some boneturnover markers and some oxidants, antioxidants parameters of betathalassemicpatients. The study included 50 patients were diagnosedas beta-thalassemia major aged between 3 and 40 years, 30 males and20 females compared to 34 normal controls of same age and sex ratio.The patients and the controls were divided into 2 groups: group A1≤18 years compared to their controls group B1 and group A2 > 18years compared to their controls group B2. All were subjected to fullclinical examination and laboratory analysis of their blood and urinefor bone turnover markers; osteocalcin (OC), bone specific alkalinephosphatase (BAP) and urinary deoxypyridinoline (DPD).Alsoparathormone (PTH), serum calcium (Ca) and phosphorus (Ph).Oxidants and antioxidants determined were; plasma malondialdehyde(MDA), nitric oxide (NO), blood reduced glutathione (GSH),erythrocyte Cu- Zn Superoxide dismutase (SOD). Serum levels ofcopper (Cu), zinc (Zn), selenium (Se), vitamin E and total antioxidantcapacity (TAOC) were also determined. The results showedsignificant increase in urinary DPD and decrease in serum OC, BAPand PTH in thalassemic groups compared to controls. Also, the resultsrevealed significant elevation in plasma MDA, NO, SOD and serumCu and TAOC especially in group A1. While there was significant decrease in GSH, serum Zn, Se, and vitamin E. Plasma OC waspositively correlated with serum iron and NO and negativelycorrelated with plasma TAOC in thalassemic patients within agegroup 3 ≤18 years. On other hand, plasma BAP level was positivelycorrelated with the frequency of transfusion. Moreover, a significantinverse correlation of plasma PTH with blood GSH and plasma Vit.Ewere observed in thalassemic patients within age group 18 ≤ 40.Furthermore, a significant positive correlation of plasma OC withheight, DPD with age and Ph. were seen too in the same group. Also,plasma DPD was negatively correlated with NO in thalassemicpatients within age group 18 ≤ 40. In Conclusion, there aredisturbance in bone turnover markers in beta-thalassemic patientswhich favor increased bone resorption and decreased bone formation.These markers have to some extent correlations with oxidantantioxidantparameters in those patients.Key Words : Oxidative stress markers , MDA , antioxidant , osteocalcin, PTH