Background: Thalassemia Major (TM) is a hereditary disease caused by defective globin
synthesis. Because of the significant increase in life expectancy, these patients suffer from various
health conditions, including endocrinopathies and low bone mineral density.
Aim: The aim of the present study was to evaluate the fracture incidence regarding the markers of
bone metabolism, bone mineral density and treatment of osteoporosis as well as the treatment of
Methods: Sixty-four patients with TM (32 men and 32 women) participated in a cross-sectional
study design. The patients were recruited from “Aghia Sofia” Children’s Hospital and evaluated
using Dual-energy X-ray Absorptiometry (DXA) of the lumbar spine and femoral neck and with
markers of bone remodeling including Receptor Activator of Nuclear factor Kappa-Β Ligand
(RANKL), Osteoprotegerin (OPG), C-Terminal Telopeptide (CTX), and sclerostin.
Results: The statistical analysis of markers of bone metabolism in relation to fractures revealed no
statistical significance. However, statistical analysis of bone mineral density and markers of bone
metabolism in relation to fractures was also not significant.
Conclusions: In TM patients, fractures are not related to bone mineral density. Maybe some other
conditions are the cause, haemosidirosis, drugs, comorbid conditions.