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 bone
turnover markers and some oxidants, antioxidants parameters of betathalassemic
patients. The study included 50 patients were diagnosed
as beta-thalassemia major aged between 3 and 40 years, 30 males and
20 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 > 18
years compared to their controls group B2. All were subjected to full
clinical examination and laboratory analysis of their blood and urine
for bone turnover markers; osteocalcin (OC), bone specific alkaline
phosphatase (BAP) and urinary deoxypyridinoline (DPD).Also
parathormone (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 of
copper (Cu), zinc (Zn), selenium (Se), vitamin E and total antioxidant
capacity (TAOC) were also determined. The results showed
significant increase in urinary DPD and decrease in serum OC, BAP
and PTH in thalassemic groups compared to controls. Also, the results
revealed significant elevation in plasma MDA, NO, SOD and serum
Cu and TAOC especially in group A1. While there was significant decrease in GSH, serum Zn, Se, and vitamin E. Plasma OC was
positively correlated with serum iron and NO and negatively
correlated with plasma TAOC in thalassemic patients within age
group 3 ≤18 years. On other hand, plasma BAP level was positively
correlated with the frequency of transfusion. Moreover, a significant
inverse correlation of plasma PTH with blood GSH and plasma Vit.E
were observed in thalassemic patients within age group 18 ≤ 40.
Furthermore, a significant positive correlation of plasma OC with
height, DPD with age and Ph. were seen too in the same group. Also,
plasma DPD was negatively correlated with NO in thalassemic
patients within age group 18 ≤ 40. In Conclusion, there are
disturbance in bone turnover markers in beta-thalassemic patients
which favor increased bone resorption and decreased bone formation.
These markers have to some extent correlations with oxidantantioxidant
parameters in those patients.

Key Words : Oxidative stress markers , MDA , antioxidant , osteocalcin, PTH