Impact of disordered puberty on bone density in β‐thalassaemia major

Reduction of bone density and its associated morbidity is recognized in young adults with β‐thalassaemia major, but the aetiology is not clear. This study used dual X‐ray absorptiometry (DXA) to look at bone mineral apparent density (BMAD) in children and young adults with thalassaemia in a predominantly Asian population, in the context of sexual maturation. Fifty‐five patients were scanned (mean age 13·8 years, range 5·9–37·5) and BMAD z‐scores were calculated using normal data from locally recruited control subjects. Eighteen patients had undergone bone marrow transplantation (BMT) and the remainder were on a transfusion/chelation regimen. BMAD z‐scores ranged from –3·3–1·6 with a mean of −0·92. No difference in BMAD was found between those patients treated conventionally and those who had undergone BMT. When comparing mean BMAD z‐score according to sexual maturation, there was a highly significant difference (P