Role of serum levels of bone alkaline phosphatase and osteocalcin in thalassemia induced osteoporosis in a cohort of Egyptian females with Beta thalassemia major.

Thalassemias are heterogenous disorders caused by defects in production of globin chain of the hemoglobin tetramer. The mainstay of treatment depends on blood transfusion resulting in iron excess, blood borne infections, and alloimmunization. Osteoporosis is a prominent cause of morbidity in thalassemia. Serum Osteocalcin can be Considered as a specific marker of osteoblast function as its levels have been shown to correlate with bone formation rates. BAP is a highly specific marker of the bone-forming activity of osteoblasts. This study aims to determine the serum level of both BAP and OC in TDTM female patients and to find the relationship between them. Methods: CBC, CRP, ferritin, HCV screening by ELISA, BAP was measured by immunoenzymatic assay, vitamin D was measured immunoenzymatically, OC was by fully automated spectrophotometer, and DEXA scan was done. Results: There is positive correlation between PLR and BAP. A positive correlation was found between BAP and decreased T score of patients. There was a positive relation between splenectomized patients and increased PLR, and BAP. Moreover there was a positive relation between decreased T score and BAP, PLR, and increased platelets in patients. Conclusion: BAP and OC are surrogates of osteoporosis in thalassemic patients. BAP and OC have an inverse relationship with BMD, PLR is considered discriminative in patients with low BMD which makes it a valuable screening tool.