Skeletal muscles index in Egyptian adults with transfusion dependent Beta thalassemia

Abstract Background Transfusion-dependent β-thalassemia (TDT) has become a chronic condition associated with multiple metabolic and musculoskeletal complications. Sarcopenia is increasingly recognized as a major contributor to morbidity in adults with TDT, largely driven by chronic anemia, iron overload, and endocrine-metabolic dysfunction. Aim To detect the prevalence of sarcopenia in Egyptian adults with transfusion dependent beta thalassemia. Patients and methods Observational cross sectional study was conducted on 100 adult TDT patients at Menoufia University Hospitals from September 2023 to February 2024, IRB approval number and date 9/2023 IntM23. Clinical assessment, laboratory investigations, and CT-based SMI measurement at the L3 level were performed. Sarcopenia was diagnosed by ROC analyses according to SMI cut-offs (Male L3 SMI ≤ 52.4 cm 2 /m 2 and female L3 SMI ≤ 38.5 cm 2 /m 2 ). Logistic regression was used to determine independent risk factors and predictors of sarcopenia. Results Sarcopenia was detected in 78% of TDT patients. Compared with non-sarcopenic patients, sarcopenic patients showed significantly lower BMI, higher ferritin, phosphorus, LDH, CPK levels, and reduced estimated glomerular filtration rate (eGFR) ( p < 0.05). Conclusion Sarcopenia is highly prevalent among Egyptian adults with TDT. Phosphate dysregulation, and renal dysfunction are key determinants of muscle mass loss. Routine assessment of BMI, phosphorus, and eGFR may improve early detection and enable timely interventions to mitigate functional decline in this growing patient population.