| Objective:to investigate the calcium and phosphorus metabolism and iron overload in patients with thalassemia intermediate-type(TI),and to explore the relationship between iron overload and calcium and phosphorus metabolism in patients with thalassemia intermediate-type(TI).Methods:208 TI patients and 72 non-thalassemia control group from 2015 to 2018 were collected from the first affiliated hospital of guangxi medical university.Their calcium and phosphorus metabolism and other indicators were tested.Calcium and phosphorus metabolism and growth were compared between TI patients and non-thalassemia control group.Furthermore,calcium and phosphorus metabolism,iron overload and growth in TI patients were investigated from different age levels.Results:1.the general data of 208 patients in TI group and 72 patients in non-thalassemia control group showed that the height and weight of patients in TI group were significantly lower than those in non-thalassemia control group(P < 0.05).A total of 56 patients(26.9%)with TI were short stature and 64(30.8%)with low body weight,while 12(16.7%)with short stature and 1(1.4%)with low body weight were in the 72 patients with non-thalassemia control group.Comparison between the two groups in the 10-18 years old group,the incidence of short stature and low weight in TI male patients was significantly higher than that in the non-thalassemia control group,and the incidence of low weight in women was significantly higher than that in the non-thalassemia control group(P < 0.05).2.The levels of parathyroid hormone(PTH)and urine phosphorus in the TI group were significantly higher than those in the nonthalassemia control group(P < 0.05),while the levels of osteocalcin(OC)were significantly lower than those in the non-thalassemia control group(P < 0.05).Among the patients with TI,17(8.2%)had abnormal calcium metabolism(10 males and 7 females),among which 14 had low calcium(82.4%),and 6 of them had blood calcium ?2.13mmol/l.3 cases(17.65%)had high calcium >,2.75mmo/l,and no increase of PTH was observed in the same period.53 patients(25.5%)had abnormal phosphorus metabolism(29 males and 24 females),among which 3 patients had low phosphorus(5.7%)and 50 patients had high phosphorus(94.3%).Twelve patients(5.8%)had abnormal calcium and phosphorus metabolism.TI all ages between calcium phosphorus metabolism in patients with abnormal rate has no obvious difference(P > 0.05),but in the age group of 35 or more blood calcium level was lower than that in group 10 to 18 years old,the age < 10 groups with 10 to 18 blood phosphorus levels greater than 35 age group,or 10 to 18 years old group blood phosphorus levels greater than 18 to 35 years old,18 to 35 years old group and 35 years old age group or OC below < 10 years old group and 10 to 18 years old group.3.The incidence of low body weight in the group with abnormal calcium and phosphorus metabolism in TI patients younger than 10 years old was lower than that in the group without abnormal calcium and phosphorus metabolism in TI patients,the difference was statistically significant(p < 0.05),while the difference in short stature and low body weight in other age groups was not statistically significant(p > 0.05).In the TI patients with abnormal calcium and phosphorus metabolism,the incidence rate of short stature in the age < 10 years old group(57.1%)was higher than that in the 18-35 years old group(18.8%)and over 35 years old group(0%),and the difference was statistically significant(P < 0.05).The incidence rate of short stature in the group aged 10-18 years(44.4%)was higher than that in the group aged over 35 years(0%),and the difference was statistically significant(P < 0.05).The incidence of low body weight in the group aged 10-18 years(44.4%)was higher than that in the group aged over 35 years(0%),with statistically significant difference(P < 0.05).4.TI patients serum ferritin were 81.7% and 86%,the incidence of liver iron overload,occur for ages 5 and 10 years old,smallest age < 10 iron overload rates below 35 years old of above groups,the difference was statistically significant(p < 0.05),the degree of iron overload and the correlation analysis between different age(p < 0.05),serum ferritin as an index of correlation coefficient is 0.311,liver iron as indicators of the correlation coefficient of 0.432.There was no significant difference in the incidence of abnormal calcium and phosphorus metabolism,short stature and low body weight between different levels of serum ferritin(SF)and liver iron(LIC)in TI patients(P > 0.05).5.There was no correlation between serum calcium,blood phosphorus,urinary calcium,urinary phosphorus,height,weight,PTH,SF and LIC in TI patients(P > 0.05),Osteocalcin was negatively correlated with SF and LIC(P < 0.05).Conclusion:1.208 TI patients had a higher incidence of short stature and low body weight than non-thalassemia patients(26.9% and 30.8%).2.208 TI patients had an incidence of abnormal calcium and phosphorus metabolism of 27.9%,and 2.9% of hypoparathyroidism.The effect of abnormal calcium and phosphorus metabolism on growth may be influenced by age.3.Iron overload in TI patients is mainly mild and moderate,and the higher the age,the heavier the iron overload,which may have nothing to do with abnormal calcium and phosphorus metabolism and growth.4.Iron overload reduced OC expression in TI patients. |
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