*ASSESSMENT OF BONE BIOCHEMICAL INDICATORS IN THALASSAEMIA AND SICKLE CELL ANEMIA*

Background: Patients with thalassaemia present progressive damage of bone early from childhood. Skeletal disorders and complications such as automatic fractures, osteopenia and severe osteoporosis are frequent findings. In bone damage of thalassaemia the etiology is multifactorial since acquired and genetic factors are involved .Some patients with sickle cell anemia have deficiency of vit.D and low bone mass.Sothe understanding of the existent mechanisms in bone damage in thallasaemia and in sickle cell anemia is of prime importance. We evaluated the abnormalities of calcium, phosphorus, parathormone and osteocalcin in these patients. Methods; We studied 65 patients ,25 men and 40 women, aged from 18 to 75 years, divided in three groups.30 patients with omozygous β- thalassaemia, 20 with intermedia and 15 with sickle cell anemia.We also used a control group of 35 healthy subjects. Calcium (Ca) and phosphorus (Pi) serum levels were determined using photometric method. Parathormone (i-PTH) and osteocalcin (BGP) were measured with electrochemiluminescence immunoassay. Results: Serum level of BGP was significantly lower both in patients with omozygous β- thalassaemia and in patients with sickle cell anemia,p<0,05) compared to the healthy group,(p<0,05). All bone marker levels in patients with intermedia thalassaemia were normal. There was no statistically significant difference compared to the healthy group in the serum levels of Ca, Pi and i-PTH. Positive statistic correlation was found in subjects with omozygous β- thalassaemia between BGP and Pi (r=0,534,p<0,01)and in subjects with sickle cell disease between BGP and i-PTH (r=0,723,p<0,01). Conclusions::1.The patients with omozygous β- thalassaemia, intermedia- thalassaemia and sickle cell anemia have lower bone anabolism compared to the healthy group. 2. Osteocalcin (BGP) consists a very useful marker in the biochemical assessment of bone metabolism in patients with thalassaemia and with sickle cell anemia. It is observed that, even after the correction of the hemoglobine levels, the satisfactory hormone therapy and the efficient iron chelation, the patients continue to have abnormal bone metabolism. As a result they present severe decrease of bone density probably because of the elevated bone absorption.