Serum Dickkopf-1 and Correlation with Bone Mineral Density in Patients with Beta Thalassemia Major in North-Eastern of Iran

Background and Aims: Iron overload is one of the effects of frequent transfusion in beta-thalassemia major (BTM) patients. Osteopenia and osteoporosis are the secondary complications of frequent transfusion due to toxic effects of iron on osteoblasts. Dickkopf-1 (DKK-1) is a secreted protein which plays an important role in the development of osteoporosis. The aim of this study was to investigate the relationship between DKK-1 protein and iron overload in BTM patients. Materials and Methods: Fifty BTM patients and fifty healthy individuals participated in this case-control study. Each group were similar in terms of age and gender. We evaluated serum levels of DKK-1 and ferritin by enzyme-linked immunosorbent assay (ELISA) method. Dual-energy X-ray absorptiometry method was used to evaluate patients bone density. Complete blood count and osteoporosis parameters (densitometry test results) were checked in both groups. Results: The mean age of BMT patients was 25.82 years (24 male/26 female); it was 26.98 years (25 male/25 female) in control group. Significantly, the serum level of DKK-1 was higher in BTM samples (p < 0.001). Mean of DKK-1 was 34447.1 pg/ml in patients, and 15252.0 pg/ml in controls. Mean of serum ferritin was 3808.6 ng/ml and 73.9 ng/ml in both groups, respectively. A significant association was found between DKK1, ferritin and osteoporosis parameters (p < 0.001). Conclusions: Probably, DKK-1 protein plays a significant role in the development and intensification of osteoporosis in BTM patients; it can be used as an applicable factor for early diagnosis of osteoporosis and follow-up in adult BTM patients.