الفهرس 
Chapter(1) ThalassemiaOnly 14 pages are availabe for public view
 |  | from | 149 |  |  |
| | | from | 149 | | |
Abstract
Background:
The thalassemias, a group of inherited disorders of hemoglobin synthesis, are the most common monogenetic, hereditary hematologic disorders in humans worldwide. Osteoporosis and decreased linear growth or height are commonly seen in young thalassemia patients. Zinc deficiency can be one of the factors contributing to decreased height and BMD in these children.
Objective:
To study the effect of zinc supplementation on linear growth and bone mineral density in prepubertal thalassemic children.
Methodology:
An intervention study with a sample of 40 patients,19 males and 21 females ,all aged 6 to 10 years old. Patients were recruited from regular attendants to the Hematology Clinic, Pediatric Department, Ain Shams University hospitals.
Serum zinc level, height, height percentile and BMD in the form of Z-score were evaluated. All patients had stunted growth and were osteoporotic, with Z-score<- 2.5. Zinc was provided to all patients in the form of oral zinc capsule 25 mg daily for a period of one year. After that, serum zinc, height, height percentile, and BMD Z-scoring were evaluated.
RESULTS:
Before zinc was provided mean serum zinc was 67.925±6.896 ( μg/dl), mean height was120.00±11.543cm and mean BMD Z-score was-3.008± 0.410. After zinc supplementation for one year, mean serum zinc was70.250±6.348 ( μg/dl), mean height was 127.59± 12.005cm and mean Z-score was-2.465± 0.496 .
The difference between all the measured parameters before and after zinc supplementation was statistically significant (P value <0.05).
There was no statistically significant difference between males and females in terms of figures of the former items before or after zinc was provided (P value> 0.05). Meanwhile there was statistically significant difference in males on measuring the previously mentioned items before and after zinc supplementation (P value< 0.05). The same applies for females.
RECOMMENDATIONS:
• Establishing of a proper screening program to detect low BMD and short stature in school age children, specially for thalassemic children. Planning for a good referral system and follow up of these children in specialized clinics.
• Zinc supplementation to prepubertal thalassemic children is advised to improve their BMD and linear growth.
• Community awareness programs directed towards clarifying the importance of zinc.
• Development of proper school feeding programs in which zinc supplementation is considered.
• More future studies on zinc impact in improving linear growth and BMD are required, especially if done on a larger sample size of patients, putting in consideration to start zinc intake earlier in life and continue giving zinc for a longer period.
CONCLUSION:
Zinc supplementation has a positive impact on linear growth and bone mineral density in prepubertal thalassemic children, regardless of their gender.