Growth retardation and pathological fractures are very common in thalassemic patients and a substantial proportion of those patients are affected with osteoporosis and osteopenia. The main sites of Klotho expression are the kidney and parathyroid glands. Klotho knock-out mice express an aging phenotype which includes reduced bone mineral density, growth retardation similar to BTM.
The aim of this study was to compare Klotho levels in β-Thalssemia patients with healthy controls. Moreover, we analyzed possible correlations between Klotho level with osteoporosis and fractures.
50 patients were enrolled in this cross-sectional study, 27 had β -thalassemia major and 23 had B-thalassemia intermedia. We assessed Klotho level using ELISA assay for patients compared to healthy control group.
The mean Klotho level in thalassemic patients were significantly lower than controls (P-value <0.001) but no significant difference between thalassemia major and intermedia. Klotho levels were significantly lower in patients who had previous fragility fractures than those who had no fractures (P-value 0.033). Bone mineral density at the neck of femur showed that Klotho levels were significantly lower in patients who were osteopenic than those who were normal. Similarly, At lower spine, Klotho levels were lower in osteopenic and osteoporotic patients compared to controls (P-value <0.001). Lastly, significant positive correlations were found between Klotho levels in patients and BMD at the neck of femur and lower spine (P-value <0.001).
Our data identify Klotho as a potential risk factor for osteopenia, osteoporosis and fragility fractures in Thalassemic patients.