Liver density measured by DEXA correlates with serum ferritin in patients with β-Thalassemia Major

Patients with beta-Thalassemia Major have a requirement for repeated blood transfusion, which ultimately results in liver iron- and whole body iron-overload. These patients are also at risk of reduced bone mineral density (BMD). Seventeen patients (9 female, age 19-32 yr) were referred for bone density estimations of the hip, spine, and whole body. As well as calculating the usual indices of body composition, we superimposed regions of interest over the liver, and expressed the result as "BMD" (g/cm(2)). This was compared with the serum ferritin as a noninvasive indication of total body iron status. Twelve patients were studied at least twice, more than 18 mo apart. This group showed a significantly below average BMD (T-spine -2.1, T-femoral neck -1.2, T-whole body -1.7, p < 0.001). The group's hepatic density correlated significantly with initial serum ferritin (r = 0.90, p < 0.001). Changes in individual liver density did not correlate significantly with changes in ferritin levels (p = 0.15), possibly due to wide variability in individual results. DEXA may be a useful noninvasive technique for estimating liver-iron concentration.