Correlation between Nutritional Intake and Body Composition in Adolescents with Thalassemia Major

Background : Growth failure is common in thalassemia major (TM) patients. Measurement of lean body mass, fat mass, and bone mass density (BMD) are important components in assessing the body composition and nutritional status of TM patients. There are no previous studies in Indonesia that have evaluated the correlation between macronutrient or micronutrient intake and body composition in adolescents with TM. Methods : This study included 55 subjects with TM aged 10-18 years old at the Thalassemia Center of Dr. Cipto Mangunkusumo National Hospital Jakarta. Macronutrient and micronutrient intake were evaluated using a three-day food record. Fat mass, lean mass, and bone mineral density (BMD) were assessed using dual-energy X-ray absorptiometry (DXA). Vitamin D levels were evaluated using enzyme-linked immunosorbent assay (ELISA) method. The data was analyzed with Pearson and Spearman correlations, depending on the type of distribution. Results: Energy intake was significantly associated with muscle mass, fat mass, and BMD (r = 0.35, 0.39, and 0.27 respectively, p-value <0.05). There was a significant correlation between protein intake on muscle mass, fat mass, and BMD (r = 0.60, 0.37, and 0.31 respectively, p-value <0.05). There was a mild correlation between energy intake and fat mass percentage in male and female subjects (r= 0,25, p= 0,017; r= 0,38, p= 0,02). There was no correlation between carbohydrate, fat, and protein, vitamin D, vitamin E, calcium, and folic acid on the proportion of muscle mass percentage, fat mass percentage, and BMD. Conclusion : More than half of adolescent TM patients are malnourished and lack protein intake. Body composition correlates with total calorie intake.