It is hypothesized that patients with beta-thalassemia have low bone mass, in part, due to zinc deficiency. Sub-optimal zinc status has been identified in patients with thalassemia and zinc supplementation has been shown to improve linear growth. To test the primary hypothesis, Dr. Fung is undertaking a 24-month randomized placebo-controlled trial of zinc supplementation (25 mg Zn/day) plus usual care therapy (calcium + vitamin D) vs. usual therapy alone in 60 young patients (9-25 yrs) with beta-thalassemia and low bone mass (spine BMD Z-score < -1.0).

Bone health, as estimated from measurements of bone mass (by DXA and QCT) and markers of bone formation and resorption will be the primary outcome variables. The secondary aim of the study is to evaluate zinc homeostasis in a sub-sample of subjects at baseline and following 6 months of zinc supplementation through the use of compartmental models of zinc metabolism. This will be the first study to examine the effects of zinc supplementation on bone health in patients with ? thalassemia. If zinc supplementation is found to have a clinically important effect, this simple, safe, non-invasive therapy could quickly become a part of the standard care of these young patients and improve overall health in children and adult patients with beta-thalassemia.