en <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span class="fontstyle01" style="font-family:Minion-Regular,serif"><span style="color:#242021"><span style="font-weight:normal"><span style="font-style:normal"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#44546a">Aims:</span></span></span></b></span></span></span></span> <span style="font-size:10.0pt"><span cambria="" style="font-family:">Thalassemia major patients are at a heightened risk for osteopenia and osteoporosis, influenced by factors including hypogonadism. However, treatment with steroids alone has not consistently yielded substantial improvements in bone density indicators. This study aimed to evaluate the impact of bisphosphonate therapy, both with and without testosterone, on bone density indices in male patients with thalassemia major.</span></span><span class="fontstyle01" style="font-family:Minion-Regular,serif"><span style="color:#242021"><span style="font-weight:normal"><span style="font-style:normal"><span style="font-size:10.0pt"><span style="font-family:"Cambria",serif"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span class="fontstyle01" style="font-family:Minion-Regular,serif"><span style="color:#242021"><span style="font-weight:normal"><span style="font-style:normal"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#44546a">Materials & Methods:</span></span></span></b></span></span></span></span><span class="fontstyle01" style="font-family:Minion-Regular,serif"><span style="color:#242021"><span style="font-weight:normal"><span style="font-style:normal"><span style="font-size:10.0pt"><span cambria="" style="font-family:"> T</span></span></span></span></span></span><span style="font-size:10.0pt"><span cambria="" style="font-family:">his quasi-experimental study included 40 male patients with thalassemia major, selected through convenience sampling, and divided into four groups: 1) a hypogonadism group receiving testosterone and alendronate (HTA group), 2) a hypogonadism group receiving testosterone alone (HT group), 3) a non-hypogonadism group treated with alendronate (NHA group), and 4) a hypogonadism group that declined any treatment (H group). Bone density was evaluated using Bone Mineral Densitometry via Dual-energy X-ray absorptiometry, both before and one year after the interventions, with results compared across the groups. Data analysis was conducted using SPSS version 24, with a significance level set at p<0.05</span></span><span class="fontstyle01" style="font-family:Minion-Regular,serif"><span style="color:#242021"><span style="font-weight:normal"><span style="font-style:normal"><span style="font-size:10.0pt"><span cambria="" style="font-family:">.</span></span></span></span></span></span><b><span style="font-size:10.0pt"><span style="font-family:"Cambria",serif"></span></span></b></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span class="fontstyle01" style="font-family:Minion-Regular,serif"><span style="color:#242021"><span style="font-weight:normal"><span style="font-style:normal"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#44546a">Findings:</span></span></span></b></span></span></span></span> <span style="font-size:10.0pt"><span cambria="" style="font-family:">Thirty-eight participants, with a mean age of 22.46 &plusmn; 4.64 years, completed the study. Post-intervention results showed significant improvements in Lumbar Z score (p=0.001), Hip Z score (p=0.001), and Radius Z score (p=0.005) across the four groups. One year after intervention, the HTA group demonstrated greater improvements in bone mineral density compared to the NHA and HT groups.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span class="fontstyle01" style="font-family:Minion-Regular,serif"><span style="color:#242021"><span style="font-weight:normal"><span style="font-style:normal"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#44546a">Conclusion:</span></span></span></b></span></span></span></span> <span style="font-size:10.0pt"><span cambria="" style="font-family:">Combining bisphosphonates with testosterone in thalassemia patients with hypogonadism enhances bone density more effectively than treatment with testosterone or bisphosphonates alone.</span></span></span></span></span> Bisphosphonate,Testosterone,Bone Mineral Density,Thalassemia, 165 171 http://jccs.daneshafarand.org/browse.php?a_code=A-10-230-2&slc_lang=en&sid=8 Sh. Ansari Damavandi 1003194753284600387619 1003194753284600387619 No “Department of Pediatric Hematology & Oncology, School of Medicine” and “Aliasghar Children’s Hospital”, Iran University of Medical Sciences, Tehran, Iran D. Amirkashani 1003194753284600387620 1003194753284600387620 No “Department of Pediatric Metabolic & Endocrine Disease, School of Medicine” and “Aliasghar Children’s Hospital”, Iran University of Medical Sciences, Tehran, Iran M. Tagrian Isfahani 1003194753284600387618 1003194753284600387618 Yes “Department of Pediatric Hematology & Oncology, School of Medicine” and “Hakim Children’s Hospital”, Tehran University of Medical Sciences, Tehran, Iran