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Bone mineral density in children with sickle cell anemia

Ashutosh Lal1, Ellen B Fung, Zahra Pakbaz

  • 1Children's Hospital & Research Center at Oakland, Oakland, California 94609, USA. alal@mail.cho.org

Pediatric Blood & Cancer
|December 1, 2005
PubMed

Insights

Children with sickle cell anemia (SCA) exhibit low bone mineral density (BMD) and significant deficiencies in calcium and vitamin D. These findings highlight critical nutritional and skeletal health concerns in pediatric SCA patients.

Area of Science:

  • Pediatric Hematology
  • Bone Metabolism
  • Nutritional Science

Background:

  • Sickle cell anemia (SCA) is a genetic blood disorder with significant systemic complications.
  • Bone health is a frequently overlooked but critical aspect of managing children with SCA.
  • Understanding factors affecting bone mineralization is essential for improving patient outcomes.

Purpose of the Study:

  • To assess bone mineral density (BMD) in children with severe sickle cell anemia (SCA).
  • To identify risk factors associated with poor bone mineralization in this pediatric population.

Main Methods:

  • Dual-energy X-ray absorptiometry (DXA) was used to measure BMD at the lumbar spine and proximal femur.
  • Z-scores were calculated using age, sex, and ethnicity-specific reference data.
  • Dietary calcium intake and serum 25-hydroxy vitamin D (25-OHD) levels were assessed.

Main Results:

  • The study included 25 children with severe SCA, with a median age of 12.8 years.
  • 60% had inadequate calcium intake, and 74% had vitamin D levels below 50 nM.
  • Markedly reduced median Z-scores were observed (-2.3 lumbar spine, -1.7 proximal femur), with 64% of patients exhibiting low bone density.

Conclusions:

  • Children with severe SCA demonstrate significantly low bone mineral density (BMD).
  • These patients often have substantial deficits in both dietary calcium and circulating vitamin D.
  • These deficiencies are critical factors contributing to poor bone health in pediatric SCA.
Abstract

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