Sickle cell anaemia: is it a cause for secondary osteoporosis?

The risk of osteoporosis and osteopenia i s patients with sickle cell anaemia is not well established. This prospective study was conducted to assess the prevalence of osteoporosis and osteopenia in sickle cell anaemia.

Consecutive adult sickle cell anaemia patients who were treated at the department of orthopaedic surgery of King Fahd University Hospital, AIKhobar, SaudiArabia, between April and July 2006, were the subjects of study. After a verbal consent to participate in the study, patients age and sex were documented and body mass index (BMI) was calculated. Blood was extracted for haematological and biochemistry which also included haemoglobin electrophoresis. Bone mineral density (BMD) measurement was done using dual energy x-rayabsorbtiometry (DEXA) at the lumbar spine and the upper femur. Osteopenia and osteoporosis was diagnosed as per the WHO criteria.

The results of 36 patients were analyzed. There were 23 males and 13 females. The average age in males was 34.21+/-6.35 years, and females was 35.38+/-5.40 years. Eighty-two percent of males and 76% of the females were either osteopenic or osteoporotic. The prevalence of osteoporosis in males was highest at lumbar spine (P= 0.001).

This study finds the prevalence of osteopenia and osteoporosis is quite high among Saudi adult SCA patients. Physicians should be aware of the risk of osteoporosis in sickle cell patients and every effort should be made to treat them adequately and prevent osteoporosis related fractures.