Unveiling Bone Health in Sickle Cell Disease: A Comprehensive Analysis of Bone Mineral Density

Sickle Cell Disease is a well-known haemoglobinopathy affecting a substantial load of population across the globe. Although mainly characterized by anaemia, the overall effects of the disease are not just limited to the haematological system and in fact involves the bones, renal and endocrine organs. The repeated Vaso-occlusive episodes in SCD imparts a negative impact on bone mineral density of the patients and affects the bone growth and metabolism. The study aims to evaluate the bone mineral density in patients with sickle cell disease and as well as establishing potential correlations between bone mineral density and the clinical manifestations of the disease. The present study was conducted in the Dept of Medicine, Assam Medical College & Hospital on 70 sickle cell disease patients. Detailed clinical history was taken and other relevant physical examinations and investigations like anthropometric measurements, routine haematological investigations and bone densitometry using Dual Energy X-ray Absorptiometry (DEXA) were done. Data were represented in appropriate format and statistical analysis was performed using SPSS and Microsoft Excel. Statistical significance was analysed by independent t test and chi square test. Out of the total of 70 participants of the study there were 26 male and 44 female participants. The mean age of patients was 24.72 years and majority of patients belonged to the tea tribe community. Based on DEXA scan, 45 patients (64.3%) were having low BMD defined as either osteopenia or osteoporosis. The prevalence of low BMD in the present study was higher at lumbar spine compared to neck of femur. Low BMD was significantly correlated with low BMI (p<0.001), low haemoglobin (p=0.003), low calcium (p=0.001) and low ferritin level (p=0.001). There is an intricate interplay between low BMD in Sickle Cell Disease and various clinical parameters, revealing strong associations with low Body Mass Index, diminished haemoglobin levels, reduced calcium levels, and elevated serum ferritin levels. This emphasizes the need for comprehensive management strategies addressing nutritional, haematological, and metabolic factors to optimize bone health in this patient population.