Prevalence of Low Bone Mineral Density Increases With Age in Sickle Cell Disease

Skeletal complications are common in sickle cell disease (SCD). We previously showed that the prevalence of low areal bone mineral density (aBMD) increased with age in a pediatric SCD cohort, even after adjusting for short stature. Data on age-related aBMD trends in young adults is lacking.

Using retrospective data from the Sickle Cell Clinical Research and Intervention Program (SCCRIP), we converted lumbar spine (LS) and total body (TB) aBMD from 713 SCCRIP participants (49.2% females, ages 6-24 years) to age-, sex-, ancestry-, and height-adjusted Z-scores, using data from healthy African American controls enrolled in the Bone Mineral Density in Childhood Study.

Low TB bone density prevalence rates increased with age: 29.5% in children (6-< 12 years), 36.7% in adolescents (12-< 18 years), and 42.2% in young adults (18-24 years). LS aBMD followed a similar age-related trend. Multivariable analysis revealed older age (OR 1.10, 95% CI 1.06-1.16), lower hemoglobin (OR 0.833, 95% CI 0.740-0.936), and higher eGFR (OR 1.01, 95% CI 1.00-1.02) as independent predictors for low TB BMD.

These findings highlight the progressive decline of aBMD in SCD and underscore the need for early screening to mitigate morbidity due to SCD-related skeletal complications. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.