Abstract

Low bone mineral density in Saudi adult patients with sickle cell disease: myth or fact?

Author(s): Rasha M Ghaleb & Emad Ali Saleh Al Khoufi

Objective: Although Sickle Cell Disease (SCD) is prevalent in Saudi-Arabia, there have been no data about the prevalence of low bone mineral density (BMD) in adult patients suffering from SCD in the eastern region in KSA. Our study aimed to assess the prevalence of low bone mineral density in adult patients with SCD in the eastern region in KSA and its association with other sickle cell disease manifestations. Methodology: In King Faisal University Polyclinic, Al-Ahsa, Saudi Arabia, a cross sectional study was carried out. Ninety adult patients known to suffer from SCD between August 2017 and May 2018 were recruited for the study. Patients were interviewed; demographic and clinical data were recorded. Blood was extracted for serum levels of calcium, phosphorus, alkaline phosphatase and vitamin D 25 OH. Dual X-ray absorptiometry (DEXA) bone scan were used for all patients to determine BMD in the lumbar spine, femoral neck and distal radius. T-scores were used to classify patients as being normal, osteopenic or osteoporotic according to WHO classification. Data were analyzed by the Statistical Package for the Social Sciences (SPSS, version 20) with p value of <0.05 being statistically significant with confidence interval of 95%. Results: A total of ninety patients were studied. There were 54 male and 36 female patients. The mean age of patients was 26.28 ± 9.37 years. Based on DEXA scan; 52/90 (57.8%) were showing low BMD defined as either osteopenic or osteoporotic. The prevalence of low BMD in our patients was highest at lumbar spine (48.1%). Low BMD was significantly correlated with low BMI (p<0.05), presence of AVN (p=0.001), low vitamin D (p=0.005). Conclusions: This study supports the view that prevalence of osteopenia and osteoporosis among adult Saudi sickle cell anemia patients is high. As a result, sickle cell anemia is considered one of the important causes of secondary osteoporosis and physician’s awareness about this issue is essential for early diagnosis of and appropriate treatment.