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Year : 2011  |  Volume : 2  |  Issue : 1  |  Page : 34-40

Low bone mineral density in patients with sickle cell disease: Association with blunted parathyroid hormone response and accelerated bone turnover

1 Biochemistry Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
2 Center of excellence for osteoporosis research and Hematology department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

Correspondence Address:
Mohamed F Elshal
Biochemistry Department Faculty of Science and Center of excellence for osteoporosis research King Abdulaziz University Jeddah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

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Background/aim: Bone complications in sickle cell disease (SCD) have been well documented, but the mechanisms underlying SCD are poorly characterized. Therefore, we conducted this study to elucidate the factors affecting bone health in patients with SCD by measuring bone turnover markers and correlating them with bone mineral density (BMD). Patients and methods: Serum from 30 patients with confirmed SCD and 20 age-matched healthy controls were included in the study. Dual X-ray absorptiometry was used to determine the BMD of the lumbar spine (L2ΠL 4) and of the whole body. results: According to the WHO definitions for T-scores, 30% of HbSS patients were osteopenic (30%) or osteoporotic (50%) in at least 1 of the 3 studied locations. BMD, serum calcium, and parathyroid hormone (PTH) showed a significant decrease, while PO4, osteocalcin (OC), and bone-specific alkaline phosphatase (b-ALP) showed a significant increase in the patient group compared to the control group (P<0.05, for all). Multivariate analysis identified only serum PTH as an independent determinant of low whole-body BMD in HbSS (P=0.0399), whereas it identified osteocalcin, magnesium, and CTX as independent predictors for PTH. conclusions: These findings suggest that low BMD is prevalent in SCD and that blunted PTH response to reduced total calcium levels and accelerated bone turnover may be the underlying mechanisms.

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