Osteoporosis and Vitamin D Deficiency in Patients with Sickle Cell Disease

Aim: Bone disorders such as osteopenia or osteoporosis are the most common clinical manifestations seen in sickle cell disease (SCD) with a high of morbidity. There are many reasons, including vitamin D deficiency for the appearance of bone problems. In the present study we aimed to evaluate osteopathy in patients with SCD using bone mineral densitometry (BMD) and biochemical indices. Material and Method: 61 patients (29 female, 32 male) were included in the study. The age, gender, and biochemical parameters with BMD were evaluated using dual energy X-ray absorptiometry from lumbar vertebrae. According to Z scores, [<-1] was normal, [-1/-2] was osteopenia, and [>-2] was considered as osteoporosis. Multivariate analysis was performed to determine the factors influencing BMD. Results: There were a total of 61 SCD patients. The average age was 21.06 +/- 5.06 (15-27) years and the mean BMI was 19.15 +/- 2.98 kg/m2.23 patients were osteopenic (11 female, 12 male) (37.7%) and 26 were osteoporotic (12 female, 13 male) (44.3%). Twelve patients (6 female and 6 male) (18%) had normal Z scores. Vitamin D was found severely deficient (<10 ng/mL) in 12 patients (19.67%) (10 female, 2 male). Vitamin D was deficient (10-20 ng/mL) in 20 patients (32.8%) (14 female, 6 male) and insufficient (20-30 ng/mL) in 26 patients (42.6%) (14 female, 12 male). Almost all of the females (28 of 29) had vitamin D levels lower than 20 ng/mL and 18 of 32 males had deficiency. Lumbar BMD was positively correlated with age (p<0.001), height (p<0.001), weight (p<0.001), BMI (p<0.001), Hb (p=0.017), and Z score (p<0.001). Discussion: There are many indicators playing a role in the ethiopathogenesis of osteopathy in SCD patients. These factors should be considered, the diagnosis should not be delayed, and measures should be taken to improve the quality of life of these patients.