Advertisement

BioMetals

, Volume 24, Issue 1, pp 19–22 | Cite as

Does high serum iron level induce low bone mass in sickle cell anemia ?

  • Mir Sadat-AliEmail author
  • Osama Sultan
  • Haifa Al-Turki
  • Abdulmohsen AlElq
Article

Abstract

Iron overload is quite common in patients suffering from hemoglobinopathies causing arthropathies, endocrinal affection and neuropathies. Recently low bone mass was added to the list of complications. This study is conducted to find any correlation between serum iron level and low bone mass in sickle cell anemia (SCA). Patients ≥18 years of age with sickle cell anemia, who attended outpatient clinics or admitted to King Fahd University Hospital, Al Khobar, Saudi Arabia,between 1st September 2006 and August 2007 were the subjects of this study. Patients age and sex were documented and body mass index was calculated. Apart from routine hematological tests, serum ferritin, serum Iron level, total estradiol, testosterone level was done. Bone mineral density measurement was done using dual energy X-ray absorptiometry (DEXA) at upper femur and lumbar spine. The data of 100 patients was analyzed, 48 males and 52 females. The mean age was 27.5 ± 6.1 years. In 64 patients (32 males and 32 females) serum iron level was 319.35 μg/dl and the mean serum ferritin level in males and females was within the normal range. Sixty-eight percent of females and 71.8% of males patients in whom serum iron was high had lower bone mass P = < 0.001. Our study shows that SCA patients in whom serum iron level was higher than normal effected bone mass. Further studies are needed to confirm this as a cause of osteoporosis in SCA patients.

Keywords

Low bone mass Serum iron level Sickle cell anemia Osteoporosis 

References

  1. Al-Elq AH, Al-Saeed HH (2004) Endocrinopathies in patients with thalassemias. Saudi Med J 25(10):1347–1351PubMedGoogle Scholar
  2. Al-Rimawi HS, Jallad MF, Amarin ZO, Obeidat BR (2005) Hypothalamic-pituitary-gonadal function in adolescent females with beta-thalassemia major. Int J Gynaecol Obstet 90(1):44–47CrossRefPubMedGoogle Scholar
  3. Ballas SK (2001) Iron overload is a determinant of morbidity and mortality in adult patients with sickle cell disease. Semin Hematol 28(Suppl 1):30–36CrossRefGoogle Scholar
  4. Banerjee S, Owen C, Chopra S (2001) Sickle cell hepatopathy. Hepatology 33(5):1021–1028CrossRefPubMedGoogle Scholar
  5. Brittenham GM, Griffith PM, Nienhuis AW, McLaren CE, Young NS, Tucker EE et al (1994) Efficacy of deferoxamine in preventing complications of iron overload in patients with thalassemia major. N Engl Med J 331:567–573CrossRefGoogle Scholar
  6. Chan YL, Pang LM, Chik KW, Cheng JC, Li CK (2002) Patterns of bone diseases in transfusion-dependent homozygous thalassaemia major: predominance of osteoporosis and desferrioxamine-induced bone dysplasia. Pediatr Radiol 32(7):492–497CrossRefPubMedGoogle Scholar
  7. Darbari DS, Kple-Faget P, Kwagyan J, Rana S, Gordeuk VR, Castro O (2006) Circumstances of death in adult sickle cell disease patients. Am J Hematol 81(11):858–863CrossRefPubMedGoogle Scholar
  8. Diamond T, Stiel D, Posen S (1989) Osteoporosis in hemochromatosis: iron excess, gonadal deficiency, or other factors? Ann Intern Med 110(6):430–436PubMedGoogle Scholar
  9. Eyres KS, McCloskey EV, Fern ED, Rogers S, Beneton M, Aaron HE et al (1992) Osteoprotic fractures: an unusual presentation of haemochromatosis. Bone 13(6):431–433CrossRefPubMedGoogle Scholar
  10. Fung EB, Hamartz PR, Lee PD, Milet M, Bellevue R, Jeng MR et al (2006) Increased prevalence of iron-overload associated endocrinopathy in thalassaemia versus sickle-cell disease. Br J Haematol 135(4):574–582CrossRefPubMedGoogle Scholar
  11. Guggenbuhl P, Deugnier Y, Boisdet JF, Rolland Y, Perdriger A, Pawlotsky Y et al (2005) Bone mineral density in men with genetic hemochromatosis and HFE gene mutation. Osteoporos Int 16(12):1809–1814CrossRefPubMedGoogle Scholar
  12. Harmatz P, Butensky E, Quirolo WilliamsR, Ferrell L, Moyer T et al (2000) Severity of ironload in patients with sickle cell disease receiving chronic red blood cell transfusion therapy. Blood 96:76–79PubMedGoogle Scholar
  13. Manci EA, Culberson DE, Yang YM, Gardner TM, Powell R, Haynes J et al (2003) Investigators of the cooperative study of sickle cell disease causes of death in sickle cell disease: an autopsy study. Brit J Hematol 123:359–365CrossRefGoogle Scholar
  14. Matsushima S, Toril M, Ozaki K, Narama I (2003) Iron lactate-induced osteomalacia in association with osteoblast dynamics. Toxicol Pathol 31(6):646–654PubMedGoogle Scholar
  15. Miller RG, Segal JB, Ashar BH, Leung S, Ahmed S, Siddique S et al (2006) High prevalence and correlates of low bone mineral density in young adults with sickle cell disease. Amer J Hemat 81:236–241CrossRefGoogle Scholar
  16. Niederau C, Fischer R, Purschel A, Stremmel W, Haussinger D, Strohmeyer G (1996) Long-term survival in patients with hemochromotosis. Gastroentrology 110:1107–1119CrossRefGoogle Scholar
  17. Sadat-Ali M, AlElq AH (2007) Sickle cell anemia: is it a cause for secondary osteoporosis? West African J Med 26(2):134–137Google Scholar
  18. Sarrai M, Duroseau H, D’Augustine J, Moktan S, Bellevue R (2007) Bone mass density in adults with sickle cell disease. Br J Haematol 136:666–672CrossRefPubMedGoogle Scholar
  19. Shah FT, Chatterjee R, Owusu-Asante M, Porter JB (2004) Adults with severe sickle cell anemia and iron overload have a high incidence of osteopenia and osteoporosis. Blood 104. In: Annual Meeting American Society for Hematology. Abstract 1684Google Scholar
  20. Vichinsky E, Butensky E, Fung E, Hudes M, Theil E, Ferrell L et al (2005) Comparison of organ dysfunction in transfused patients with SCD or beta thalassemia. Amer J Hematol 80:70–74CrossRefGoogle Scholar
  21. Vogiatzi MG, Autio KA, Schneider R, Giardina PJ (2004) Low bone mass in prepubertal children with thalassemia major: insights into the pathogenesis of low bone mass in thalassemia. J Pediatr Endocrinol Metab 17(10):1415–1421PubMedGoogle Scholar
  22. Voskaridou E, Terpos E (2004) New insights into the pathophysiology and management of osteoporosis in patients with beta thalassaemia. Br J Haematol 127(2):127–139CrossRefPubMedGoogle Scholar
  23. Weinberg ED (2006) Iron loading: a risk factor for osteoporosis. Biometals 19:633–635CrossRefPubMedGoogle Scholar
  24. Weinberg ED (2007) Iron loading in humans: a risk factor for enhanced morbidity and mortality. J Nutr Environ Med 16:43–51CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Mir Sadat-Ali
    • 3
    • 4
    Email author
  • Osama Sultan
    • 1
  • Haifa Al-Turki
    • 2
  • Abdulmohsen AlElq
    • 1
  1. 1.Department of Internal Medicine, College of MedicineUniversity of DammamDammamSaudi Arabia
  2. 2.Department of Obstetrics and Gynecology, College of MedicineUniversity of DammamDammamSaudi Arabia
  3. 3.Department of Orthopaedic Surgery, College of MedicineUniversity of DammamDammamSaudi Arabia
  4. 4.King Fahd University HospitalAl-KhobarSaudi Arabia

Personalised recommendations