Orak hücreli anemi hastalarında metabolik kemik hastalıkları sıklığı ve bununla ilişkili faktörlerin değerlendirilmesi
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Tarih
2018
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Orak hücreli anemi (OHA), dünyada sık görülen genetik bir hemoglobinopatidir. OHA, mikro ve makro dolaşımda vazo-oklüzyon yaparak doku infarktına neden olan multisistemik bir hastalıktır. Osteoporoz (OP), kemik kitlesinde azalma ve bunun sonucunda kemik dokunun daha kırılgan hale gelmesiyle karakterize bir kemik hastalığıdır. Yapılan çalışmalarda osteopeni ve osteoporozun orak hücreli anemi hastalarında genel populasyonla karşılaştırıldığında daha sık ve daha erken yaşlarda görüldüğü saptanmıştır. Bu çalışmada; orak hücreli anemi hastalarında, metabolik kemik hastalıklarının sıklığını ve ilişkili faktörleri araştırmayı amaçladık. Yöntem: Hatay Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi İç Hastalıkları Anabilim Dalı Hematoloji, Genel Dahiliye ve Endokrinoloji ve Metabolizma Hastalıkları polikliniklerine 01.01.2012-30.12.2016 tarihleri arasında başvuran, yaşları 15-48 (30,01±8,64) arasında olan toplam 70 orak hücreli anemi tanılı hastanın medikal kayıtları retrospektif olarak incelendi. Hastaların serum kreatinin, laktat dehidrogenaz (LDH), ürik asit, total bilirubin (T. bil), direkt bilirubin (D. bil), hemoglobin, beyaz küre sayısı, trombosit sayısı, kalsiyum, fosfor, paratiroid hormon, alkalen fosfataz, 25 (OH) vitamin D, ferritin, C reaktif protein (CRP), Tiroid stimülan hormon (TSH) düzeyleri ve Dual enerjili X ışını absorpsiyometri (DEXA) ile hesaplanan kemik mineral dansitometri sonuçları değerlendirildi. Osteopeni ve osteoporoz tanısı WHO kriterlerine göre konuldu. Hastaların avasküler nekroz ve kemik kırığı durumunu belirlemek için, direkt grafi ve MR raporları ve epikriz notları incelendi. Bulgular: Orak hücreli anemi tanısı olan 70 hastanın %50'si (n=35) kadın, %50'si (n=35) erkek idi. Çalışmaya alınan tüm hastaların yaş ortalaması 30.01±8.64 yıl idi. T skoru bakılan 62 hastanın %46,8'i normal, %45,1'i osteopenik (-2.5
Aim: Sickle cell anemia (SCA) is a commonly seen hemoglobinopathy in the world. SCA is a multisystemic disease that causes tissue infarction by vaso-occlusion in micro and macro circulation. Osteoporosis (OP) is a bone disease characterised by a decrease in bone mass and consequent bone texture becoming more fragile. Studies have shown that in sickle cell patients osteopenia and osteoporosis are seen more frequently and earlier than the general population. In this study; we aimed to investigate the frequency of metabolic bone diseases and related factors in patients with sickle cell anemia. Method: We evaluated the medical records of 70 patients with sickle cell anemia retrospectively who had been admitted to Hatay Mustafa Kemal University Tayfur Ata Sökmen Medical Faculty Internal Medicine Department, Hematology Department and Endocrinology and Metabolism Diseases Department between the dates of 01.01.2012-30.12.2016, aged between 15-48 years. We assesed serum creatinine, LDH, total bilirubin, direct bilirubin, uric acid, Wbc, Hb, Plt, calcium, phosphorus, parathormone, alkaline phosphatase, 25 (OH) vitamin D, ferritin, CRP and bone mineral densitometry that calculated by DEXA. We diagnosed osteopenia and osteoporosis as per the WHO criteria. To find out status of avascular necrosis and bone fracture we examined x-ray and MR reports and epicrisis reports of patients. Results: Fifty percent of seventy patients were male (n=35) and 50% of patients were female (n=35). The mean age was 30.01±8.64. Among 62 patients, we observed osteoporosis in 8.1% of patients (n=28) and osteopenia in 45.1% of patients (n=5). There were bone fracture in 8.6% of patients and 83,3% of them were femoral fracture; 16.7% of them were vertebral fracture. There was a statistically significant, negative correlation between parathyroide hormone and BMD (p<0.01). There was positive correlation between WBC and BMD (p=0.04). We found positive correlation between serum ferritin levels and BMD (p=0.01). There was positive correlation between calcium and femoral T and Z scores. Other variables like BMI, genotype (SS and Sbeta), degree of anemia, plt, LDH, T. bil, D. bil, uric acid, CRP, TSH, 25 (OH) vit D didn't affect bone mass. Conclusion: Patients with sickle cell anemia have increased risk of osteopenia and osteoporosis. In that case, some precautions must be taken in these patients for protecting bone mass.
Aim: Sickle cell anemia (SCA) is a commonly seen hemoglobinopathy in the world. SCA is a multisystemic disease that causes tissue infarction by vaso-occlusion in micro and macro circulation. Osteoporosis (OP) is a bone disease characterised by a decrease in bone mass and consequent bone texture becoming more fragile. Studies have shown that in sickle cell patients osteopenia and osteoporosis are seen more frequently and earlier than the general population. In this study; we aimed to investigate the frequency of metabolic bone diseases and related factors in patients with sickle cell anemia. Method: We evaluated the medical records of 70 patients with sickle cell anemia retrospectively who had been admitted to Hatay Mustafa Kemal University Tayfur Ata Sökmen Medical Faculty Internal Medicine Department, Hematology Department and Endocrinology and Metabolism Diseases Department between the dates of 01.01.2012-30.12.2016, aged between 15-48 years. We assesed serum creatinine, LDH, total bilirubin, direct bilirubin, uric acid, Wbc, Hb, Plt, calcium, phosphorus, parathormone, alkaline phosphatase, 25 (OH) vitamin D, ferritin, CRP and bone mineral densitometry that calculated by DEXA. We diagnosed osteopenia and osteoporosis as per the WHO criteria. To find out status of avascular necrosis and bone fracture we examined x-ray and MR reports and epicrisis reports of patients. Results: Fifty percent of seventy patients were male (n=35) and 50% of patients were female (n=35). The mean age was 30.01±8.64. Among 62 patients, we observed osteoporosis in 8.1% of patients (n=28) and osteopenia in 45.1% of patients (n=5). There were bone fracture in 8.6% of patients and 83,3% of them were femoral fracture; 16.7% of them were vertebral fracture. There was a statistically significant, negative correlation between parathyroide hormone and BMD (p<0.01). There was positive correlation between WBC and BMD (p=0.04). We found positive correlation between serum ferritin levels and BMD (p=0.01). There was positive correlation between calcium and femoral T and Z scores. Other variables like BMI, genotype (SS and Sbeta), degree of anemia, plt, LDH, T. bil, D. bil, uric acid, CRP, TSH, 25 (OH) vit D didn't affect bone mass. Conclusion: Patients with sickle cell anemia have increased risk of osteopenia and osteoporosis. In that case, some precautions must be taken in these patients for protecting bone mass.
Açıklama
Anahtar Kelimeler
Endokrinoloji ve Metabolizma Hastalıkları, Endocrinology and Metabolic Diseases, Sickle cell anemia, osteopenia, osteoporosis, bone mineral density
