Influence of androgens on bone mass in young women with sickle cell anemia

Objective: To evaluate the relationship between the gender hormonal levels and bone mineral density in premenopausal women suffering with sickle cell disease. Methods: A cross-sectional study including consecutive female adult patients with sickle cell anemia attending the outpatient hematology/orthopaedic clinics, or admitted to King Fahd University Hospital, Al-Khobar, Saudi Arabia, between August 2006 and June 2007. Patient’s age was documented, and body mass index was calculated. Blood was drawn for complete blood picture, biochemistry, and hormonal profile including total estradiol (E2) and total testosterone (Te). Bone mineral density (BMD) was measured for all patients using dual energy x-ray absorptiometry scan at the hip and lumbar spine. Results: We analyzed the data of 51 patients with an average age of 26±3.1 years. Patients were divided into 2 groups (group A and group B). Group A had normal BMD and group B with low BMD. Thirty-one (60.8%) were in group A and 20 (39.2%) were in group B. The E2 level was not statistically different between the 2 groups, while Te level was significantly lower in women with low BMD (38±11.8 versus 22.3±11.7 ng/dl, p 0.001). Conclusions: Our study indicates that in premenopausal female patients with sickle cell anemia, testosterone may play a role in the preservation of bone mass.