The Role of Biochemical Markers Associated with Osteoporosis in Patients with Sickle Cell Anemia in Diagnosis

Abstract

Objective: The risk of osteopenia and osteoporosis has not been clearly defined in sickle cell anemia (SCA). In this study, it was aimed to evaluate the bone formation/resorption markers together and examine the relationships between each other in order to investigate the relationship between SCA and osteoporosis. Methods: Our study included 33 patients with sickle cell anemia and 34 healthy controls. Bone formation markers are Type 1 collagen N-terminal propeptide (P1NP), Type 1 collagen C-terminal propeptide (P1CP), Bone Alkaline Phosphatase (BALP) and Osteocalcin (OC), and bone resorption markers are Type 1 collagen carboxyterminal telopeptide (CTX), Pyridinoline (PYD) and Deoxypyridinoline (DPD) and Hydroxyproline (HYP) were analyzed. In addition, 25(OH)D levels of the groups were assayed. Results: The OC level was significantly higher in the patient group compared to the control group (p=0.016). 25(OH)D level was significantly decreased in the patient group compared to the control group (p=0.01). There was no statistically significant difference between the groups for both bone formation and resorption markers (PINP, PICP, PYD, DPD, BALP, CTX, HYP). Conclusion:It is predicted that the evaluation of bone turnover markers will contribute more to the diagnosis in understanding the effect of SCA on bone metabolism.

Keywords

• Sickle Cell Anemia
• Osteopenia
• Osteoporosis
• Bone Tunover Markers

Project Number

16797

Orak Hücre Anemili Hastalarda Osteoporoz ile İlişkili Biyokimyasal Markerlerin Tanıdaki Yeri

Abstract

Amaç: Orak hücreli anemi (OHA)’de osteopeni ve osteoporoz riski net olarak ortaya konmamıştır. Bu çalışmada OHA-osteoporoz ilişkisini araştırmak amacıyla kemik yapım/yıkım belirteçleri bir arada değerlendirilerek aralarındaki korelasyonun incelenmesi amaçlandı. Gereç ve Yöntem: Çalışmanın hasta grubu 33 orak hücreli birey ve kontrol grubu ise 34 sağlıklı bireyden oluşturuldu. Kemik yapım belirteçlerinden Tip 1 kollajen N-terminal propeptit (P1NP), Tip 1 kollajen C-terminal propeptit (P1CP), Kemik Alkalen Fosfataz (BALP) ve Osteokalsin (OC), kemik yıkım belirteçlerinden ise, Tip 1 kollajen karboksiterminal bağlı telopeptit (CTX), Pridinolin (PYD) ve Deoksipridinolin (DPD) ve Hidroksiprolin (HYP) analiz edildi. Ayrıca grupların 25(OH)D düzeyleri ölçüldü. Bulgular: OC düzeyi hasta grubunda kontrol grubuna kıyasla anlamlı derecede yüksekti. (p=0.016). 25(OH)D düzeyi hasta grubunda kontrol grubuna kıyasla önemli ölçüde düşüktü. (p=0.01). Gruplar arasında diğer yapım ve yıkım belirteçlerinde (PINP, PICP, PYD, DPD, BALP, CTX, HYP) istatistiksel olarak anlamlı fark bulunmadı. Sonuç: OHA’nın kemik metabolizmasına etkisinin anlaşılmasında kemik döngüsü belirteçlerinin de değerlendirilmesinin tanıya daha fazla katkıda bulunacağı öngörülmüştür.

Keywords

• Orak Hücre
• Osteopeni
• Osteoporoz
• Kemik Döngüsü Belirteçleri

Supporting Institution

Hatay Mustafa Kemal Üniversitesi

Project Number

16797

Thanks

Hatay Mustafa Kemal Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğüne katkılarından dolayı teşekkür ederiz.

References

1. Mandal AK, Mitra A, Das R. Sickle Cell Hemoglobin. Subcell Biochem. 2020;94:297-322. DOI:https://doi.org/ 10.1007/978-3-030-41769-7_12
2. Pinto VM, Balocco M, Quintino S, Forni GL. Sickle cell disease: a review for the internist. Intern Emerg Med. 2019;14(7):1051-64. https://doi.org/ 10.1007/s11739-019-02160-x
3. Aguilar C, Vichinsky E, Neumayr L. Bone and joint disease in sickle cell disease. Hematol Oncol Clin North Am. 2005;19(5):929-41, viii. https://doi.org/ 10.1016/j.hoc.2005.07.001
4. Rees DC, Williams TN, Gladwin MT. Sickle-cell disease. Lancet. 2010;376(9757):2018-31. https://doi.org/ 10.1016/S0140-6736(10)61029-X
5. Kim HK, Kim MG, Leem KH. Osteogenic activity of collagen peptide via ERK/MAPK pathway mediated boosting of collagen synthesis and its therapeutic efficacy in osteoporotic bone by back-scattered electron imaging and microarchitecture analysis. Molecules. 2013;18(12):15474-89.
6. Guillerminet F, Beaupied H, Fabien-Soulé V, Tomé D, Benhamou CL, Roux C, et al. Hydrolyzed collagen improves bone metabolism and biomechanical parameters in ovariectomized mice: an in vitro and in vivo study. Bone. 2010;46(3):827-34. https://doi.org/ 10.1016/j.bone.2009.10.035
7. da Silva Junior GB, Daher EeF, da Rocha FA. Osteoarticular involvement in sickle cell disease. Rev Bras Hematol Hemoter. 2012;34(2):156-64. https://doi.org/ 10.5581/1516-8484.20120036
8. Nolan VG, Nottage KA, Cole EW, Hankins JS, Gurney JG. Prevalence of vitamin D deficiency in sickle cell disease: a systematic review. PLoS One. 2015;10(3):e0119908. https://doi.org/10.1371/journal.pone.0119908

9. Garrido C, Cela E, Beléndez C, Mata C, Huerta J. Status of vitamin D in children with sickle cell disease living in Madrid, Spain. Eur J Pediatr. 2012;171(12):1793-8. https://doi.org/ 10.1007/s00431-012-1817-2
10. Nelson DA, Rizvi S, Bhattacharyya T, Ortega J, Lachant N, Swerdlow P. Trabecular and integral bone density in adults with sickle cell disease. J Clin Densitom. 2003;6(2):125-9. https://doi.org/ 10.1385/jcd:6:2:125
11. Miller RG, Segal JB, Ashar BH, Leung S, Ahmed S, Siddique S, et al. High prevalence and correlates of low bone mineral density in young adults with sickle cell disease. Am J Hematol. 2006;81(4):236-41. https://doi.org/ 10.1002/ajh.20541
12. Lal A, Fung EB, Pakbaz Z, Hackney-Stephens E, Vichinsky EP. Bone mineral density in children with sickle cell anemia. Pediatr Blood Cancer. 2006;47(7):901-6. https://doi.org/ 10.1002/pbc.20681
13. Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, et al. Endotext. 2000.
14. Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011;22(2):391-420. https://doi.org/ 10.1007/s00198-010-1501-1
15. Lorentzon M, Branco J, Brandi ML, Bruyère O, Chapurlat R, Cooper C, et al. Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis. Adv Ther. 2019;36(10):2811-24. https://doi.org/ 10.1007/s12325-019-01063-9
16. Henriksen K, Christiansen C, Karsdal MA. Role of biochemical markers in the management of osteoporosis. Climacteric. 2015;18 Suppl 2:10-8. https://doi.org/ 10.3109/13697137.2015.1101256
17. Eastell R, Garnero P, Audebert C, Cahall DL. Reference intervals of bone turnover markers in healthy premenopausal women: results from a cross-sectional European study. Bone. 2012;50(5):1141-7. https://doi.org/ 10.1016/j.bone.2012.02.003
18. Guañabens N, Filella X, Monegal A, Gómez-Vaquero C, Bonet M, Buquet D, et al. Reference intervals for bone turnover markers in Spanish premenopausal women. Clin Chem Lab Med. 2016;54(2):293-303. https://doi.org/ 10.1515/cclm-2015-0162
19. Azinge EC, Bolarin DM. Osteocalcin and bone-specific alkaline phosphatase in sickle cell haemoglobinopathies. Niger J Physiol Sci. 2006;21(1-2):21-5. https://doi.org/ 10.4314/njps.v21i1-2.53934
20. Eren E, Yilmaz N. Biochemical markers of bone turnover and bone mineral density in patients with beta-thalassaemia major. Int J Clin Pract. 2005;59(1):46-51. https://doi.org/ 10.1111/j.1742-1241.2005.00358.x
21. Kaza PL, Moulton T. Severe vitamin D deficiency in a patient with sickle cell disease: a case study with literature review. J Pediatr Hematol Oncol. 2014;36(4):293-6. https://doi.org/ 10.1097/MPH.0000000000000045
22. Adewoye AH, Chen TC, Ma Q, McMahon L, Mathieu J, Malabanan A, et al. Sickle cell bone disease: response to vitamin D and calcium. Am J Hematol. 2008;83(4):271-4. https://doi.org/ 10.1002/ajh.21085
23. Cabral HW, Andolphi BF, Ferreira BV, Alves DC, Morelato RL, Chambo A, et al. The use of biomarkers in clinical osteoporosis. Rev Assoc Med Bras (1992). 2016;62(4):368-76. https://doi.org/ 10.1590/1806-9282.62.04.368