title: Bone mineral density, growth, pubertal development and other parameters in Brazilian children and young adults with sickle cell anaemia.
abstract: OBJECTIVE
  To evaluate the occurrence of low bone mineral density (BMD) and its relationship with clinical and laboratorial characteristics in children and young adults with sickle cell anaemia living in Northeast-Brazil, and to assess the role of radiography in diagnosing low BMD.
  
  
  METHODS
  Bone mineral density of lumbar spine was measured by dual energy X-ray absorptiometry (DXA) in 27 patients with Sickle cell anaemia (SCA) aged 7-28 years. Clinical history, calcium and calorie intake, laboratory measurements, anthropometrics and pubertal development were assessed, and X-rays were obtained. Z-scores and T-scores for weight, height, Body Mass Index (BMI) and BMD were calculated using age and gender matched reference data.
  
  
  RESULTS
  Mean lumbar spine BMD Z-scores and T-scores were -1.81 SD in boys and -0.80 SD in girls. BMD Z-scores were below -2 SD in 33.3% of girls and in 46.7% of boys. Low BMD (<-2 SD) occurred significantly more in patients with low height-for-age (P = 0.02), low weight-for-age (P = 0.001) and low BMI-for-age (P = 0.006). No significant relationships were found between BMD and other clinical and laboratory parameters. Radiography had a sensitivity of 75% and a specificity of 36% to detect low BMD, and was considered not useful in this context.
  
  
  CONCLUSIONS
  Patients with low height and/or low weight-for-age seem to be at high risk for developing low BMD.
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Meeuwes
authors.forename: T F
authors.initials: TF
authors.lastname: Souza de Carvalho
authors.forename: R
authors.initials: R
authors.lastname: Cipolotti
authors.forename: R Q
authors.initials: RQ
authors.lastname: Gurgel
authors.forename: T O
authors.initials: TO
authors.lastname: Ferrão
authors.forename: M
authors.initials: M
authors.lastname: Peters
authors.forename: C
authors.initials: C
authors.lastname: Agyemang
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D015519:Bone Density; D001938:Brazil; D002648:Child; D005260:Female; D006130:Growth Disorders / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D011627:Puberty; D055815:Young Adult
keywords: Brazil; Paediatrics; Sickle cell anaemia; bone mineral density