The Relationship between Anemia and Bone Mineral Density Measured by Dual X-Ray Absorptiometry

Rania Jamal Ahmed; Numan Salman Dawood; Maan Hamad Al-Khalisy

doi:10.54133/ajms.v6i2.800

Authors

Rania Jamal Ahmed Department of Physiology, College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0009-0002-9607-1729
Numan Salman Dawood Department of Physiology, College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0000-0002-5064-7051
Maan Hamad Al-Khalisy Department of Anatomy, College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0009-0005-6536-6083

DOI:

https://doi.org/10.54133/ajms.v6i2.800

Keywords:

Anemia, DEXA, Osteoporosis, Lumbar vertebrae

Abstract

Background: The bone mineral density of the lumbar vertebra has been assessed according to the results of the Dual-Energy X-Ray Absorptiometry (DEXA). Although anemia is known to affect bone mineral density, at the present time, it is not clear which vertebra is more affected by this disease. Objective: To evaluate the effects of anemia on the bone mineral density of the lumbar vertebra in comparison with a normal subject and determine which part of the lumbar vertebra is more affected by anemia. Methods: All 205 participants in this study complained of bone pain (90 males and 105 females). 95 patients, including both sexes, suffered from anemia. Additionally, the study included 110 seemingly healthy volunteers as the control group. All participants were studied regarding their bone mineral density for lumbar vertebrae using dual-energy x-ray absorptiometry. Results: The DEXA outcomes revealed highly statistically significant differences between the control and patients of each lumbar vertebra in the same sex. In addition, there were significant differences in bone mineral density among the lumbar vertebrae of the same sex. Conclusions: Our findings suggest that examining the bone mineral density of the lumbar vertebrae is a more effective and appropriate method for studying the bone mineral density (BMD) of the bony skeleton in any subject, with L1 and L4 vertebrae being more susceptible to osteoporosis than other vertebrae.

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References

Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46-56 doi: 10.5152/eurjrheum.2016.048.

Sato M, Vietri J, Flynn JA, Fujiwara S. Bone fractures and feeling at risk for osteoporosis among women in Japan: patient characteristics and outcomes in the National Health and Wellness Survey. Arch Osteoporosis. 2014;9(1):199. doi: 10.1007/s11657-014-0199-7.

Choi HG, Kim DS, Lee B, Youk H, Lee JW. High risk of hip and spinal fractures after distal radius fracture: A longitudinal follow-up study using a national sample cohort. Int J Environ Res Public Health. 2021;18(14):7391. doi: 10.3390/ijerph18147391.

Lewis SR, Macey R, Parker MJ, Cook JA, Griffin XL. Arthroplasties for hip fracture in adults. Cochrane Database Syst Rev. 2022;2(2):CD013410. doi: 10.1002/14651858.CD013410.pub2.

Saleh MF, Aldiwan J, Ahmed AH. Possible relationships of selected food items to osteoporosis among a group of Iraqi women. J Fac Med Baghdad. 2022;63(4):171-175. doi: 10.32007/jfacmedbagdad.6341868.

Wris Choi HG, Kim DS, Lee B, Youk H, Lee JW. High risk of hip and spinal fractures after distal radius fracture: A longitudinal follow-up study using a national sample cohort. Int J Environ Res Public Health. 2021;18(14):7391. doi: org/10.3390/ijerph18147391.

Abdel Aziz ZS, Dawood NS, Al-Khalisy MH. Study of the effect of diabetes mellitus I on bone mineral density of upper and lower limbs by dual-energy X-ray absorptiometry. Revis Bionatura. 2023;8(3):75. doi: 10.21931/RB/CSS/2023.08.03.75.

Al-Hafidh AH, Saeed GT, Goral FI. Comparison of lean body mass & body fat mass in pre and postmenopausal women in Baghdad teaching hospital with their impact on bone mineral density. J Pharm Sci Res. 2018;10(12):3124-3127.

Dautzenberg L, Beglinger S, Tsokani S, Zevgiti S, Raijmann RCMA, Rodondi N, et al. Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis. J Am Geriatr Soc. 2021;69(10):2973-2984. doi: 10.1111/jgs.17375.

Radecka A, Lubkowska A. The significance of dual-energy X-ray absorptiometry (DXA) examination in Cushing's syndrome: A systematic review. Diagnostics. 2023;13(9):1576. doi: 10.3390/diagnostics13091576.

Blake GM, Fogelman I. The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J. 2007; 83(982)509–517. doi: 10.1136/pgmj.2007.057505.

Dawood NS, Abdel Aziz ZS, Alkhaales HM. Evaluation of the relationship between osteoporosis and body fat mass of the upper and lower extremities by dual-energy X-ray absorptiometry. Al-Rafidain J Med Sci. 2024;6(1):34-38. doi: 10.54133/ajms.v6i1.410.

Oh KW, Lee WY, Rhee EJ, Baek KH, Yoon KH, Kang MI, et al. The relationship between serum resistin, leptin, adiponectin, ghrelin levels and bone mineral density in middle-aged men. Clin Endocrinol (Oxf). 2005;63(2):131-138. doi: 10.1111/j.1365-2265.2005.02312.x.

LeBoff MS, Greenspan SL, Insogna KL, Lewiecki EM, Saag KG, Singer AJ, et al. The clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2022;33(10):2049-2102. doi: 10.1007/s00198-021-05900-y.

Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-281. doi: 10.1016/j.diabres.2018.02.023.

Martinez-Torres V, Torres N, Davis JA, Corrales-Medina FF. Anemia and associated risk factors in pediatric patients. Pediatric Health Med Ther. 2023;14:267-280. doi: 10.2147/PHMT.S389105.

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care. 2023 ;46(Suppl 1):S19-S40. doi: 10.2337/dc23-S002.

Lecka-Czernik B. Diabetes, bone and glucose-lowering agents: basic biology. Diabetologia. 2017;60(7):1163–1169. doi: 10.1007/s00125-017-4269-4.

Tebé C, Martínez-Laguna D, Carbonell-Abella C, Reyes C, Moreno V, Diez-Perez A, et al. The association between type 2 diabetes mellitus, hip fracture, and post-hip fracture mortality: a multi-state cohort analysis. Osteoporos Int. 2019;30(12):2407-2415. doi: 10.1007/s00198-019-05122-3.

Harris MM, Houtkooper LB, Stanford VA, Parkhill C, Weber JL, Flint-Wagner H, et al. Dietary iron is associated with bone mineral density in healthy postmenopausal women. J Nutr. 2003;133(11):3598-3602. doi: 10.1093/jn/133.11.3598.

Singh DK, Winocour P, Farrington K. Erythropoietic stress and anemia in diabetes mellitus. Nat Rev Endocrinol. 2009;5(4):204-210. doi: 10.1038/nrendo.2009.17.

Yan C, Zhang J, An F, Wang J, Shi Y, Yuan L, et al. Research progress of ferroptosis regulatory network and bone remodeling in osteoporosis. Front Public Health. 2022;10:910675. doi: 10.3389/fpubh.2022.910675.

Liu X, An J. Dietary iron intake and its impact on osteopenia/osteoporosis. BMC Endocr Disord. 2023;18;23(1):154. doi: 10.1186/s12902-023-01389-0.

Shi L, Lin CL, Su CH, Lin KC, Leong KH, Wang YT, et al. The risk of developing osteoporosis in hemolytic anemia: What aggravates the bone loss? J Clin Med. 2021;10(15):3364. doi: 10.3390/jcm10153364.

Abdel Aziz ZS, Dawood NH. Al-Khalisy M. Evaluation of the effect of type II diabetes mellitus on bone mineral density of upper and lower limbs by dual-energy X-ray absorptiometry. J Fac Med Bagdad. 2023;65(1):27-33. doi: 10.32007/jfacmedbagdad.6511980.

Kharroubi A, Karmi B, Shamasneh W, Saba E. Bone mineral density among Palestinian patients suffering from hemoglobinopathy disorders. Arch Osteoporos. 2020;15(1):181. doi: 10.1007/s11657-020-00853-x.

Abed E, Rasheed MK, Hussein KG. Assessment of total procollagen type 1 intact N-terminal propeptide, C-telopeptide of type 1 collagen, bone mineral density and its relationship to body mass index in men with type 2 diabetes. J Fac Med Baghdad. 2022; 64(2):81-85. doi: 10.32007/jfacmedbagdad.6421942.

Hamdi RA. Evaluation of serum osteocalcin level in Iraqi postmenopausal women with primary osteoporosis. J Fac Med Baghdad. 2013;55(2):166-169. doi: 10.32007/jfacmedbagdad.552649.

Dawood NS, Mussttaf RA, AL-Sahlanee MHR. Model for prediction of the weight and height measurements of patients with disabilities for diagnosis and therapy. Int J Bioautomation. 2021:25(4):343-352. doi: 10.7546/ijba.2021.25.4.000824.

Valderrábano RJ, Lui LY, Lee J, Cummings SR, Orwoll ES, Hoffman AR, et al. Bone density loss is associated with blood cell counts. J Bone Miner Res. 2017;32(2):212-220. doi: 10.1002/jbmr.3000.

Liang X, Du Y, Wen Y, Liu L, Li P, Zhao Y, et al. Assessing the genetic correlations between blood plasma proteins and osteoporosis: A polygenic risk score analysis. Calcif Tissue Int. 2019;104(2):171-181. doi: 10.1007/s00223-018-0483-4.

Lovejoy CO, McCollum MA. Spinopelvic pathways to bipedality: why no hominids ever relied on a bent-hip-bent-knee gait. Philos Trans R Soc Lond B Biol Sci. 2010;365(1556):3289-99. doi: 10.1098/rstb.2010.0112.

McCollum MA, Rosenman BA, Suwa G, Meindl RS, Lovejoy CO. The vertebral formula of the last common ancestor of African apes and humans. J Exp Zool B Mol Dev Evol. 2010;314(2):123-134. doi: 10.1002/jez.b.21316.

Gadó K, Khodier M, Virág A, Domján G, Dörnyei G. Anemia of geriatric patients. Physiol Int. 2022;109(2):119-134. doi: 10.1556/2060.2022.00218.

Yang J, Li Q, Feng Y, Zeng Y. Iron deficiency and iron deficiency anemia: Potential risk factors in bone loss. Int J Mol Sci. 2023; 24(8):6891. doi: 10.3390/ijms24086891.

Hannemann A, Nauck M, Völzke H, Weidner H, Platzbecker U, Hofbauer LC, et al. Interactions of anemia, FGF-23, and bone in healthy adults-results from the study of health in pomerania (SHIP). J Clin Endocrinol Metab. 2021;106(1):e288-e299. doi: 10.1210/clinem/dgaa716.

Jassim NA. Bone mineral density status in 48 Iraqi hyperthyroid patients. J Fac Med Baghdad. 2009;51(2):136-138. doi: 10.32007/jfacmedbagdad.5121141.

Chuang TL, Koo M, Chuang MH, Wang YF. Bone mineral density and hemoglobin levels: Opposite associations in younger and older women. Int J Environ Res Public Health. 2021;18(10):5495. doi: 10.3390/ijerph18105495.