Is Anemia a Risk Factor for Osteoporosis in the Spine?
New Study Looks at Anemia and Bone Mineral Density in Postmenopausal Women
In a study that published in the March 2012 edition of the European Journal of Internal Medicine, researchers examined the link between bone mineral density (BMD)—specifically BMD in the spine and femur—and anemia in postmenopausal women (with and without osteoporosis) living in Turkey.
The results of their study appear in the article “Anemia as a risk factor for low bone mineral density in postmenopausal Turkish women.” A total of 371 postmenopausal women were included in the study.
Researchers used dual-energy x-ray absorptiometry (DXA) to determine if the women had osteopenia or osteoporosis; they also measured hemoglobin levels in these women to determine whether they were anemic.
Out of the 371 women, researchers found that 82 of them were anemic.
The study participants who had osteopenia or osteoporosis (T-score <-1.0 SD) were grouped as having low bone mass (LBM).
In the study, the research team found that the anemic women were older and had a significantly longer duration of menopause.
Additionally, when compared with the participants who had normal hemoglobin levels, the anemic women had significantly lower scores overall; they had lower femur T-scores, femur BMD, femur Z-scores, spinal T-scores, spinal BMD, and spinal Z-scores (p<0.001).
It was also noted that the ratio of study participants who had LBM in the femur (p<0.002) and spine (p<0.002) was significantly higher in the anemic women.
When using bi-variate correlation analysis, the researchers determined that there is a significant relationship between hemoglobin values and femur T-scores (r=0.150; p=0.004), femur BMD (r=0.148; p=0.004), spine T-scores (r=0.160; p=0.002), and spine BMD (r=0.164; p=0.001) in the study population.
Using logistic regression analysis, the research team also found that anemia in these women was an independent predictor of LBM in the spine (odds ratio: 2.483; 95% confidence interval [CI]: 1.309 to 4.712; p<0.005).
In addition, the number of anemic women was significantly higher in both the low femur BMD (56 vs 26; p=0.01) and low spine BMD (66 vs. 16; p=0.002) groups.
After adjusting for body mass index and other confounders in postmenopausal Turkish women, the researchers concluded that anemia is an independent predictor of low bone mass in the spine.