Alterations in basal nutrient metabolism increase  resting energy expenditure in sickle cell disease

Borel, Myfanwy J.; Buchowski, Maciej S.; Turner, Edward L.; Peeler, Benjamin B.; Goldstein, Richard E.; Flakoll, Paul J.

doi:10.1152/ajpendo.1998.274.2.e357

Cited by 32 publications

(33 citation statements)

References 35 publications

(45 reference statements)

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“…Resting energy expenditure was increased in several studies of children with SCD and is probably related to anemia, chronic inflammation, high cardiac output, and high protein turnover. [33][34][35] Interventions that decrease anemia and inflammation may have a beneficial effect on growth as well. HU has modest effects on the severity of hemolysis and anemia and may also decrease inflammation.…”

Section: Discussionmentioning

confidence: 99%

Hydroxyurea and Growth in Young Children With Sickle Cell Disease

et al. 2014

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BACKGROUND: Growth impairment is a known complication of sickle cell disease. Effects of hydroxyurea (HU) on growth in very young children are not known. METHODS: Height, weight, BMI, and head circumference (HC) were compared with World Health Organization (WHO) standards in BABY HUG, a multicenter, randomized, double-blinded, placebo-controlled 2-year clinical trial of HU in 193 children 9 to 18 months of age. Anthropometric data were closely monitored and converted to z scores by using WHO standardized algorithms for descriptive analyses. The treatment and placebo groups were compared longitudinally by using a mixed model analysis. RESULTS: At entry, the z scores of BABY HUG children were higher than WHO norms. After 2 years of HU or placebo treatment, there were no significant differences between the groups, except for the mean HC z scores at study exit (HU: +0.8 versus placebo: +1.0, P = .05). Baseline z scores were the best predictors of z scores at study exit. The absolute neutrophil count, absolute reticulocyte count, and total white blood cell count had significant negative correlations with growth measures. CONCLUSIONS: Both groups had normal or near normal anthropometric measures during the study. The HC z scores at study entry and exit were slightly greater than WHO norms. Higher baseline white blood cell count, absolute reticulocyte count, and absolute neutrophil count were associated with poorer growth. The significance of the slightly lower HC in the treatment group at study exit is not clear. Trends toward normalization of weight and height and effects on HC will be monitored in ongoing BABY HUG follow-up studies.

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Section: Discussionmentioning

confidence: 99%

Hydroxyurea and Growth in Young Children With Sickle Cell Disease

et al. 2014

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“…3 Energy and nutrient supplies are likely to be limited or compromised in SCA by a combination of factors: (i) reduced intake 4 potentially from the anorexic effects of comorbidities; 5 (ii) decreased absorption of nutrients; (iii) increased degradation and losses of nutrients; 6 increased requirements from an elevated basal metabolic rate; 7 and alterations in metabolic pathways. 8,9 Poor growth has been previously documented in SCA. [10][11][12] However, the causes and clinical significance are not well understood.…”

Section: Introductionmentioning

confidence: 95%

Nutritional status, hospitalization and mortality among patients with sickle cell anemia in Tanzania

Cox¹,

Makani²,

Fulford³

et al. 2011

Haematologica

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BackgroundReduced growth is common in children with sickle cell anemia, but few data exist on associations with long-term clinical course. Our objective was to determine the prevalence of malnutrition at enrolment into a hospital-based cohort and whether poor nutritional status predicted morbidity and mortality within an urban cohort of Tanzanian sickle cell anemia patients. Design and MethodsAnthropometry was conducted at enrolment into the sickle cell anemia cohort (n=1,618; ages 0.5-48 years) and in controls who attended screening (siblings, walk-ins and referrals) but who were found not to have sickle cell anemia (n=717; ages 0.5-64 years). ResultsSickle cell anemia was associated with stunting (OR=1.92, P<0.001, 36.2%) and wasting (OR=1.66, P=0.002, 18.4%). The greatest growth deficits were observed in adolescents and in boys. Independent of age and sex, lower hemoglobin concentration was associated with increased odds of malnutrition in sickle cell patients. Of the 1,041 sickle cell anemia patients with a body mass index z-score at enrolment, 92% were followed up until September 2009 (n=908) or death (n=50). Body mass index and weight-for-age z-score predicted hospitalization (hazard ratio [HZR]=0.90, P=0.04 and HZR=0.88, P=0.02) but height-for-age z-score did not (HZR=0.93, NS). The mortality rate of 2.5 per 100 person-years was not associated with any of the anthropometric measures. ConclusionsIn this non-birth-cohort of sickle cell anemia with significant associated undernutrition, wasting predicted an increased risk of hospital admission. Targeted nutritional interventions should prioritize treatment and prevention of wasting.Key words: sickle cell anemia, nutrition, growth, anthropometry, Africa, mortality, morbidity. Citation

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“…In humans, for example, it is estimated that ca. 50% of the increase in MR associated with an infection is due to protein synthesis (Borel et al, 1998).…”

Section: Energy Balancementioning

confidence: 99%

Is there an energetic-based trade-off between thermoregulation and the acute phase response in zebra finches?

Burness

Armstrong

Fee

et al. 2010

Journal of Experimental Biology

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SUMMARYThere has been recent interest in understanding trade-offs between immune function and other fitness-related traits. At proximate levels, such trade-offs are presumed to result from the differential allocation of limited energy resources. Whether the costs of immunity are sufficient to necessitate such energy reallocation remains unclear. We tested the metabolic and behavioural response of male zebra finches (Taeniopygia guttata) to the combined effects of thermoregulation and generation of an acute phase response (APR). The APR is the first line of defence against pathogens, and is considered energetically costly. We predicted that at cold temperatures zebra finches would exhibit an attenuated APR when compared with individuals at thermoneutrality. We challenged individuals with bacterial lipopolysaccharide (LPS), an immunogenic compound that stimulates an APR. Following LPS injection, we measured changes in food intake, body mass, activity, and resting and total energy expenditure. When challenged with LPS under ad libitum food, individuals at both temperatures decreased food intake and activity, resulting in similar mass loss. In contrast to predicted energetic trade-offs, cold-exposed individuals injected with LPS increased their nocturnal resting energy expenditure more than did individuals held at thermoneutrality, yet paradoxically lost less mass overnight. Although responding to LPS was energetically costly, resulting in a 10% increase in resting expenditure and 16% increase in total expenditure, there were few obvious energetic trade-offs. Our data support recent suggestions that the energetic cost of an immune response may not be the primary mechanism driving trade-offs between immune system function and other fitness-related traits.

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Alterations in basal nutrient metabolism increase resting energy expenditure in sickle cell disease

Cited by 32 publications

References 35 publications

Hydroxyurea and Growth in Young Children With Sickle Cell Disease

Hydroxyurea and Growth in Young Children With Sickle Cell Disease

Nutritional status, hospitalization and mortality among patients with sickle cell anemia in Tanzania

Is there an energetic-based trade-off between thermoregulation and the acute phase response in zebra finches?

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