Risk factors of metabolic syndrome among adult Sudanese sickle cell anemia patients

Abstract

BackgroundSickle cell disease is a hereditary disorder characterized by haematological anaemia. Several studies assumed that adult sickle patients might develop metabolic syndrome features as hyperglycaemia, hypertension and dyslipidaemia. The aim of this study was to evaluate the metabolic syndrome risk factors among adult Sudanese with sickle cell anemia in the steady state.MethodsA prospective cross sectional study design was conducted among thirty adult patients with sickle cell anemia Hb SS (mean age 23 ± 6.1 years) and thirty healthy individuals matched for age and gender. Waist and hip circumferences were measured by simple tape. Venous blood sample were analysed to detect blood glucose level, uric acid, total cholesterol, triglycerides, low and high-density lipoprotein after 8 h overnight fasting by spectrophotometer. Blood pressure was measured by sphygmomanometer. National Cholesterol Education Program-Adult Treatment Panel III was utilised to define metabolic syndrome. Statistical analysis was performed SPSS software version 23. Continuous data were expressed using mean ± SD. P-value of < 0.05 (two-tailed) was used to establish statistical significance. Unpaired independent T- test was used.ResultsNo significant difference in mean systolic blood pressure in patients group compared to control (P value = 0.3). Mean value of diastolic blood pressure was significantly low in patients group compared to control (65.4 ± 10. 4 VS72.33 ± 8.27 mmHg, P value< 0.001). Fasting triglycerides level was comparable between patients group and control (P value = 0.56). While high-density lipoprotein was significantly lower in sicklers compared to control (30.2 ± 8.2 mg/dL vs 44.71 ± 1.85 mg/dL, P value< 0.001). Fasting blood glucose was significantly low in sickle compared to control (92.6 ± 13 mg/dL vs 106.83 ± 25.11 mg/dL P value< 0.001). Uric acid level was not statistically differed in patients group compared to control (p value = 0.5).ConclusionThere was significant decrease in fasting High-density lipoprotein, diastolic blood pressure, mean arterial pressure and fasting blood glucose among SCA patients compared to control. There was no significant difference in waist circumference, systolic blood pressure, fasting triglycerides and uric acid levels between patients and control groups.

Increased iron stores influence glucose metabolism in sickle cell anaemia

“…Our results differ from some recent studies, in which fasting insulin 5 , fasting insulin and HOMA2‐IR 6 , or fasting glucose 7 were lower in SCA patients than controls. In the first study, however, β‐cell function negatively correlated with ferritin, and patients in the latter two studies were younger than the current cohort.…”

Associations of Hyper-filtration and Proteinuria with Clinical Severity Score among Adult Sudanese Sickle anemia patients

“…In SCA high uric acid level may result from increased haemolysis and rapid turnover of the RBCs and decreased uric acid clearance by the kidneys (29). No significant difference regarding UA between sickle and control group (Table 3), this finding is similar to former study among Sudanese population (24). In this study hyperuricemia is reported only in 6.3% of SCA group; this likely due to the compensation of the high GFR (high UA clearance) among those young group; as age increases, GFR decreases and they may develop higher rates of hyperuricemia (30).…”

“…Significant reduction in diastolic Blood Pressure (BP) was noted (p value 0.02) in SCA group compared to the control group. Other studies also showed similar observations (15,23,24). This may be due to loss of sodium and water related to medullary tonicity defects (25).…”

Endurance training improves oxygen uptake/demand mismatch, metabolic flexibility and recovery in patients with sickle cell disease

“…From that point of view, the present results (elevated RER and %CHOox) suggest that glucose uptake and its subsequent utilization by the skeletal muscle are not dampened in patients with SCD. This latter inference is in accordance with the lower fasting blood glucose observed by Babiker et al 37 . Further studies would be necessary to characterize the relationship between this elevated glucose utilization and risk of metabolic syndrome in SCD; however, the prevalence of metabolic syndrome in sickle cell anemia patients has been reported to be approximately half of that in African-American counterparts 38 .…”