Higher values of triglycerides:HDL-cholesterol ratio hallmark disease severity in children and adolescents with sickle cell anemia

Teixeira, Rozana dos Santos; Arriaga, María B.; Terse-Ramos, Regina; Ferreira, Tatiane Anunciação; Machado, V.R.; Rissatto‐Lago, Mara Renata; Silveira-Mattos, Paulo S.; Boa‐Sorte, Ney; Ladeia, Ana Marice; Andrade, Bruno B.

doi:10.1590/1414-431x20198833

Cited by 17 publications

(22 citation statements)

References 32 publications

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“…Our findings stand in agreement with other studies that also reported decreased total cholesterol, HDL-C, and LDL-C levels among SCA individuals in comparison to HbAA individuals [ 19 , 20 , 25 , 27 ]. It is thought that the hypocholesterolemia seen in SCA results from the augmented cholesterol utilization in erythropoiesis consequent to anemia and hemolysis.…”

Section: Discussionsupporting

confidence: 94%

“…In addition, the occurrence of hypocholesterolemia in patients with nonhemolytic anemia suggests increased erythropoietic activity [ 17 ]. Moreover, it is also relevant to point that our investigation was carried out in a pediatric population of SCA patients, which could explain some discrepancies with data in the literatures, such as lack of association with different clinical manifestations; however, many of our results are in accordance with previous publications involving patients of a similar age, as well as adults [ 19 , 20 , 25 ]. The cross-sectional design of our study made it difficult to establish any causative roles for lipid parameters with regard to clinical manifestations in SCA, yet the relevant associations found herein will be useful in guiding further evaluations.…”

Section: Discussionsupporting

confidence: 80%

“…As has been previously demonstrated by several studies, the significant alterations in lipid parameters presented by SCA patients have been associated with hemolysis, anemia, vasoocclusive crises, activation of the TGF- β pathway, pulmonary hypertension, acute chest syndrome, and other complications [ 18 – 21 , 24 , 25 ]. Thus, we decided to investigate associations between the lipid profile in SCA individuals and previous history of clinical manifestations.…”

Section: Discussionmentioning

confidence: 90%

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Investigation of Lipid Profile and Clinical Manifestations in SCA Children

et al. 2020

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Introduction. Clinical complications in sickle cell anemia (SCA) are heterogeneous and involve several molecules. It has been suggested that SCA individuals present a dyslipidemic phenotype and that lipid parameters are associated with severe clinical complications, such as pulmonary hypertension. We sought to investigate associations between lipid parameters and clinical manifestations, as well as other laboratory parameters in a population of pediatric SCA patients. Methods. Our cross-sectional evaluation included 126 SCA patients in steady state and who were not undergoing lipid-lowering therapy. Hematological and biochemical parameters were characterized, and previous clinical manifestations were investigated. Results. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels were increased in patients with a previous history of pneumonia, which also positively correlated with HbS levels. Decreased LDL-C levels were also associated with leg ulcers and anemia. Elevated high-density lipoprotein cholesterol (HDL-C) levels were associated with pain crises, increased viscosity, and decreased hemolysis. Several studies have determined that lipids play a role in the vascular impairment seen in SCA, which was corroborated by our findings. Conclusions. In sum, our results suggest that total cholesterol, HDL-C, and LDL-C levels are associated with hemolysis and anemia markers and, most importantly, with clinical complications related to vasculopathy in SCA.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 90%

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Investigation of Lipid Profile and Clinical Manifestations in SCA Children

et al. 2020

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“…Hypocholesterolemia in SCD patients has been reported in many SCD cohort studies worldwide, yet the mechanism, pathophysiological manifestations, and association with mortality rate of these altered lipid levels have yet to be 3 BioMed Research International clarified [26][27][28]. Additionally, Song et al have found that the cholesterol level has a U-shaped relation with mortality among Korean adult males and the probability of mortality is increased in patients with cholesterol levels below 135 mg/dL compared to those with cholesterol level between 135 and 200 mg/dL.…”

Section: Discussionmentioning

confidence: 99%

Plasma Lipids and Lipoproteins in Sickle Cell Disease Patients in the Northern West Bank, Palestine

Samarah

Srour

Dumaidi

2021

BioMed Research International

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Background. Lipid metabolism may be altered in red cell genetic disorders. The erythrocyte and plasma lipids are defected which may increase the risk of cardiovascular disease. In the present study, we hypothesized a possible link between severity of anemia and altered lipid profile in SCD. Methods. A total of 151 SCD patients, including 62 patients with sickle cell anemia (SS), 54 patients with sickle β-thalassemia (ST), and 35 individuals with sickle cell trait (AS), were studied. The control group consisted of 160 healthy individuals. Total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) were enzymatically measured. Results. Total cholesterol and LDL-C were significantly lower ( P value < 0.001) in SS and ST patients compared to AS individuals and AA controls. However, LDL-C was significantly lower in AS individuals (both males and female) compared to AA controls ( P value < 0.001). The HDL-C in SS and ST patients (both males and females) was significantly lower than that in AS individuals ( P value < 0.001). In addition, the HDL-C was significantly higher in SS and ST males and AS (males and females) compared to AA controls ( P value < 0.001). The HDL-C was also significantly higher in SS males ( P value < 0.001) and females ( P value < 0.05) compared to ST patients. The HDL-C was significantly higher in AS individuals ( P value < 0.001) compared to AA controls. The triglycerides in SS males was significantly lower than that in ST patients ( P value < 0.001), but there was no significant difference when compared to AS individuals and AA controls. In contrast, triglycerides in SS females were significantly lower than those in ST ( P value < 0.05), AS ( P value < 0.001), and AA controls ( P value < 0.001). In males of ST patients, triglycerides were significantly higher than those observed in AS males and AA males ( P value < 0.001). In contrast, females of ST patients have a significantly lower triglycerides compared to AS and AA females ( P value < 0.001). Conclusions. In SCD, the plasma is affected in some way, especially the plasma cholesterol that was investigated in this study. Further prospective studies should examine the contribution of an altered lipid profile to the severity and clinical complications in SCD patients.

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“…Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels were determined using an A25 chemistry analyzer (Biosystems S.A, Barcelona, Catalunya, Spain), while LDL-C and VLDL-C levels were determined by the Friedewald equation [ 26 ]. TC/HDL-C, LDL-C/HDL-C, and triglyceride/HDL-C ratios were calculated to evaluate cardiovascular risk [ 27 – 31 ]. In addition, non-HDL-C was calculated by TC–HDL-C [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

Transforming Growth Factor Beta Receptor 3 Haplotypes in Sickle Cell Disease Are Associated with Lipid Profile and Clinical Manifestations

Santiago

Figueiredo

Fiuza

et al. 2020

Mediators of Inflammation

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Individuals with sickle cell disease (SCD) present both chronic and acute inflammatory events. The TGF-β pathway is known to play a role in immune response, angiogenesis, inflammation, hematopoiesis, vascular inflammation, and cell proliferation. Polymorphisms in the transforming growth factor-beta receptor 3 (TGFBR3) gene have been linked to several inflammatory diseases. This study investigated associations between two TGFBR3 haplotypes and classical laboratory parameters, as well as clinical manifestations, in SCD. We found that individuals with the GG haplotype presented higher levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides, non-HDL cholesterol, total proteins, and globulin than individuals with non-GG haplotypes. In addition, the GG haplotype was associated with a previous history of pneumonia. Individuals with the CGG haplotype presented increased plateletcrit, TC, LDL-C levels, and non-HDL cholesterol. The CCG haplotype was also associated with a previous history of pneumonia. Our findings suggest that individuals with the GG and CGG haplotypes of TGFBR3 present important alterations in lipid profile.

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Higher values of triglycerides:HDL-cholesterol ratio hallmark disease severity in children and adolescents with sickle cell anemia

Cited by 17 publications

References 32 publications

Investigation of Lipid Profile and Clinical Manifestations in SCA Children

Investigation of Lipid Profile and Clinical Manifestations in SCA Children

Plasma Lipids and Lipoproteins in Sickle Cell Disease Patients in the Northern West Bank, Palestine

Transforming Growth Factor Beta Receptor 3 Haplotypes in Sickle Cell Disease Are Associated with Lipid Profile and Clinical Manifestations

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