Abstract
Background: Hemoglobin polymerization in sickle cell anemia (SCA) leads to abnormally rigid and adhesive erythrocytes that obstruct blood vessels, leading to poor tissue perfusion, hence provoking inflammation and damage of surrounding tissues. Adiponectin, a protein hormone, presumptively has anti-inflammatory characteristics, hence may be an important therapeutic target in SCA. Aim: The aim of the study was to evaluate the status of adiponectin and its correlation with disease severity in SCA. Patients and Methods: A total of 84 subjects were recruited for the study comprising 34 homozygous sickle cell (HbSS) subjects (25 in the steady state and nine in the resolving crisis state) and 50 controls (25 heterozygous sickle cell [HbAS] and 25 hemoglobin phenotype AA subjects). The hemoglobin phenotype, adiponectin levels, and full blood counts were evaluated. Anthropometric measurements were also conducted. Results: A significant difference was observed in the mean body mass index between the different hemoglobin phenotype groups and also between the SCA in crisis resolution patients and the control group (p < 0.05). There was no significant difference in the median serum levels of adiponectin in the different hemoglobin phenotype groups and between SCA patients in the steady state compared with those in the crisis resolution state. Also, there was no correlation between disease severity and adiponectin in SCA patients in the steady state (p = 0.87). Conclusion: Our study seems to suggest that in our data set of sickle cell anemia patients in the steady state, adiponectin does not constitute part of the endocrinopathy that affects these patients.
Highlights
Sickle cell disease (SCD) is a group of genetic conditions that result from the inheritance of abnormal genes, thereby resulting in the production of abnormal hemoglobin in red blood cells (Akinyanju, 2015)
There was no significant difference in the median serum levels of adiponectin in the different hemoglobin phenotype groups and between sickle cell anemia patients in the steady state and crisis resolution state
We have shown from this study that the mean serum adiponectin levels were not significantly different amongst the subjects from the different hemoglobin phenotypes, which is in contrast to the findings by Makis et al, who reported elevated adiponectin levels in steady state sickle cell anemia patients when compared with control subjects
Summary
Sickle cell disease (SCD) is a group of genetic conditions that result from the inheritance of abnormal genes, thereby resulting in the production of abnormal hemoglobin in red blood cells (Akinyanju, 2015). Keikhaei et al showed that pro-inflammatory cytokines, especially lL-8 and IL-17 were increased in SCD patients in the steady state when compared to those in controls (apparently normal individuals) and increased in the crisis state when compared to the steady state (Keikhaei et al, 2013). This suggests that there is a background inflammation in the steady state which escalates during crisis. Hemoglobin polymerization in sickle cell anemia (SCA) leads to abnormally rigid and adhesive erythrocytes that obstruct blood vessels, leading to poor tissue perfusion, provoking inflammation and damage of surrounding tissues. Adiponectin, a protein hormone, presumptively has anti-inflammatory characteristics, may be an important therapeutic target in SCA
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