BODY MASS INDEX AND IRON INDICES OF ADULT SICKLE CELL ANEMIA SUBJECTS VISITING LAGOS UNIVERSITY TEACHING HOSPITAL
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Abstract
Sickle cell anemia (SCA) is a major health problem in Nigeria, contributing greatly to illness and death. Nutrition and iron balance play key roles in how the disease progresses. Body mass index (BMI) affects the general health of SCA patients, while changes in iron levels, whether too low or too high, can worsen anemia and related complications. This study examined the relationship between body mass index (BMI) and iron indices among adult sickle cell anemia (SCA) patients attending the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos and to determine their association with disease severity. A cross-sectional analytical design was adopted, involving 45 confirmed HbSS patients and 45 HbAA age- and sex-matched controls. Data on sociodemographic characteristics, pain frequency, and disease severity were obtained using structured questionnaires, the Adult Sickle Cell Quality of Life
Measurement Information System (ASCQ-ME), and the Modified Disease Severity Scoring System for SCA. Anthropometric variables were measured following
standard protocols, and BMI was classified based on WHO criteria. Blood samples were analyzed for full blood count, serum iron, serum ferritin, and total iron-binding
capacity (TIBC) using standard ELISA and spectrophotometric techniques. Disease severity score was obtained for each Hbss subject by summing up the scores for crisis rate, number of complications and degree of anemia. HbSS total scores of <3 were considered to have mild anemia. Those with score of > 3 but < and =7 were taken have moderately anemia while subjects with scores > 7 were deemed to have severe
anemia. Most participants were young adults. In the SCA group, 46.7% were aged 18–25, while 40% of the control group fell within this range. Participants aged 26–35 constituted 20% of the SCA group and 17.8% of controls. Those aged 36–45
represented 22.2% of the SCA group and 28.9% of the controls. Smaller proportions were observed in the 46–55 age bracket, with both groups recording 8.9%. Only a few
participants were 56 years and above, comprising 2.2% of the SCA group and 4.4% of the control group. The SCA patients had significantly lower hemoglobin (HGB), packed cell volume (PCV), and red blood cell (RBC) counts compared to controls (p
< 0.001). Mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were significantly higher in SCA subjects (p < 0.001). Ferritin concentrations were markedly elevated (p < 0.001), whereas TIBC was significantly reduced (p < 0.001). Serum iron levels did not differ significantly between groups (p > 0.05). BMI distribution indicated that 28 (62.2%) of the SCA subjects had normal weight, 13
(28.9%) were underweight, and 4 (8.9%) overweight. Lower BMI correlated with more severe anemia and higher disease severity scores (p < 0.05). Painful crises were common, with vaso-occlusive crisis and acute chest syndrome observed in all patients, while mild to moderate anemia predominated (75.6%). In conclusion, this study demonstrates that low TIBC and elevated serum ferritin are frequent among adult
SCA patients, reflecting chronic inflammation and increased iron stores within the reticuloendothelial system. Nutritional monitoring and iron indices evaluation should be integral to routine care for SCA patients to reduce disease complications and improve quality active life.
Measurement Information System (ASCQ-ME), and the Modified Disease Severity Scoring System for SCA. Anthropometric variables were measured following
standard protocols, and BMI was classified based on WHO criteria. Blood samples were analyzed for full blood count, serum iron, serum ferritin, and total iron-binding
capacity (TIBC) using standard ELISA and spectrophotometric techniques. Disease severity score was obtained for each Hbss subject by summing up the scores for crisis rate, number of complications and degree of anemia. HbSS total scores of <3 were considered to have mild anemia. Those with score of > 3 but < and =7 were taken have moderately anemia while subjects with scores > 7 were deemed to have severe
anemia. Most participants were young adults. In the SCA group, 46.7% were aged 18–25, while 40% of the control group fell within this range. Participants aged 26–35 constituted 20% of the SCA group and 17.8% of controls. Those aged 36–45
represented 22.2% of the SCA group and 28.9% of the controls. Smaller proportions were observed in the 46–55 age bracket, with both groups recording 8.9%. Only a few
participants were 56 years and above, comprising 2.2% of the SCA group and 4.4% of the control group. The SCA patients had significantly lower hemoglobin (HGB), packed cell volume (PCV), and red blood cell (RBC) counts compared to controls (p
< 0.001). Mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were significantly higher in SCA subjects (p < 0.001). Ferritin concentrations were markedly elevated (p < 0.001), whereas TIBC was significantly reduced (p < 0.001). Serum iron levels did not differ significantly between groups (p > 0.05). BMI distribution indicated that 28 (62.2%) of the SCA subjects had normal weight, 13
(28.9%) were underweight, and 4 (8.9%) overweight. Lower BMI correlated with more severe anemia and higher disease severity scores (p < 0.05). Painful crises were common, with vaso-occlusive crisis and acute chest syndrome observed in all patients, while mild to moderate anemia predominated (75.6%). In conclusion, this study demonstrates that low TIBC and elevated serum ferritin are frequent among adult
SCA patients, reflecting chronic inflammation and increased iron stores within the reticuloendothelial system. Nutritional monitoring and iron indices evaluation should be integral to routine care for SCA patients to reduce disease complications and improve quality active life.
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