Serum homocysteine and disease severity in sickle cell anemia patients in Lagos

拉各斯镰状细胞性贫血患者的血清同型半胱氨酸和疾病严重程度

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作者:Ebele Uche, Oluwaseun Adelekan, Akinsegun Akinbami, Vincent Osunkalu, Kamal Ismail, Ann Abiola Ogbenna, Mulikat Badiru, Adedoyin Dosunmu, Esther Oluwole, Omolara Kamson

Conclusion

Homocysteine levels were significantly higher in HbSS patients compared with matched HbAA controls and showed a positive correlation with disease severity scores in the SCA patients.

Methods

This was a cross-sectional study done among SCA patients in steady state attending the Haematology Clinic of the Lagos State University Teaching Hospital (LASUTH). Matched age and sex HbAA controls were also recruited. Serum homocysteine of each participant was done with enzyme-linked immunosorbent assay and disease severity score assessed in every SCA patient using clinical and laboratory parameters.

Purpose

Hypercoagulability in sickle cell anemia (SCA) may be responsible for the increased development of vascular occlusion in certain organs as well as acute pain episodes. The causes of hypercoagulability in SCA are multifactorial and include raised homocysteine levels. This study, therefore, aimed to determine serum homocysteine levels in SCA patients in steady state and to correlate its levels with SCA disease severity. Patients and

Results

The mean value for homocysteine in the study group (SCA patients) was 19.80±19.75 µmol/L whilst that of the control group was 9.16±4.29 µmol/L. Thirty-nine out of 96 (46.6%) SCA patients had elevated homocysteine levels (>15 µmol/L) whilst all 96 participants in the control group had normal homocysteine levels. The difference in the means in the two groups was statistically significant with p=0.001. Majority (62.5%) of the SCA patients had a mild disease (severity score ≤3). There was a significant correlation between serum homocysteine levels and disease severity scores with p=0.04; χ2=4.04.

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