Levels of high-density lipoprotein cholesterol (HDL-C) among children with steady-state sickle cell disease.
BACKGROUND
The search for sickle cell disease (SCD) prognosis biomarkers is a challenge. These markers identification can help to establish further therapy, later severe clinical complications and with patients follow-up. We attempted to study a possible involvement of levels of high-density lipoprotein cholesterol (HDL-C) in steady-state children with SCD, once that this lipid marker has been correlated with anti-inflammatory, anti-oxidative, anti-aggregation, anti-coagulant and pro-fibrinolytic activities, important aspects to be considered in sickle cell disease pathogenesis.


METHODS
We prospectively analyzed biochemical, inflammatory and hematological biomarkers of 152 steady-state infants with SCD and 132 healthy subjects using immunochemistry, immunoassay and electronic cell counter respectively. Clinical data were collected from patient medical records.


RESULTS
Of the 152 infants investigated had a significant positive association of high-density lipoprotein cholesterol with hemoglobin (P < 0.001), hematocrit (P < 0.001) and total cholesterol (P < 0.001) and a negative significant association with reticulocytes (P = 0.046), leukocytes (P = 0.015), monocytes (P = 0.004) and platelets (P = 0.005), bilirubins [total bilirubin (P < 0.001), direct bilirubin (P < 0.001) and indirect bilirubin (P < 0.001], iron (P < 0.001), aminotransferases [aspartate aminotransferase (P = 0.004), alanine aminotransferase (P = 0.035)], lactate dehydrogenase (P < 0.001), urea (P = 0.030), alpha 1-antitrypsin (P < 0.001), very low-density lipoprotein cholesterol (P = 0.003), triglycerides (P = 0.005) and hemoglobin S (P = 0.002). Low high-density lipoprotein cholesterol concentration was associated with the history of cardiac abnormalities (P = 0.025), pneumonia (P = 0.033) and blood transfusion use (P = 0.025). Lipids and inflammatory markers were associated with the presence of cholelithiasis.


CONCLUSIONS
We hypothesize that some SCD patients can have a specific dyslipidemic subphenotype characterized by low HDL-C with hypertriglyceridemia and high VLDL-C in association with other biomarkers, including those related to inflammation. This represents an important step toward a more reliable clinical prognosis. Additional studies are warranted to test this hypothesis and the probably mechanisms involved in this complex network of markers and their role in SCD pathogenesis.
Seixas
Magda O
MO
Laboratório de Patologia e Biologia Molecular, Centro de Pesquisa Gonçalo Moniz, Fundação de Pesquisa Oswaldo Cruz (FIOCRUZ), Salvador, Bahia, Brasil.
Rocha
Larissa C
LC
Carvalho
Mauricio B
MB
Menezes
Joelma F
JF
Lyra
Isa M
IM
Nascimento
Valma M L
VM
Couto
Ricardo D
RD
Atta
Ájax M
ÁM
Reis
Mitermayer G
MG
Goncalves
Marilda S
MS
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002769:Cholelithiasis / Q000150:complications / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000453:epidemiology; D006461:Hemolysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008499:Medical Records; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis
D015415:Biomarkers; D008076:Cholesterol, HDL; D018836:Inflammation Mediators; D008055:Lipids
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