title: Weight status of children with sickle cell disease.
abstract: OBJECTIVE
  Historically, many children and adolescents with sickle cell disease (SCD) were underweight. Treatment advances like hydroxyurea have been associated with improved growth. We hypothesized that increased hemoglobin (Hb) levels would be associated with increased weight status of children with SCD.
  
  
  METHODS
  Investigators at 6 institutions conducted a retrospective chart review of all patients aged 2 to 19 years of age for the calendar years 2007-2009. Height, weight, baseline Hb levels, demographic information, and select comorbidities were recorded from the most recent clinic visit. Overweight and obesity were defined as ≥85th and ≥95th BMI percentiles for age and gender, respectively, and underweight was defined as <5th BMI percentile.
  
  
  RESULTS
  Data were collected on 675 children and adolescents in 3 New England states. In this sample, 22.4% were overweight or obese, whereas only 6.7% were underweight. Overweight or obese status was associated with sickle genotypes other than Hb SS or Hb Sβ(0) disease, and were associated with higher baseline Hb levels. Underweight individuals were more likely to be male, older, and have had at least 1 SCD-related complication. After adjusting for demographic factors, any SCD-related complication, SCD-directed treatments, and obesity-related conditions, there was a 36% increased odds of overweight/obesity for each 1 g/dL increase in baseline Hb levels.
  
  
  CONCLUSIONS
  Nearly one-quarter of children and adolescents with SCD in New England are overweight or obese. Longitudinal studies are needed to determine the impact of elevated BMI on the morbidity and mortality of both children and adults with SCD.
authors: Division of Pediatric Hematology/Oncology, Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, 593 Eddy St, Providence, RI 02903, USA. achawla@lifespan.org
authors: Anjulika
authors: A
authors: Chawla
authors: Philippa G
authors: PG
authors: Sprinz
authors: Jennifer
authors: J
authors: Welch
authors: Matthew
authors: M
authors: Heeney
authors: Naheed
authors: N
authors: Usmani
authors: Farzana
authors: F
authors: Pashankar
authors: Patricia
authors: P
authors: Kavanagh
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications* / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009511:New England; D009765:Obesity / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D050177:Overweight / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013851:Thinness / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006454:Hemoglobins