title: Gender differences in severity of sickle cell diseases in non-smokers.
abstract: OBJECTIVE
  To find out gender differences in severity of sickle cell diseases (SCDs) in non-smokers.
  
  
  METHODS
  Three groups of SCDs patients on the basis of red blood cell (RBC) transfusions were included. Less than 10 units in their lives were kept in Group-1, Ten units of higher in Group-2 and 50 units or higher as the Third Group. Patients with a history of using one pack of cigarettes -year or above were excluded.
  
  
  RESULTS
  The study included 269 patients. Mean ages of the groups were similar (28.4, 28.5, and 28.9 years, respectively). Prevalences of cases without any RBC transfusion in their lives were 7.2% and 3.7% in females and males, respectively (p<0.05). Prevalences of cases without any painful crisis were 13.8% and 6.0% in females and males, respectively (p<0.001). There was progressive increase according to mean painful crises, clubbing, chronic obstructive pulmonary disease (COPD), leg ulcers, stroke, chronic renal disease (CRD), pulmonary hypertension, and male ratio from the first towards the third groups (p<0.05, nearly for all). Mean ages of mortal cases were 29.1 and 26.2 years in females and males, respectively (p>0.05).
  
  
  CONCLUSIONS
  The higher painful crises per year, digital clubbing, COPD, leg ulcers, stroke, CRD, pulmonary hypertension, and male ratio of the third group, lower male ratio of patients without any RBC transfusion, lower male ratio of patients without any painful crisis, lower mean ages of male SCDs patients with mortality, and longer overall survival of females in the world could not be explained by well known strong atherosclerotic effects of smoking alone, instead it may be explained by the dominant role of male sex in life.
authors.affiliation: Mehmet Rami Helvaci, MD, Assoc. Prof. of Internal Medicine, Medical Faculty of the Mustafa Kemal University, Antakya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Rami Helvaci
authors.affiliation: Orhan Ayyildiz, MD, Professor of Internal Medicine, Faculty of the Dicle University, Diyarbakir, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Ayyildiz
authors.affiliation: Mehmet Gundogdu, MD, Professor of Internal Medicine, Medical Faculty of the Ataturk University, Erzurum, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gundogdu
keywords: Atherosclerosis; Gender differences; Non-smokers; Sickle cell diseases