title: Physical activity level is not a determinant of autonomic nervous system activity and clinical severity in children/adolescents with sickle cell anemia: A pilot study.
abstract: BACKGROUND
  Autonomic nervous system (ANS) activity has been suggested to modulate the clinical severity of sickle cell anemia (SCA) by increasing the risk for vaso-occlusive events. Regular physical activity (PA) is known to improve ANS activity and health status in several cardiovascular and metabolic diseases. Whether regular PA improves the health status of SCA patients remains unknown.
  
  
  METHODS
  Twenty-two patients with SCA and 15 healthy (AA) children/adolescents participated to the study. Heart rate variability was measured in supine position and after a tilt-test to quantify the ANS activity. PA energy expenditure (PAEE) was assessed with questionnaire.
  
  
  RESULTS
  1) PAEE was lower in SCA compared to AA (190 ± 152 vs. 432 ± 277 kcal · d(-1), respectively, P < 0.01), 2) overall ANS activity was lower in SCA compared to AA, 3) parasympathetic withdrawal was observed in SCA with aging, 4) ANS reactivity was slightly impaired in SCA compared to AA (reduction in HFnu: -38 ± 27 vs. -58 ± 14%, respectively, P < 0.05), 5) ANS indices, PAEE, and rates of clinical events were not correlated.
  
  
  CONCLUSIONS
  Both the level of PA and ANS activity are reduced in SCA compared to AA children/adolescents, particularly in those older than 15 years. Neither PAEE, nor ANS activity seem to influence the clinical severity of children/adolescents with SCA.
authors.affiliation: UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France.
authors.forename: Keyne
authors.initials: K
authors.lastname: Charlot
authors.affiliation: UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France.
authors.forename: Berenike
authors.initials: B
authors.lastname: Moeckesch
authors.affiliation: Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Jumet
authors.affiliation: UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Romana
authors.affiliation: UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Waltz
authors.affiliation: Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Lydia
authors.initials: L
authors.lastname: Divialle-Doumdo
authors.affiliation: UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France.
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Hardy-Dessources
authors.affiliation: Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Petras
authors.affiliation: Centre Investigation Clinique Antilles Guyane 1424 Inserm, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Tressières
authors.affiliation: Laboratory MOVE, EA6314, University of Poitiers, Poitiers, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Pichon
authors.affiliation: Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Tarer
authors.affiliation: Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Hue
authors.affiliation: Sickle Cell Center, Academic Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Maryse
authors.initials: M
authors.lastname: Etienne-Julan
authors.affiliation: Laboratory ACTES (EA 3596), Department of Physiology, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Antoine-Jonville
authors.affiliation: UMR Inserm U1134, French West Indies and Guiana University, Pointe-à-Pitre, Guadeloupe, France.|Laboratoire d'Excellence du Globule Rouge (LABEX GR-Ex) PRES Sorbonne, Paris, France.|Institut Universitaire de France (IUF), Paris, France.|Laboratory CRIS EA647, Section Vascular Biology and Red Blood Cell, University of Lyon, Lyon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Connes
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002648:Child; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009043:Motor Activity; D010865:Pilot Projects; D011788:Quality of Life
keywords: acute chest syndrome; heart rate variability; physical activity energy expenditure; sickle cell disease; vaso-occlusive crises