Abstract

Background: Atherosclerosis may be the main cause of aging and death.

Methods: All patients with sickle cell diseases (SCD) were included.

Results: We studied 222 males and 212 females with mean ages of 30.8 vs 30.3 years, p>0.05, respectively. Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBC) in their lifespans (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% vs 7.0%, p<0.001), coronary heart disease (CHD) (18.0% vs 13.2%, p<0.05), cirrhosis (8.1% vs 1.8%, p<0.001), leg ulcers (19.8% vs 7.0%, p<0.001), clubbing (14.8% vs 6.6%, p<0.001), chronic renal disease (CRD) (9.9% vs 6.1%, p<0.05), and stroke (12.1% vs 7.5%, p<0.05) were all higher in males.

Conclusion: As an accelerated atherosclerosis, hardened RBC-induced capillary endothelial damage initiating at birth terminates with multiorgan failures in early years of life in SCD. Excess fat tissue may be much more important than smoking and alcohol for atherosclerosis because excess weight-induced diabetes mellitus is the most common cause of CRD, and CHD and stroke are the main causes of deaths even in the COPD. The efficacy of acarbose to lower blood glucose by preventing breakdown of starch into sugar in the small intestine is obvious. Since acarbose is a safe, cheap, oral, and effective drug for excess weight, it should be advised in COPD because there are nearly 20 kg of excess fat even between upper and lower borders of normal weight in adults.

Key words: Acarbose, chronic obstructive pulmonary disease, sickle cell diseases, excess fat tissue, smoking, vascular endothelial inflammation, atherosclerosis