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Abstract
Background: Atherosclerosis
may be the main cause of aging
and shortened survival in
human beings.
Methods:
All patients with sickle cell
diseases (SCD) were included.
Results:
We studied 222 males and 212
females with similar mean
ages (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 lives (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), stroke
(12.1% vs 7.5%, p<0.05),
chronic renal disease (9.9%
vs 6.1%, p<0.05), cirrhosis
(8.1% vs 1.8%, p<0.001),
chronic obstructive pulmonary
disease (25.2% vs 7.0%, p<0.001),
coronary heart disease (18.0%
vs 13.2%, p<0.05), leg
ulcers (19.8% vs 7.0%, p<0.001),
and clubbing (14.8% vs 6.6%,
p<0.001) were all higher
in males.
Conclusion:
As an accelerated atherosclerotic
process, hardened RBC-induced
capillary endothelial damage
initiated at birth terminates
with multiorgan insufficiencies
in early decades in the SCD.
Diabetes mellitus (DM) may
actually be one of the atherosclerotic
endpoints of the pancreas.
Although all of the above
atherosclerotic consequences
are frequent in SCD, we have
not detected any case of DM
probably due to the significantly
lower body mass indexes of
them. Similarly, just 20%
of elderly have DM, but 55%
of patients with DM are obese.
So excess fat tissue may be
much more significant than
smoking, alcohol, or other
chronic inflammatory or infectious
processes for systemic atherosclerosis.
Acarbose and metformin are
safe, cheap, oral, long-term
used, and effective drugs
for loss of excess fat tissue.
Key
words: Sickle cell diseases,
excess fat tissue, capillary
endothelial inflammation,
atherosclerotic endpoints,
diabetes mellitus, acarbose,
metformin
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