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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 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 (CRD)
(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 failures in
early decades in SCD. Excess
fat may be more important
than smoking and alcohol for
atherosclerosis since excess
weight-induced diabetes mellitus
is the most common cause of
the CRD. The efficacy of acarbose
to lower blood glucose by
preventing breakdown of starch
into sugar in the small intestine
is well-known. Since acarbose
is a safe, cheap, oral, long-term
used, and effective drug for
excess weight, it should be
prescribed in prevention of
stroke, particularly after
the age of 50 years even in
cases with normal weight because
there are nearly 19 kg of
excess fat even between the
lower and upper borders of
normal weight in adults.
Key
words: Sickle cell diseases,
stroke, acarbose, capillary
endothelial inflammation,
excess fat tissue, systemic
atherosclerosis, smoking
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