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Cordovil K, Crivelli M, Brito FDSB, Fleury M. Body composition, energy expenditure, and markers of hemolysis in adults with sickle cell disease. THE NORTH AFRICAN JOURNAL OF FOOD AND NUTRITION RESEARCH 2022; 6:55-65. [DOI: 10.51745/najfnr.6.13.55-65] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/03/2022] [Indexed: 08/05/2024]
Abstract
Background: Historically, malnutrition is described in individuals with SCD. However, more recent studies have shown a change in the profile of the nutritional status and distribution of body composition of SCD patients, mainly adult individuals. Aims: To assess the body composition (BC), resting energy expenditure (REE), and the biomarkers of hemolysis in adults with sickle cell disease (SCD). Subjects and Methods: A cross-sectional observational study was performed with 64 individuals over 39 years old in the treatment from two reference centers for SCD located in the city of Rio de Janeiro, Brazil. The dual-energy X-ray absorptiometry (DXA) and indirect calorimetry were used to assess BC and REE, respectively. Blood levels of hemoglobin, reticulocytes, lactate dehydrogenase (LDH), leukocytes, platelets, total and direct bilirubin, total protein, and albumin were measured to assess the hemolysis and protein status. The descriptive and inferential analysis was composed of the different methods (one-way ANOVA with the multiple comparison test of Tukey, Student t-test, and Pearson's correlation coefficient). Were considered statistically significant when the p-values were ≤ 0.05. Results: Most participants with SCD were female sex, colored (brown/black), and mean age of 51.2 years old. The obesity prevalence was 70.7% according to the body fat (BF%), with a major mean among women (p < 0.0001). Men had a higher mean of lean mass (LM) (p=0.0005) and fat-free mass (FFM) (p=0.0007). There was no difference for REE in comparing the genotypes (p= 0.53), and genders (p=0.075). The hemolysis markers (LDH, reticulocytes, and TB) correlated inversely with BMI (p=0.013), FM (p=0.022), and FFM (p=0.034). Conclusions: The important change observed in body composition in people with sickle cell disease was characterized by a high percentage of fat body and a decrease in lean mass. The hemolysis markers LDH, reticulocytes, and BT correlated inversely with BMI, FM, and FFM indicating that high levels of hemolysis may affect nutritional status, without influencing the REE.
Keywords: sickle cell disease, body composition, fat mass, fat-free mass, energy expenditure, hemolysis.
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Affiliation(s)
- Karen Cordovil
- Postgraduate Program in Medical Science, Medical Science College, State University of Rio de Janeiro. Professor Manoel de Abreu Avenue, 444, second floor, Vila Isabel. Rio de Janeiro, RJ, Brazil. Zip Code 20550-170
| | - Marise Crivelli
- Postgraduate Program in Nutrition, Food and Health, Nutrition Institute, State University of Rio de Janeiro. São Francisco Xavier Street, 900, João Lyra Filho Pavilion, Twelfth floor, Maracanã, Rio de Janeiro, RJ, Brazil. Zip Code 20550-000
| | - Flávia dos Santos Barbosa Brito
- Department Social Nutrition, Nutrition Institute, State University of Rio de Janeiro. São Francisco Xavier Street, 900, João Lyra Filho Pavilion, Twelfth floor - Maracanã, Rio de Janeiro, RJ, Brazil. Zip Code 20550-000
| | - Marcos Fleury
- Laboratory Clinical Analysis, Pharmacy College, Federal University of Rio de Janeiro. Carlos Chagas Filho Avenue, Block K, Room 50, Ilha do Fundão, Cidade Universitária, Rio de Janeiro, RJ, Brazil. Zip Code 21941-590
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Advanced Lipid Technologies® (ALT®): A Proven Formulation Platform to Enhance the Bioavailability of Lipophilic Compounds. JOURNAL OF DRUG DELIVERY 2019; 2019:1957360. [PMID: 31360551 PMCID: PMC6644232 DOI: 10.1155/2019/1957360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/20/2019] [Accepted: 06/25/2019] [Indexed: 02/08/2023]
Abstract
Despite recent advances, the drug development process continues to face significant challenges to efficiently improve the poor solubility of active pharmaceutical ingredients (API) in aqueous media or to improve the bioavailability of lipid-based formulations. The inherent high intra- and interindividual variability of absorption of oral lipophilic drug leads to inconsistent and unpredictable bioavailability and magnitude of the therapeutic effect. For this reason, the development of lipid-based drugs remains a challenging endeavour with a high risk of failure. Therefore, effective strategies to assure a predictable, consistent, and reproducible bioavailability and therapeutic effect for lipid-based medications are needed. Different solutions to address this problem have been broadly studied, including the approaches of particle size reduction, prodrugs, salt forms, cocrystals, solid amorphous forms, cyclodextrin clathrates, and lipid-based drug delivery systems such as self-emulsifying systems and liposomes. Here, we provide a brief description of the current strategies commonly employed to increase the bioavailability of lipophilic drugs and present Advanced Lipid Technologies® (ALT®), a combination of different surfactants that has been demonstrated to improve the absorption of omega-3 fatty acids under various physiological and pathological states.
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Ohemeng A, Boadu I. The role of nutrition in the pathophysiology and management of sickle cell disease among children: A review of literature. Crit Rev Food Sci Nutr 2017; 58:2299-2305. [PMID: 28686043 DOI: 10.1080/10408398.2017.1319794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Sickle cell disease (SCD) is one of the common inherited blood disorders in humans and has been associated with decreased dietary intake which results in poor nutritional status and impaired growth. Nutrition is one of the most important but often forgotten aspect of care of patients with chronic disorders and there have been emerging concern in literature on increased nutritional needs of SCD patients. This paper sought to review the available literature on the roles of individual nutrients in the pathophysiology and management of SCD among children. Children with SCD have been shown to exhibit suboptimal status with respect to both macronutrients and micronutrients. Thus, nutrition could play an important role in the management of SCD. However, there is paucity of evidence coming from trials with large sample sizes to support the suggestion that supplementation with various nutrients that have been considered in this review will be helpful.
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Affiliation(s)
- Agartha Ohemeng
- a Department of Nutrition and Food Science , School of Biological Sciences, University of Ghana , Legon , Accra , Ghana
| | - Isaac Boadu
- a Department of Nutrition and Food Science , School of Biological Sciences, University of Ghana , Legon , Accra , Ghana
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