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Teixeira RS, Arriaga MB, Terse-Ramos R, Ferreira TA, Machado VR, Rissatto-Lago MR, Silveira-Mattos PS, Boa-Sorte N, Ladeia AMT, Andrade BB. Higher values of triglycerides:HDL-cholesterol ratio hallmark disease severity in children and adolescents with sickle cell anemia. ACTA ACUST UNITED AC 2019; 52:e8833. [PMID: 31618296 PMCID: PMC6799940 DOI: 10.1590/1414-431x20198833] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/26/2019] [Indexed: 01/01/2023]
Abstract
Dyslipidemia has been described in sickle cell anemia (SCA) but its association with increased disease severity is unknown. Here, we examined 55 children and adolescents with SCA as well as 41 healthy controls to test the association between the lipid profiles in peripheral blood and markers of hemolysis, inflammation, endothelial function, and SCA-related clinical outcomes. SCA patients exhibited lower levels of total cholesterol (P<0.001), low-density lipoprotein cholesterol (LDL-c) (P<0.001), and high-density lipoprotein cholesterol (HDL-c) (P<0.001), while displaying higher triglyceride (TG) levels and TG/HDL-c ratio values (P<0.001). TG/HDL-c values were positively correlated with lactate dehydrogenase (P=0.047), leukocyte count (P=0.006), and blood flow velocity in the right (P=0.02) and left (P=0.05) cerebral artery, while being negatively correlated with hemoglobin levels (P<0.04). Acute chest syndrome (ACS) and vaso-occlusive events (VOE) were more frequent in SCA patients exhibiting higher TG/HDL-c values (odds ratio: 3.77, P=0.027). Multivariate logistic regression analysis confirmed independent associations between elevated TG/HDL-c values and SCA. Thus, children and adolescents with SCA exhibited a lipid profile associated with hemolysis and inflammatory parameters, with increased risk of ACS and VOE. TG/HDL-c is a potential biomarker of severity of disease.
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Affiliation(s)
- R S Teixeira
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.,Departamento de Pediatria, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - M B Arriaga
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Fundação José Silveira, Salvador, BA, Brasil
| | - R Terse-Ramos
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - T A Ferreira
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - V R Machado
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil
| | - M R Rissatto-Lago
- Departamento de Ciências da Vida, Universidade Estadual da Bahia, Salvador, BA, Brasil
| | - P S Silveira-Mattos
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Fundação José Silveira, Salvador, BA, Brasil
| | - N Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.,Departamento de Ciências da Vida, Universidade Estadual da Bahia, Salvador, BA, Brasil
| | | | - B B Andrade
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.,Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Fundação José Silveira, Salvador, BA, Brasil.,Universidade Salvador, Laureate International Universities, Salvador, BA, Brasil
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Fraga LGA, Sampaio A, Boa-Sorte N, Veiga ML, Nascimento Martinelli Braga AA, Barroso U. Obesity and lower urinary tract dysfunction in children and adolescents: Further research into new relationships. J Pediatr Urol 2017; 13:387.e1-387.e6. [PMID: 28434632 DOI: 10.1016/j.jpurol.2017.03.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/08/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Lower urinary tract dysfunction (LUTD) involves faults in the filling and emptying phases of bladder function in toilet-trained children with no previous infection or any other obvious pathology. Lower urinary tract dysfunction is associated with conditions such as vesicoureteral reflux, recurrent urinary infection, behavioral alterations and decreased quality of life. The literature suggests an association between LUTD and obesity; however, the association between each individual symptom and obesity has yet to be evaluated. OBJECTIVE To evaluate the association between excess weight and LUTD in children and adolescents in a community-based sample. STUDY DESIGN This cross-sectional study included 423 children and adolescents aged 5-17 years, and randomly selected in public places and schools between May and July 2015. The participants and their mothers completed the Dysfunctional Voiding Scoring System (DVSS) questionnaire, except for the questions on constipation and with the addition of a question on enuresis. They also completed the Rome III questionnaire, in which two positive responses defined the presence of constipation. Participants were classified as being of normal weight, overweight or obese, which was based on the BMI-for-age indicator. RESULTS Mean age was 9.7 years (SD 2.9), with girls comprising 50.6% of the sample and adolescents 52.5%. The prevalence of LUTD was 7.1%, with 13.5% of participants being overweight and 12.1% obese (Figure). Constipation was present in 5.9% of participants and enuresis in 10.8%. In the multivariate analysis, three factors were independently and significantly associated with a positive DVSS: age <10 years (β = 0.76; 95% CI: 0.34-1.18), constipation (β = 1.79; 95% CI: 0.88-2.70) and obesity (β = 0.89; 95% CI: 0.25-1.52). DISCUSSION Only bladder filling symptoms were associated with obesity. This may be explained by the fact that both obese individuals and those with emptying symptoms were shown to have activation alterations in the same brain regions. One limitation of this study was the use of questionnaires alone to diagnose LUTD and constipation. CONCLUSION Only the bladder-emptying symptoms of LUTD appear to be associated with obesity. This hypothesis may serve as a basis for future studies.
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Affiliation(s)
- L G A Fraga
- CEDIMI (Center of Micturition Disturbance), Bahiana School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - A Sampaio
- CEDIMI (Center of Micturition Disturbance), Bahiana School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - N Boa-Sorte
- CEDIMI (Center of Micturition Disturbance), Bahiana School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - M L Veiga
- CEDIMI (Center of Micturition Disturbance), Bahiana School of Medicine, Federal University of Bahia, Bahia, Brazil
| | | | - U Barroso
- CEDIMI (Center of Micturition Disturbance), Bahiana School of Medicine, Federal University of Bahia, Bahia, Brazil.
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