|
Abstract
Background: Atherosclerosis
may be the major underlying
cause of aging and death.
Methods:
All patients with sickle
cell diseases (SCD) were included.
Results:
We studied 222 males and 212
females with similar 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), coronary
heart disease (CHD) (18.0%
vs 13.2%, p<0.05), cirrhosis
(8.1% vs 1.8%, p<0.001),
chronic obstructive pulmonary
disease (25.2% vs 7.0%, p<0.001),
leg ulcers (19.8% vs 7.0%,
p<0.001), digital clubbing
(14.8% vs 6.6%, p<0.001),
chronic renal disease (9.9%
vs 6.1%, p<0.05), and stroke
(12.1% vs 7.5%, p<0.05)
were all higher in males,
significantly.
Conclusion:
As a prototype of systemic
atherosclerosis, hardened
RBC-induced capillary endothelial
damage initiating at birth
terminates with end-organ
failure in much earlier ages
in the SCD. Excess fat tissue
may be much more important
than smoking and alcohol for
the development of atherosclerosis,
and stroke and CHD are the
two terminal causes of death
with any underlying etiology.
The efficacy of metformin
in loss of appetite is well
known for several years. Since
metformin is a safe, cheap,
orally used, and effective
drug for excess weight, it
should be prescribed for prevention
of stroke after the age of
50 years even in normal weight
individuals, since there are
nearly 20 kg of excess fat
tissue between the upper and
lower borders of normal weight.
Key
words: Sickle cell diseases,
stroke, coronary heart disease,
excess fat tissue, vascular
endothelial inflammation,
atherosclerosis, aging
|
