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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), chronic
renal disease (CRD) (9.9%
vs 6.1%, p<0.05), coronary
heart disease (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),
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
failures 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 end-organ insufficiencies
in human being. 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 the treatment of CRD even
in normal weight individuals,
since there are nearly 20
kg of excess fat tissue between
the upper and lower borders
of normal weight in adults.
Key
words: Sickle cell diseases,
chronic renal disease, excess
fat tissue, vascular endothelial
inflammation, atherosclerosis,
smoking, aging
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