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Abstract
Background: Hardened
red blood cells (RBC)-induced
capillary endothelial damage
initiates at birth, and terminates
with atherosclerotic end-organ
insufficiencies in early years
of life in the sickle cell
diseases (SCD).
Methods:
All patients with the SCD
were studied.
Results:
We included 222 males and
212 females with similar mean
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 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 obstructive pulmonary
disease (COPD) (25.2% vs 7.0%,
p<0.001), cirrhosis (8.1%
vs 1.8%, p<0.001), leg
ulcers (19.8% vs 7.0%, p<0.001),
digital clubbing (14.8% vs
6.6%, p<0.001), coronary
heart disease (18.0% vs 13.2%,
p<0.05), 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: SCD are
prototypes of an accelerated
atherosclerotic process all
over the body. On the other
hand, the role of excess fat
tissue on the systemic atherosclerosis,
the efficacy of metformin
in loss of appetite, and atherosclerotic
background of COPD are obvious
in the literature. Since metformin
is a safe, cheap, oral, long
term used, and effective drug
for the treatment of excess
weight, it should be prescribed
in COPD even in patients with
the normal weight to minimise
the adverse effects of excess
fat tissue on the lungs since
there are approximately 20
kg of excess fat tissue between
the upper and lower borders
of the normal weight in adults.
Key
words: Sickle cell diseases,
chronic obstructive pulmonary
disease, smoking, excess fat
tissue, vascular endothelial
inflammation,
systemic atherosclerosis,
end-organ insufficiency
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