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Abstract
Background:
Hardened red blood cells (RBC)-induced
capillary endothelial damage
initiating at birth terminates
with atherosclerotic end-organ
failures in much earlier ages
of life in sickle cell diseases
(SCD).
Methods:
All patients with the SCD
were included.
Results:
We studied 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),
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),
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.
Conclusion:
SCD terminate with an accelerated
atherosclerotic process in
whole body, and cirrhosis
may just be one of the several
consequences of systemic atherosclerosis.
Excess fat tissue may be much
more important than alcohol
and smoking for the development
of cirrhosis all over the
world at the moment. The efficacy
of metformin in loss of appetite
is well knownin the literature.
Since metformin is a safe,
cheap, orally used, and effective
drug for the treatment of
excess weight, it should be
advised in cirrhosis even
in patients with the normal
weight since there are approximately
20 kg of excess fat tissue
even between the upper and
lower borders of normal weight
in adults.
Key
words: Sickle cell diseases,
cirrhosis, excess fat tissue,
alcohol, smoking,
vascular endothelial inflammation,
systemic atherosclerosis
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