Abstract
Sickle cell anemia (HbSS) is characterized by hypermetabolism, chronic inflammation, and increased oxidative stress, but the relationship between these factors is undefined. In this study, we examined indicators of inflammatory process and markers of oxidative damage and their impact on resting energy expenditure (REE) in stable HbSS adolescents (n = 35) and healthy controls carrying normal hemoglobin genotype (HbAA) (n = 39). C-reactive protein (CRP), white blood cell (WBC) count, and proinflammatory cytokines were measured as markers of inflammation and 2,3-dinor-5,6-dihydro-15-F2t-isoprostane (F2-IsoPM) as a marker of oxidative stress. REE was measured by indirect calorimetry. WBC counts (11.90 ± 5.3 ×103/μL versus 5.6 ± 1.9 ×103/μL; p < 0.001), serum CRP (9.1 ± 11.0 μg/mL versus 0.4 ± 0.7 μg/mL; p < 0.001) and serum IL-8 (7.5 ± 4.4 pg/mL versus 5.5 ± 4.8 pg/mL; p = 0.011) were higher in HbSS than HbAA, suggesting an anti-inflammatory response in HbSS. Higher urinary F2-IsoPM in HbSS (1.2 ± 0.4 versus 0.7 ± 0.3 ng/mg creatinine; p < 0.001) indicates increased oxidative stress. Fat free mass (FFM), hemoglobin (Hgb), interleukin (IL)-8, and F2-IsoPM were independent predictors of REE in HbSS (overall r2 = 0.778; p < 0.001). Low-grade inflammation and increased oxidative stress are present in adolescents with HbSS in the absence of acute crisis, and their markers are correlated with elevated REE.
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Abbreviations
- CRP:
-
C-reactive protein
- F2-IsoPM:
-
2,3-dinor-5,6-dihydro-15-F2t-isoprostane
- FFM:
-
fat free mass
- FM:
-
fat mass
- GCRC:
-
General Clinical Research Center
- HbAA:
-
healthy controls carrying normal hemoglobin genotype
- HbSS:
-
sickle cell anemia
- Hgb:
-
hemoglobin
- REE:
-
resting energy expenditure
- RetCt%:
-
reticulocyte proportion
- WBC:
-
circulating white blood cell
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Acknowledgements
The authors thank the staff of the General Clinical Research Center at Vanderbilt University for help with this project. They also thank Kay Hongu, Ph.D., and Cindy Dorminy, M.Ed., for their technical assistance; Dan Byrne, M.S., for statistical expertise in analyzing the data; and Leena Choi, Ph.D., for helping with graphic data presentation. Finally, they acknowledge our participants and their parents for their enthusiasm and commitment to this study.
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Study supported in part by National Institutes of Health grants M01 RR00095 and by funds from GM008037, GM15431, CA77839, DK48831, and ES13125.
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Akohoue, S., Shankar, S., Milne, G. et al. Energy Expenditure, Inflammation, and Oxidative Stress in Steady-State Adolescents With Sickle Cell Anemia. Pediatr Res 61, 233–238 (2007). https://doi.org/10.1203/pdr.0b013e31802d7754
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DOI: https://doi.org/10.1203/pdr.0b013e31802d7754
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