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More Information on Disease Associations with Sickle Cell Trait
A growing body of evidence has suggested previously unrecognized associations between sickle cell trait (SCT) and various medical conditions. In this study, researchers explored this topic using data from the UK Biobank — a repository of genetic and clinical information.
Among 8000 people who self-identified as Black in this database, 8.7% had genetically confirmed SCT. In analyses adjusted for age, sex, and other genetic variables, Black participants who had SCT — compared with Black participants without SCT or sickle cell disease — had significantly higher prevalence of type 2 diabetes, hypertension, retinal disorders, chronic kidney disease, end-stage renal disease, and rhabdomyolysis. Additional analyses suggested that diabetes was not a mediating factor for some of these associations; for example, SCT was associated significantly with hypertension and end-stage renal disease among people without diabetes.
Comment
Traditional teaching is that SCT causes complications only under conditions of physiologic stress (e.g., hypoxemia, severe dehydration), but this analysis and others raise questions about broader adverse effects of SCT. Interestingly, 78% of people with genetically identified SCT in this cohort did not have a clinical diagnosis of SCT in their medical record; whether early identification of these people would result in beneficial clinical intervention remains unclear. Finally, a recent study suggested that SCT was associated with excess mortality in patients with COVID-19 (NEJM JW Gen Med Oct 1 2022 and JAMA Intern Med 2022; 182:796).
Citation(s)
Author:
Hulsizer J et al.
Title:
Sickle cell trait and risk for common diseases: Evidence from the UK Biobank.
Source:
Am J Med
2022
Aug
; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Allan S. Brett, MD