Akinlade K S, Atere A D, Rahamon S K, Olaniyi J A
Department of Chemical Pathology University of Ibadan/University College Hospital, Ibadan.
Niger J Physiol Sci. 2013 Dec 20;28(2):159-64.
It is well known that individuals with SCA undergo constant physiological stress even, in steady state. However, there is little information on the relationship between the severity of sickle cell anaemia (SCA) and serum levels of biomarkers of stress. This study therefore determined the serum levels of copeptin, cortisol and CRP in adults with SCA in different severity groups. Sixty adults with sickle cell anaemia in steady state (27.1±6.3 years) and in vaso-occlusive crisis (24.9±4.9 years) were recruited into this cross-sectional study. Degree of severity (mild, moderate or severe) was determined using a scoring system incorporating annual number of blood transfusions, crisis and presence of anaemia, vaso-occlusive pain and organ complications. Standard methods were used for the determination of packed cell volume (PCV), total white blood cell count (WBC), blood pressure measurements and anthropometric indices. Serum levels of copeptin, cortisol and CRP were determined using ELISA with the ratios calculated accordingly. Data obtained were statistically analyzed using the Student's t-test, Mann Whitney U and Chi-square test as appropriate. P<0.05 was considered significant. The mean systolic blood pressure (SBP) and copeptin level were significantly higher in subjects with moderate SCA compared with those with mild SCA. Similarly SBP, pulse, WBC, copeptin and cortisol were significantly higher while body weight was significantly lower in subjects with severe SCA compared with subjects with mild SCA. However, WBC and cortisol-to-copeptin ratio were significantly higher in subjects with severe SCA compared with subjects with moderate SCA. There was progressive rise in serum levels of CRP from mild SCA through severe SCA but the differences were not statistically significant. Also, proportions of subjects with elevated SBP and WBC were higher than the proportion of subjects with lower SBP and WBC in the severe SCA group. Serum levels of cortisol, copeptin, and their ratio could differentiate severe SCA from mild or moderate SCA. Also, elevated systolic blood pressure and total white blood cell count are associated with severe sickle cell anaemia.
众所周知，即使在稳态下，患有镰状细胞贫血（SCA）的个体也会持续经历生理应激。然而，关于镰状细胞贫血（SCA）的严重程度与应激生物标志物血清水平之间的关系，目前所知甚少。因此，本研究测定了不同严重程度组的成年SCA患者的血清中 copeptin、皮质醇和 CRP 的水平。60 名处于稳态（27.1±6.3 岁）和血管闭塞性危机（24.9±4.9 岁）的镰状细胞贫血成年患者被纳入这项横断面研究。使用包含年度输血次数、危机以及贫血、血管闭塞性疼痛和器官并发症情况的评分系统来确定严重程度（轻度、中度或重度）。采用标准方法测定血细胞比容（PCV）、白细胞总数（WBC）、血压测量值和人体测量指标。使用 ELISA 测定血清中 copeptin、皮质醇和 CRP 的水平，并相应计算比值。所获数据根据情况使用学生 t 检验、曼-惠特尼 U 检验和卡方检验进行统计学分析。P<0.05 被认为具有统计学意义。与轻度 SCA 患者相比，中度 SCA 患者的平均收缩压（SBP）和 copeptin 水平显著更高。同样，与轻度 SCA 的患者相比显著更高，而体重显著更低。然而，与中度 SCA 患者相比，重度 SCA 患者的 WBC 和皮质醇与 copeptin 的比值显著更高。从轻度 SCA 到重度 SCA，血清 CRP 水平呈逐渐上升趋势，但差异无统计学意义。此外，重度 SCA 组中收缩压和 WBC 升高的受试者比例高于收缩压和 WBC较低的受试者比例。血清皮质醇、copeptin 及其比值可将重度 SCA 与轻度或中度 SCA 区分开来。此外，收缩压升高和白细胞总数升高与严重镰状细胞贫血相关。
