Olatunji Lawrence A, Olabode Olatunde P, Akinlade Olawale M, Babatunde Abiola S, Olatunji Victoria A, Soladoye Ayodele O
1HOPE Cardiometabolic Research Team and Department of Physiology, College of Health Sciences, University of Ilorin, P.M.B 1515, Ilorin, Kwara State 240003 Nigeria.
2Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo State Nigeria.
Clin Hypertens. 2018 Feb 16;24:3. doi: 10.1186/s40885-018-0088-2. eCollection 2018.
A seemingly interesting observation in patients with sickle cell anaemia (SCA) is that they usually have lower systemic blood pressures (BP) and insulin resistance than persons in the general population in spite of chronic inflammation and vasculopathy. However, relative systemic hypertension (rHTN) has been linked to pulmonary hypertension, increased blood viscosity and renal insufficiency, which could indicate a risk of developing cardiometabolic disorder (CMD) in SCA.We therefore hypothesized that neck circumference (NC) and CMD marker; triglyceride glucose (TyG) index would independently predict rHTN in young adults with SCA in steady state.
We compared the anthropometrical, hematological, hemorheological and CMD markers between SCA patients with normal BP < 120/70 mmHg; nHTN, = 65) and those with rHTN (BP ≥ 120/70 mmHg, = 32).
Our results showed that SCA with rHTN had significantly higher body weight, waist circumference, NC, plasma viscosity, systolic and diastolic BP. Results also indicated that NC (OR: 2.98; 95% CI 1.46 to 6.10, < 0.01) was a predictor of rHTN in SCA independent of gender, age, weight, waist circumference, BMI, blood viscosity, triglyceride or TyG. A receiver operating characteristic curve analysis also showed that NC was the most efficient predictor of rHTN than other CMD markers.
The present study demonstrates that increased NC is a salient risk factors that is independently associated with rHTN in SCA. The finding therefore underscores the utility of NC in early detection and stratification of systemic hypertension, particularly in individuals with SCA.
镰状细胞贫血(SCA)患者中一个看似有趣的现象是,尽管存在慢性炎症和血管病变,但他们的全身血压(BP)和胰岛素抵抗通常低于普通人群。然而,相对性系统性高血压(rHTN)与肺动脉高压、血液粘度增加和肾功能不全有关,这可能表明SCA患者有发生心脏代谢紊乱(CMD)的风险。因此,我们假设颈围(NC)和CMD标志物甘油三酯葡萄糖(TyG)指数将独立预测稳态下SCA年轻成人的rHTN。
我们比较了血压正常(<120/70 mmHg;nHTN,n = 65)和rHTN(BP≥120/70 mmHg,n = 32)的SCA患者之间的人体测量学、血液学、血液流变学和CMD标志物。
我们的结果显示,患有rHTN的SCA患者体重、腰围、NC、血浆粘度、收缩压和舒张压显著更高。结果还表明,NC(比值比:2.98;95%置信区间1.46至6.10,P<0.01)是SCA患者rHTN的预测指标,独立于性别、年龄、体重、腰围、体重指数、血液粘度、甘油三酯或TyG。受试者工作特征曲线分析还表明,与其他CMD标志物相比,NC是rHTN最有效的预测指标。
本研究表明,NC增加是SCA患者中与rHTN独立相关的一个显著危险因素。因此这一发现强调了NC在系统性高血压早期检测和分层中的作用,特别是在SCA患者中。