Tuono De Manfouo Romaric, Louokdom Josué Simo, Chetcha Bernard Claude, Nya Prosper Cabral Biapa, Pieme Constant Anatole, Tagny Claude Tayou
Department of Microbiology, Parasitology, Hematology, and Infectious Diseases, Faculty of Medicine and Biomedical Sciences Université de Yaoundé 1 Yaoundé Cameroon.
Department of Medicine, Pharmacy, and Biomedical Sciences, Higher Institute of Health Sciences Université des Montagnes Bangangté Cameroon.
Health Sci Rep. 2023 Oct 4;6(10):e1609. doi: 10.1002/hsr2.1609. eCollection 2023 Oct.
Major sickle cell syndromes are subjected to a high frequency of hemolysis, infections, oxidative stress, and vasooclusive crises which promote inflammation and iron balance disorders. We aimed to systematically review and analyze the studies in this patients addressing in general, and Africa in particular.
The systematic review of published articles in the Pubmed and Google Scholar databases was carried out according to the recommendations of the PRISMA model. The case-control articles have been included. The data extracted from the articles were analyzed using statistical software R. The standardized mean difference (SMD) was used to assess the extent of the disease on the different variables studied.
At the end, 128 articles were obtained; but only 33 were elligible for meta-analysis. A SMD of -1.79 was obtained for hemoglobin between the sickle cell patients and the controls due to the deviation from the overall mean hemoglobin in the cases (8 ± 2 g/dL) and in controls (13 ± 3 g/dL). Sickle cell disease showed a significant extent on ferritin [SMD = 2.61; (95% confidence interval, CI: 2.39-2.83); ( < 0.01)] compared to non-sickle cell patients thus describing a higher risk for sickle cell sufferer to have ferritin disorders. The included studies also described the influence of sickle cell anemia on serum iron [SMD = 1.52; (95% CI: 1.32-1.76); ( < 0.01)] compared to normal subjects. The high risk of inflammation has been described as higher in sickle cell patients [SMD = 0.38; (95% CI: 0.25-0.50)], reflecting the moderate extent of sickle cell disease on inflammation.
Patients with major sickle cell syndrome in inflammation have a higher risk of iron profile disorders compared to the normal population. Further studies are needed to explore mechanisms for preventing the deleterious effects of iron from this hemolysis, for example haptoglobin genotyping.
主要的镰状细胞综合征患者频繁出现溶血、感染、氧化应激和血管阻塞性危机，这些会促进炎症和铁平衡紊乱。我们旨在系统回顾和分析针对此类患者，特别是非洲患者的研究。
根据PRISMA模型的建议，对PubMed和谷歌学术数据库中已发表的文章进行系统回顾。纳入了病例对照研究文章。使用统计软件R对从文章中提取的数据进行分析。标准化均数差（SMD）用于评估疾病在不同研究变量上的程度。
最终获得128篇文章，但只有33篇符合荟萃分析的条件。镰状细胞患者与对照组之间血红蛋白的SMD为-1.79，这是由于病例组（8±2 g/dL）和对照组（13±3 g/dL）的总体平均血红蛋白存在偏差。与非镰状细胞患者相比，镰状细胞病在铁蛋白方面表现出显著差异[SMD = 2.61；（95%置信区间，CI：2.39 - 2.83）；（P < 0.01）]，这表明镰状细胞患者发生铁蛋白紊乱的风险更高。纳入的研究还描述了与正常受试者相比，镰状细胞贫血对血清铁的影响[SMD = 1.52；（95% CI：1.32 - 1.76）；（P < 0.01）]。已描述镰状细胞患者炎症的高风险[SMD = 0.38；（95% CI：0.25 - 0.50）]，反映了镰状细胞病在炎症方面的中等程度。
与正常人群相比，患有炎症的主要镰状细胞综合征患者发生铁代谢紊乱的风险更高。需要进一步研究探索预防这种溶血中铁的有害影响的机制，例如触珠蛋白基因分型。
