Iron stores in steady-state sickle cell disease children accessing care at a sickle cell disease clinic in Kumasi, Ghana: A cross-sectional study.
Iron stores in steady-state sickle cell disease children accessing care at a sickle cell disease clinic in Kumasi, Ghana: A cross-sectional study.
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DOI：
10.1002/hsr2.934
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发表时间：
2022-11
影响因子：
2
通讯作者：
Osei-Akoto, Alex
中科院分区：
文献类型：
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作者：
Amanor, Ernest;Kwarteng, Alexander;Larbi, Amma;Fordjour, Fatima Amponsah;Koranteng, Kelvin Kwaku;Sackey, David Sebbie;Bannor, Emmanuel;Osei, Francis Adjei;Mohammed, Aliyu;Ackah, Ezekiel Bonwin;Odoom, Samuel Frimpong;Nguah, Samuel Blay;Paintsil, Vivian;Osei-Akoto, Alex
患有镰状细胞病（SCD）的儿童多次输血的风险增加，这可能使他们易于升高铁储存。该研究的目的是确定加纳稳态SCD儿童人群中铁储备升高的程度和相关的风险因素。这项横断面研究在Komfo Anokye教学医院的儿科镰状细胞诊所进行。对（n = 178）稳态SCD儿童进行全血细胞计数和血清铁蛋白测定。进行描述性和多因素Logistic回归分析。升高的铁储存被定义为血清铁蛋白水平>300 ng/ml。统计学显著性被认为是p < 0.05。参与者的平均（标准差）年龄为9.61（±4.34）岁，其中51%为男性。大约17%的SCD儿童铁储存升高，并且在过去12个月内接受至少三次输血与铁储存升高密切相关（p < 0.001）。长期输血史增加了铁储备升高的几率（校正比值比[aOR] = 11.41; 95%置信区间[CI] = 3.11-30.85; p < 0.001），但接受羟基脲治疗的SCD患者铁储存升高的几率降低（aOR = 0.18; 95% CI = 0.06-0.602; p = 0.006）。此外，红细胞（系数=-0.84; 95%CI =-0.37，-1.32; p = 0.001），血红蛋白（系数= −0.83; 95% CI = −0.05，−1.61; p = 0.04），红细胞压积（系数= −0.85; 95% CI = −0.08，−1.63; p = 0.03），平均细胞体积（Coef. = 0.02; 95%CI = 0.01，0.03; p = 0.001）和平均细胞血红蛋白（Coef. = 0.04; 95%CI = 0.01，0.07; p = 0.002）可显著预测血清铁蛋白水平。在稳定状态下，SCD儿童的铁储备升高幅度较高。红细胞指数可以提供关于铁储备升高风险的宝贵信息。有慢性输血史或一年内至少接受过三次输血的SCD儿童应监测铁储备升高。
Children with sickle cell disease (SCD) have an increased risk of multiple hemotransfusions and this can predispose them to elevated iron stores. The objectives of the study were to determine the extent of elevated iron stores and the associated risk factors in a population of steady‐state SCD children in Ghana. This cross‐sectional study was conducted at the pediatric sickle cell clinic at the Komfo Anokye Teaching Hospital. Complete blood count and serum ferritin assay were performed for (n = 178) steady‐state SCD children. Descriptive and multivariate logistic regression analysis were performed. Elevated iron stores were defined as serum ferritin levels >300 ng/ml. Statistical significance was considered at p < 0.05. The mean (standard deviation) age of the participants was 9.61 (±4.34) years, and 51% of them were males. About 17% of SCD children had elevated iron stores and receiving at least three hemotransfusions during the last 12 months was strongly associated with elevated iron stores (p < 0.001). History of chronic hemotransfusion increased the odds of having elevated iron store (adjusted odds ratio [aOR] = 11.41; 95% confidence interval [CI] = 3.11–30.85; p < 0.001) but SCD patients on hydroxyurea treatment had reduced‐odds of having elevated iron stores (aOR = 0.18; 95% CI = 0.06–0.602; p = 0.006). Moreover, red blood cell (Coef. = −0.84; 95% CI = −0.37, −1.32; p = 0.001), hemoglobin (Coef. = −0.83; 95% CI = −0.05, −1.61; p = 0.04), hematocrit (Coef. = −0.85; 95% CI = −0.08, −1.63; p = 0.03), mean cell volume (Coef. = 0.02; 95% CI = 0.01, 0.03; p = 0.001) and mean cell hemoglobin (Coef. = 0.04; 95% CI = 0.01, 0.07; p = 0.002) could significantly predict serum ferritin levels. The magnitude of elevated iron stores was high among children with SCD in steady‐state. Red cell indices could provide invaluable information regarding the risk of elevated iron stores. SCD children who have a history of chronic hemotransfusion or had received at least three hemotransfusions in a year should be monitored for elevated iron stores.