Background: Several studies have shown that the pathophysiology of homozygous sickle cell anaemia (SCA)\r\nresults in a myriad of metabolic, nutritional, haematological and clinical effects that interact with other co-morbid\r\nfactors to determine the quality of life and life expectancy of afflicted patients. Because of its critical roles in\r\nnutrition and metabolism, inflammation, haematopoiesis and cellular immunity, this study determined the plasma\r\nlevels of leptin in steady and unsteady states of HbSS in Nigerian patients.\r\nMethods: A total of 51 SCA patients aged 5 - 35 years with 34 (61.8%) being females who were either on\r\nadmission or visiting four medical centres in Lagos, Nigeria together with 22 non-SCD controls aged 5 -30 years\r\ncomprising 12 (54.5%) females were enrolled after obtaining their informed consent and ethical approval. Patients\r\nwere further stratified into steady and unsteady cases of SCA based on clinical presentations, while blood samples\r\ncollected by venipuncture from each of the study participants were analyzed haematologically for full blood count\r\nand HbF level and microscopically for malaria, while plasma leptin was assayed using ELISA method. Body\r\ncomposition defined by weight, fat mass and body mass index (BMI) was determined using standard methods.\r\nData obtained for cases and controls were analyzed statistically.\r\nResults: Twenty - one patients had unsteady HbSS and elicited greater and significant (P < 0.05) reduction in fat\r\nmass, BMI, HbF and eosinophil count but elevated mean total leukocyte, count, level of irreversibly sickled cells and\r\nP. falciparum parasitaemia (4613.7 vs. 749.6 - 1078.4 parasites/uL), pyrexia rate (58.3 vs. 25.8%) when compared with\r\nsteady state patients or non-SCD controls. Compared to the control, significant decreases in plasma leptin before\r\nand after controlling for body fat that was worsened by crisis were observed among the SCD patients. Unlike the\r\nnon-SCD controls, leptin correlated non-significantly (P > 0.05) with all body composition indices measured in the\r\npatients except for fat mass in unsteady cases. Multivariate regression analysis identified ESR and RC as\r\nindependent predictor of low plasma leptin concentration in the SCA patients.\r\nConclusions: Base on these findings, we conclude that plasma level of leptin is further decreased in the unsteady\r\nstate of HbSS, shows poor correlation with adiposity and malarial infection but has inflammation and poor\r\nreticulocyte response as independent predictors among Nigerian patients.
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