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Updated: Mar 7, 2026
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Body Mass Index and the Association With Vaso-occlusive Crises in Pediatric Sickle Cell Disease
Andrea Zivot1, Nataly Apollonsky, Edward Gracely
1*Einstein Healthcare Network †St. Christopher's Hospital for Children, Drexel University ‡Department of Pediatrics, Drexel University, Philadelphia, PA.
Insights
Obesity in children with sickle cell disease (SCD) did not increase hospitalizations for vaso-occlusive crisis (VOC). However, obesity was more common in those with HbSC genotype compared to HbSS.
Area of Science:
- Pediatric Hematology
- Sickle Cell Disease Research
- Obesity in Chronic Illness
Background:
- Children with sickle cell disease (SCD) traditionally exhibit underweight and poor growth.
- Recent trends indicate a rise in obesity among pediatric SCD populations.
Purpose of the Study:
- To investigate the association between body mass index (BMI) extremes and hospitalizations for vaso-occlusive crisis (VOC) in pediatric SCD patients.
- To explore correlations between BMI, SCD genotype, and VOC-related hospitalizations.
Main Methods:
- Retrospective chart review of 328 pediatric SCD patients.
- Data collected included BMI, weight percentiles, SCD genotype, hemoglobin levels, comorbidities, vitamin D levels, hydroxyurea treatment, and chronic transfusions.
- Statistical analyses (t test, Mann-Whitney U, ANOVA) were used to examine associations with VOC frequency and duration.
Main Results:
- Overweight and obese children comprised 19% of the study cohort.
- BMI status did not significantly affect the frequency or duration of VOC hospitalizations (P=0.90 and P=0.65, respectively).
- Obesity showed a stronger association with HbSC genotype compared to HbSS genotype (P=0.025).
Conclusions:
- This study found no significant association between extreme BMI and VOC hospitalizations in pediatric SCD.
- Further prospective research is needed to understand the impact of obesity on pain crises in SCD, given the rising obesity trend.
Background:
Children with sickle cell disease (SCD) historically have been underweight and have poor overall growth. Recent studies have demonstrated a trend toward obesity in pediatric SCD populations.
Materials And Methods:
Through retrospective chart review of patients with SCD followed at our center, we collected patient's data, including body mass index (BMI), weight percentiles, sickle cell genotype, baseline hemoglobin, medical and psychiatric comorbidities, 25-hydroxy vitamin D level, treatment with hydroxyurea, and chronic transfusions. We identified hospitalizations to St. Christopher's Hospital for vaso-occlusive crisis (VOC) and duration of hospitalization and intravenous opioid use were recorded. Student t test, Mann-Whitney U test, and analysis of variance were used to examine associations between variables and frequency and duration of hospitalizations for VOC.
Results:
Among 328 patients with SCD, overweight and obese children constituted 19% of hospitalized and nonhospitalized patients. BMI status did not influence frequency (P=0.90) or duration of hospitalization (P=0.65) for VOC. Obesity was more associated with HbSC than HbSS (P=0.025) genotype.
Conclusions:
Our study did not demonstrate an association between extremes of BMI of patients and hospitalization for VOC. Considering current trend toward obesity, further prospective and interventional research are required to define the effects of extremes of BMI on pain crises in SCD.
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