Plasma chitotriosidase and carotid intima-media thickness in children with sickle cell disease
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Published on: September 27, 2024
Normeen A Kaddah1, Dalia A Saied1, Hanan A Alwakeel2
1Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Insights
Sickle cell disease (SCD) patients show increased carotid intima-media thickness (CIMT) and plasma chitotriosidase, indicating early vascular damage. These markers may predict atherosclerosis risk in children with SCD.
Area of Science:
- Vascular biology
- Hematology
- Biochemistry
Background:
- Chronic hemolysis and iron overload are linked to atherosclerosis in hemolytic anemias like β-thalassemia.
- The relationship between sickle cell disease (SCD) and early vascular damage is not well-established.
- Atherosclerosis is a significant concern in SCD patients, potentially leading to early vascular complications.
Purpose of the Study:
- To investigate SCD as a risk factor for early vascular insult.
- To measure carotid intima-media thickness (CIMT) and plasma chitotriosidase in pediatric SCD patients and controls.
- To assess plasma chitotriosidase as a potential quantitative indicator of vascular inflammation and atherogenesis in SCD.
Main Methods:
- Study included 30 pediatric SCD patients (3-18 years) and 30 matched controls.
- Evaluated clinical history, hematological, and biochemical parameters.
- Assessed carotid intima-media thickness (CIMT) and plasma chitotriosidase activity for all participants.
Main Results:
- CIMT was significantly higher in SCD patients (median 0.42 mm) compared to controls (median 0.36 mm), P = 0.03.
- CIMT positively correlated with age and the number of vascular incidents requiring hospitalization.
- Plasma chitotriosidase activity was significantly higher in SCD patients (median 59.6 nmol/ml plasma/h) versus controls (median 32.7 nmol/ml plasma/h), P < 0.001.
- Chitotriosidase activity correlated positively with serum ferritin and CIMT (r = 0.535, P = 0.002).
Conclusions:
- Pediatric SCD patients are at risk for developing premature atherogenic changes.
- Plasma chitotriosidase and CIMT may serve as useful predictors of these vascular changes in SCD.
- This study highlights the importance of monitoring vascular health in children with SCD.
Abstract:
The relationship between chronic hemolysis with subsequent iron overload, inflammation, and premature atherosclerosis has been documented in hemolytic anemias, particularly β-thalassemia. However, no such relationship has been established in sickle cell disease (SCD). We sought to evaluate SCD as a risk factor for early vascular insult by measuring carotid intima-media thickness (CIMT) and plasma chitotriosidase and to assess the role of the latter as a potential quantitative indicator of vascular inflammation and atherogenesis. Thirty SCD pediatric patients (3-18 years) and 30 matched controls were enrolled. Full clinical history, with hematological and biochemical parameters, was evaluated. CIMT and chitotriosidase activity were also assessed for all study participants. CIMT values were significantly higher in SCD patients (median 0.42; range 0.32-0.6 mm) compared to controls (0.36; 0.34-0.45 mm), P = 0.03. CIMT correlated positively with age (r = 0.460, P = 0.011), and total number of vascular incidents necessitating hospital admission (r = 0.439, P = 0.015). Similarly, chitotriosidase activity was significantly higher among SCD patients (median 59.6; range 7.3-512 nmol/ml plasma/h) compared to controls (32.7; 6.8-63.1 nmol/ml plasma/h), P < 0.001, and showed a positive correlation with serum ferritin (r = 0.517, P = 0.003) and CIMT (r = 0.535, P = 0.002). SCD children are at risk of developing premature atherogenic changes. Plasma chitotriosidase and CIMT may represent useful predictors of these changes.
