Fetal Hemoglobin is Associated with Peripheral Oxygen Saturation in Sickle Cell Disease in Tanzania
Year: 2017
Type: article
Study design: Observational Study
Abstract: Fetal hemoglobin (HbF) and peripheral hemoglobin oxygen saturation (SpO 2 ) both predict clinical severity in sickle cell disease (SCD), while reticulocytosis is associated with vasculopathy, but there are few data on mechanisms. HbF, SpO 2 and routine clinical and laboratory measures were available in a Tanzanian cohort of 1175 SCD individuals aged≥5years and the association with SpO 2 (as response variable transformed to a Poisson distribution) was assessed by negative binomial model with age and sex as covariates. Increase in HbF was associated with increased SpO 2 (rate ratio, RR=1.19; 95% confidence intervals [CI] 1.04, 1.37 per natural log unit of HbF; p=0.0004). In univariable analysis, SpO 2 was inversely associated with age, reticulocyte count, and log (total bilirubin) and directly with pulse, SBP, hemoglobin, and log(HbF). In multivariable regression log(HbF) (RR 1.191; 95%CI 1.04, 1.37; p=0.013), pulse (RR 1.01; 95%CI 1.00, 1.01; p=0.026), SBP (RR 1.008; 95%CI 1.00, 1.02; p=0.014), and hemoglobin (1.120; 95%CI 1.05, 1.19; p=0.001) were positively and independently associated with SpO 2 while reticulocyte count (RR 0.985; 95%CI 0.97, 0.99; p=0.019) was independently inversely associated with SpO 2 . In SCD, improving SpO 2 , in part through cardiovascular compensation and associated with reduced reticulocytosis, may be a mechanism by which HbF reduces disease severity.
Source: EBioMedicine
Institutions: Muhimbili University of Health and Allied Sciences, University of Dar es Salaam, National Institutes of Health, King's College London, National Heart, Lung, and Blood Institute, London School of Hygiene & Tropical Medicine, Nagasaki University, University of Oxford, Southampton Children's Hospital, University of Southampton, University College London, National Institute for Medical Research
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $5,780
Awards: H3ABioNet: informatics solutions for H3Africa, Developing research capacity and leadership in East Africa from the KEMRI- Wellcome Trust Research Programme, Kenya, G4878468429, The role of HbF decline and its determinants on Sickle Cell Disease expression in the first three years of life., H3ABioNet: a sustainable African Bioinformatics Network for H3Africa, University of California Launching Future Leaders in Global Health Research Training Program, Sickle Pan-African Research Consortium Clinical Coordinating Center (SPARCO Center)
OpenAlex ID: W2743266129