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A much
higher prevalence of chronic obstructive pulmonary
disease in males with sickle cell diseases even
in the absence of smoking and alcohol
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Mehmet Rami Helvaci
(1)
Emin Maden (2)
Atilla Yalcin (1)
Orhan Ekrem Muftuoglu (1)
Abdulrazak Abyad (3)
Lesley Pocock (4)
(1) Specialist of Internal Medicine,
MD
(2) Specialist of Pulmonary Medicine, MD
(3) Middle-East Academy for Medicine of Aging,
MD
(4) medi-WORLD International
Corresponding author:
Prof Dr Mehmet Rami Helvaci,
07400, ALANYA,
Turkey
Phone: 00-90-506-4708759
Email: mramihelvaci@hotmail.com
Received April 2021. Accepted
May 2021. Published June 1, 2021.Please cite this
article as: Mehmet Rami Helvaci et al. A much
higher prevalence of chronic obstructive pulmonary
disease in males with sickle cell diseases even
in the absence of smoking and alcohol.. Middle
East J Intern Med 2021; 14(1): 10-16
DOI: 10.5742/MEJIM2021.93793.
.....................................................................................................................................
ABSTRACT
Background:
We tried to understand prevalence of chronic obstructive
pulmonary disease (COPD) in both genders in sickle
cell diseases (SCD).
Methods: All cases with
the SCD in the absence of smoking and alcohol
were included.
Results: The study included
368 patients (168 males). Mean ages were similar
in males and females (29.4 versus 30.2 years,
respectively, p>0.05). Mean values of body
mass index (BMI) were similar in males and females,
too (21.7 versus 21.6 kg/m2, respectively, p>0.05).
Interestingly, total bilirubin value of the plasma
(5.2 versus 4.0 mg/dL, p=0.011), transfused units
of red blood cells (RBC) in their lives (46.8
versus 29.2, p=0.002), COPD (20.8% versus 6.0%,
p<0.001), and digital clubbing (13.0% versus
5.5%, p<0.001) were all higher in males. Whereas
painful crises per year (5.0 versus 5.0), pulmonary
hypertension (10.1% versus 12.5%), acute chest
syndrome (2.3% versus 3.5%), mortality (8.3% versus
6.5%), and mean age of mortality (29.0 versus
32.5 years) were similar in males and females,
respectively (p>0.05 for all).
Conclusion: SCD are severe
inflammatory processes on vascular endothelium
particularly at the capillary level, since capillary
system is the main distributor of hardened RBC
into tissues. The capillary endothelial damage,
inflammation, edema, and fibrosis induced hypoxia
may be the underlying cause of COPD in the SCD.
Although the similar BMI and absence of smoking
and alcohol, the much higher prevalence of COPD
may be explained by the dominant role of male
sex in life according to the physical power that
may accelerate systemic atherosclerotic process
in whole body.
Key words: Sickle
cell diseases, chronic obstructive pulmonary disease,
male sex, chronic endothelial damage, atherosclerosis,
metabolic syndrome,
aging
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