Gender differences in severity of sickle cell diseases in non-smokers

To find out gender differences in severity of sickle cell diseases [SCDs] in non-smokers. Three groups of SCDs patients on the basis of red blood cell [RBC] transfusions were included. Less than 10 units in their lives were kept in Group-1, Ten units of higher in Group-2 and 50 units or higher as the Third Group. Patients with a history of using one pack of cigarettes -year or above were excluded. The study included 269 patients. Mean ages of the groups were similar [28.4, 28.5, and 28.9 years, respectively]. Prevalences of cases without any RBC transfusion in their lives were 7.2% and 3.7% in females and males, respectively [p < 0.05]. Prevalences of cases without any painful crisis were 13.8% and 6.0% in females and males, respectively [p < 0.001]. There was progressive increase according to mean painful crises, clubbing, chronic obstructive pulmonary disease [COPD], leg ulcers, stroke, chronic renal disease [CRD], pulmonary hypertension, and male ratio from the first towards the third groups [p < 0.05, nearly for all]. Mean ages of mortal cases were 29.1 and 26.2 years in females and males, respectively [p > 0.05]. The higher painful crises per year, digital clubbing, COPD, leg ulcers, stroke, CRD, pulmonary hypertension, and male ratio of the third group, lower male ratio of patients without any RBC transfusion, lower male ratio of patients without any painful crisis, lower mean ages of male SCDs patients with mortality, and longer overall survival of females in the world could not be explained by well known strong atherosclerotic effects of smoking alone, instead it may be explained by the dominant role of male sex in life

Chronic obstructive pulmonary disease may be one of the terminal end points of metabolic syndrome

We tried to understand presence of any effect of excess weight on respiratory system by means of excessive adipose tissue functioning as an endocrine organ and causing a pulmonary inflammation. Mild [stage 1], moderate [stage 2], and severe [stage 3 and 4] chronic obstructive pulmonary disease [COPD] patients were detected, and compared according to the metabolic parameters in between. There were 145, 56, and 34 patients in the mild, moderate, and severe COPD groups, respectively. The mean age increased gradually [52.4, 56.4, and 60.0 years] from the mild towards the severe COPD groups, respectively [p<0.05 nearly in all steps]. Similarly, the mean pack-years increased gradually and significantly [26.7, 34.8, and 36.8 pack-years] in the same direction [p<0.05 nearly in all steps]. Parallel to them, the mean body mass index increased up to the moderate COPD cases [28.2 versus 29.6 kg/m2, p= 0.039], and then decreased significantly [29.6 versus 26.8 kg/m2, p=0.006]. The metabolic syndrome includes some reversible indicators such as overweight, hyperbetalipoproteinemia, hypertriglyceridemia, dyslipidemia, impaired fasting glucose, impaired glucose tolerance, and white coat hypertension for the development of terminal diseases including obesity, hypertension, diabetes mellitus, peripheral artery disease, coronary heart disease, and stroke. In our opinion, COPD may be one of the terminal end points of the syndrome

Gender differences in coronary heart disease in Turkey

To find out whether or not there are some gender differences according to prevalence and underlying risk factors of coronary heart disease [CHD]. The study was performed in the Internal Medicine Polyclinic on consecutive patients coming with any complaint at and above the age of 15 years between August 2005 and March 2007. Patients under 15 years of age are examined in Paediatrics Department. The study included 2860 cases. Prevalence of CHD was similar both in males and females [4.4% vs 3.8%, p > 0.05, respectively]. Mean age of CHD was 63.5 years in males and 61.5 years in females [p > 0.05]. Prevalence of smoking was higher in males with CHD [54.5% vs 9.6%, p < 0.001]. Females had a nonsignificantly higher mean body mass index [BMI] [28.3 vs 29.7 kg/ m2, p > 0.05]. Mean values of low density lipoprotein cholesterol [LDL-C] and triglyceride [TG] were higher in females [115.6 vs 132.6 mg/dL, p = 0.008 and 150.1 vs 250.3 mg/dL, p = 0.002, respectively]. White coat hypertension [WCH] was nonsignificant [23.6% vs 30.6%, p > 0.05], but hypertension [HT] and diabetes mellitus [DM] were significantly higher in females [p<0.001 and p < 0.05, respectively]. On the other hand, coronary artery stenting [CAS] and/or coronary artery bypass graft [CABG] surgery was greater among males [21.8% vs 1.6%, p < 0.001]. CHD is probably seen with similar prevalences in both sexes in Turkey with some prominent differences in the underlying risk factors. Prevalence of smoking was higher in males, whereas mean values of the BMI, LDL-C, TG and prevalences of the WCH, HT, DM were higher in females. On the other hand, prevalence of CAS and/or CABG surgery was significantly higher in males

Effect of sickle cell diseases on height and weight

We tried to understand what are the effects of the sickle cell diseases [SCD] on metabolic parameters, especially the body weight and height in the study. The study was performed in the Hematology and Internal Medicine Polyclinics on SCDs and routine check up patients. The study included 122 patients with SCDs [58 females] and 176 control cases. Mean age of the SCDs cases was 28.6 years. When we compared the patients and control groups, mean body weight and body mass index [BMI] were significantly reduced in the SCDs cases [71.6 vs. 57.8 kg and 24.9 vs. 20.7 kg/m2, p= 0.000 for both], whereas the mean heights were similar in both groups [166.1 vs. 168.5 cm, respectively, p>0.05]. Similar to the decresed mean body weight and BMI, mean values of the low density lipoprotein cholesterol and high density lipoprotein cholesterol were significantly lower in the patients group [p= 0.000 for both], whereas the fasting plasma glucose and triglyceride values were unchanged between the groups [p>0.05]. Additionally, probably parallel to the reduced mean body weight and BMI, mean values of the alanine aminotransferase [34.9 vs. 56.7 U/L, p= 0.000] and systolic and diastolic blood pressures were also significantly lower in the patients group [113.3 vs. 118.8 and 72.3 vs. 83.6 mmHg, respectively, p<0.01 for both], all of which can be explained by definition of the metabolic syndrome. Although the body weight can significantly be reduced by SCDs, the body height may strongly be determined by heredity

Association of increased triglyceride levels in metabolic syndrome with coronary artery disease

We tried to understand significance of increased triglyceride [TG] values in metabolic syndrome and coronary artery disease [CAD]. Check up cases with a TG value lower than 60 mg/dL were collected into the first, between 60 and 99 mg/dL into the second, between 100 and 149 mg/dL into the third, between 150 and 199 into the fourth, and 200 mg/dL and greater into the fifth groups. Study included 478 cases. Values of the mean age, weight, body mass index, TG, and low density lipoprotein cholesterol [LDL-C] and prevalences of smoking, white coat hypertension [WCH], hypertension [HT], type 2 diabetes mellitus [DM], and CAD increased gradually and significantly nearly in all steps from the first towards the fifth groups. Metabolic syndrome may be a progression step between complete physical health and irreversible end points, such as obesity, type 2 DM, HT, CAD, and stroke. Hypertriglyceridemia and White Coat Hypertension [WCH] may be the most significant reversible parameters of the syndrome, and it is better to have the lowest TG value as much as possible. The most significant increase was seen after the value of 100 mg/dL. The overweight, smoking, hypertriglyceridemia, hyperbetalipoproteinemia, and WCH may only be one of hundreds of parameters of the syndrome. Therefore, it is advisable that underlying etiologies rather than revesible parameters of the syndrome should be targeted for treatment. For example, increased TG and LDL-C values, and prevalence of WCH by aging may be secondary to decreased physical and mental stresses in elderly

Body weight and white coat hypertension

To understand prognostic significance of white coat hypertension [WCH], and any its association with excess weight. We studied consecutive check up patients between the ages of 35 and 70 years to be able to see possible consequences of excess weight on health and to avoid debility induced weight loss in elderly people. The study included 721 cases [426 females]. Prevalences of normal weight, overweight, and obesity were detected as 19.0%, 43.3%, and 37.5%, respectively. There were gradual and significant increases in the prevalences of WCH and hypertension [HT] towards the overweight and obesity groups [p<0.001 for all]. So 73.7% of the obesity cases had either WCH or HT, and overall prevalence of WCH was 37.9%, which was nearly equal to the prevalence of obesity. When we compared the groups according to the prevalences of hyperbetalipoproteinemia, dyslipidemia, diabetes mellitus [DM], and coronary heart disease [CHD], gradual and significant increases towards the overweight and obesity groups were seen nearly in all steps. There is gradual increased prevalence of WCH in the overweight and obesity groups, parallel to gradually increased prevalences of hyperbetalipoproteinemia, dyslipidemia, HT, DM, and CHD. In addition nearly equal prevalence of WCH with obesity, and additional very low prevalence of sustained normotension in obesity group, WCH should be accepted as an alarming sign of excess weight and many associated disorders in future rather than just being a predisposing factor of HT and atherosclerosis alone. Its management should be focused on prevention of excess weight