Lipid, apolipoprotein AI and B levels in Ivorian patients with sickle cell anaemia.

Plasma apolipoprotein AI, apolipoprotein B, cholesterol and triglycerides in 114 Ivorian patients with homozygous sickle cell anaemia (HbSS) were compared to 40, age and sex matched controls with normal haemoglobin (HbAA). Except for plasma triglycerides, lipid and apolipoprotein levels were found to be lower in patients with sickle cell anaemia as compared to normal control subjects. The differences between the two groups were found to be statistically significant (p < 0.05 Student's t test). In addition, a highly significant decrease of plasma apolipoprotein AI (p < 0.01) was observed during painful crisis as compared to the steady state (0.78 g.L-1 versus 1.01 g.L-1), whereas triglyceride levels were found to be higher (1.02 g.L-1 versus 0.78 g.L-1). Although the metabolism of lipoproteins is being altered, the results of this cross-sectional study do not suggest that patients with sickle cell anaemia are at higher risk of developing coronary artery disease.

[Evaluation of atherogenic risk in homozygous sickle cell disease: study of lipid and apolipoprotein AI and B plasma levels]. / Evaluation du risque athérogène chez le drépanocytaire homozygote: étude des taux plasmatiques des lipides et apolipoprotéines AI et B.

The main clinical use of measurements of Apo Al and Apo B is to determine a patient's risk status for the development of ischemic heart disease. Apo B is generally accepted as a contributory cause of coronary artery disease, while Apo Al apparently has a protective effect. The present study reports the plasma change of Apo Al and B in sickle cell anaemic subjects. Immunochemical findings revealed that Apo Al and B levels were found to be lower in sickle cell patients as compared with normal subjects (HbAA). The atherogenicity index given by Apo B/Apo Al remained in the normal range during periods of steady state (0.64 +/- 0.28), while subjects in painful crisis had high index values (0.95 +/- 0.35). Therefore, we concluded that epidemiological studies on a large sample of patients are needed to confirm this relationship between painful crisis and risk of developing coronary artery disease.