Composição Corporal, Gasto Energético e Marcadores de Hemólise em Adultos com Doença Falciforme

Abstract

Sickle cell disease (SCD) is one of the most prevalent genetic disorders in the world. It is characterized, among other things, by the presence of a hypermetabolic state which directly impacts on body composition (BC). This study aimed to assess the BC and resting energy expenditure (REE) and to study the association of these variables with biochemical indicators of hemolysis in Brazilian adults with SCD. We evaluated 64 adults with SCD older than 39 years, which were treated in two reference centers located in the State of Rio de Janeiro, Brazil. The DXA method was used to assess body composition. The REE was measured by indirect calorimetry. Blood levels of hemoglobin, reticulocytes, lactate dehydrogenase (LDH), leukocytes, platelets, total and direct bilirrubins, total protein and albumin were measured to assess the markers of hemolysis of the SCD. Statistical analysis were made by comparing the numerical variables using one-way ANOVA and Pearson correlation coefficient, with 5% of significance level. We used the statistical software SAS® System, version 6.11. Women had higher body mass index (BMI), body fat percentage (% BF), regional fat percentage (% RF), fat mass (FM) while men had higher lean mass (LM), bone mineral content (BMC), fat-free mass (FFM). There was no difference for REE between sexes. Hemolysis markers (LDH, reticulocytes and total bilirubin) correlated inversely with BMI, FM and FFM, while hemoglobin and hematocrit were positively associated with BMI, FM, LM, BMC and FFM. We obtained evidences that body composition correlates with biochemical parameters of hemolysis in adults with SCD. The BMI can be helpful to estimate fat in these individuals, but the DXA is essential for evaluation MM and BMC.There was a higher prevalence of normal weight and overweight, as opposed to the traditionally described in the literature. Also noteworthy is that there was no difference in BC and GER in different genotypes of SCD. It was concluded that the hemolysis of disease impact on the nutritional status of a person with SCD.