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People with sickle cell disease (SCD) are more likely to have cholesterol and lipid imbalances, which can increase the risk of serious SCD complications. A recent study found new biomarkers associated with SCD in a cohort of pediatric patients.

Sickle cell disease (SCD) commonly occurs in tandem with dyslipidemia. Dyslipidemia increases a patient’s risk for severe heart and circulatory complications, such as vascular dysfunction and pulmonary hypertension. A recent study published in Metabolomics identified a set of biomarkers for dyslipidemia in children with SCD.

At the Children’s Hospital of Philadelphia, Dr. Hakon Hakonarson’s group used nuclear magnetic resonance imaging to measure circulating lipid profiles from samples of pediatric SCD patients and healthy controls. They identified 249 biomarkers from 18 metabolite groups and determined their degree of association with SCD.

SCD caused widespread changes in biomarkers from all metabolomic subgroups. They found children living with SCD had lower cholesterol and lower total lipids levels than healthy controls, which is commonly found in different types of anemia. Notably, this is the first study to show decreased cholesterol without changes in large very low density lipids (VLDLs), the type of cholesterol known for causing plaque buildup in the arteries. Lower cholesterol in SCD children is likely caused by a reduction in red blood cell mass, limiting the potential for cholesterol storage.

Children with SCD risk nutritional deficiencies from impaired lipid metabolism, as reduced cholesterol can cause further complications and disease. Clinicians should consider dietary supplementation to improve symptoms of SCD caused by lipid imbalances, but further research must be done to determine a path for recommendations. Further research is also needed to evaluate the mechanism behind SCD-specific dyslipidemia. 

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Qu, H. Q., Glessner, J., Qu, J., Mentch, F., Campbell, I., Sleiman, P., Connolly, J. J., & Hakonarson, H. (2022). Metabolomic profiling for dyslipidemia in pediatric patients with sickle cell disease, on behalf of the IHCC consortium. Metabolomics, 18(12), 101. https://doi.org/10.1007/s11306-022-01954-z