PI: S. Saraf

 

Team Investigator by site: TBA

 

Specific Aims: To be determined

 

 

The manifestations of sickle cell disease could well be altered in the American context by diet and other lifestyle factors that accelerate the risk of vascular disease in the general population. Several cross-cultural contrasts can be hypothesized. For example, the atherogeneic diet of the US could increase vasculopathy and oxidant damage, and the metabolic syndrome could play a role in hemolysis-triggered inflammation and increased oxidant stress, Evidence from our pilot data demonstrates the relationship of body mass index on blood pressure and hypertension in patients with SCD, and higher blood pressures in the US, which increase the risk of stroke. There are in fact a number of factors in the social context that could influence the clinical outcomes: viz, widespread use of NSAIDs could accelerate renal dysfunction in the US the risk of leg ulcers could be influenced by use of clothing in temperate climate and obesity might well increase the risk of avascular necrosis; more pollution and asthma could exacerbate acute chest syndrome. Our group has shown significantly lower levels of vitamin D among patients with SCD in the US compared to equatorial Africa and it has been hypothesized that low vitamin D may increase the frequency of pain episodes. Evidence also exists demonstrating high levels of lead in most of West Africa; leaded gasoline is still widely used and waste disposal 

is not well managed.