576 - Lipid Profile in Children with Sickle Cell Disease in Two Urban Community Hospitals

Poster Number: 576
Publication Number: 576.321

Saikat Goswami, flushing hospital medical center, Flushing, NY, United States; Kalliopi Konstantinopoulou, Flushing Hospital Medical Center, Flushing,NY, NY, United States; Tashalee McGrath-Blagrove, Flushing Hospital Medical Center, Planfield, NJ, United States; Priya Mallikarjuna, Flushing Hospital Medical Center, Flushing, NY, United States; Vivian Chang, Flushing Hospital Medical Center, Flushing, NY, United States; Lily Q. Lew, Flushing Hospital Medical Center, Flushing, NY, United States; Won H. Baik-Han, Flushing Hospital Medical Center, Flushing, NY, United States; Partha Chatterjee, TJH Medical Services, Jericho, NY, United States

Background: Sickle cell disease (SCD) is a genetic disorder that affects hemoglobin. SCD includes HbSS, HbSC, HbSThal(beta), HbSD, HbSE, HbSO and sickle cell trait (SCT). These common types are identified on newborn screen. Studies have shown individuals with SCD have low total cholesterol (TC), low high-density lipoprotein cholesterol (HDL) and low low-density lipoprotein cholesterol (LDL) due to increased cholesterol utilization secondary to increased erythropoiesis and elevated triglyceride (TG) associated with hemolysis, vascular dysfunction and pulmonary hypertension. Low HDL and elevated TG are known risk factors for cardiovascular disease and stroke. There are no guidelines on screening and management of children and adolescents with SCD for dyslipidemia.

Objective: To explore prevalence of dyslipidemia in children and adolescents with SCD

Design/Methods: This was a retrospective chart review of patients followed at Flushing Hospital Medical Center and Jamaica Hospital Medical Center with the diagnosis of SCD between January 2013 and December 2020. Data extracted from EHR include type, age, gender, ethnicity, BMI, TC, TG, HDL and LDL. Normal TC < 170 mg/dl, high TG >150 mg/dl, low HDL < 35 mg/dl and low LDL < 110 mg/dl) were used as reference. Data were analyzed using percentages.
 

Results: Of 168 SCD charts reviewed, only 23 (14%) had documented lipid profile. More than half (52%) were SCT, almost a quarter (22%) HbSC, and the remainder divided between HbSS (13%) and HbSThal (13%). Over three quarters (78%) were African American. Only a quarter (26%) had history of crisis and hospitalizations. Most (65%) had normal BMI and a quarter (26%) were obese. Less than a tenth (9%) had family history of dyslipidemia. Less than half (43%) had first lipid profile before age nine and two thirds (66%) by age 12. Almost all (87%) had normal TC, few (9%) with TC >200 mg/dl. Elevated TG was in a tenth (9%), low HDL in a fifth (18%) and high LDL in another fifth (18%).    Conclusion(s): In our small sample, dyslipidemia was identified in children and adolescents with SCD. Healthcare providers need to be aware of their high risk, to recommend early screening and provide education on lifestyle changes.