Children with sickle cell disease (SCD) exhibit impaired growth, delayed skeletal development, and delayed sexual maturation. The pattern resembles malnutrition in which weight is affected more than height. Our previous studies have shown a significantly lower fat-free mass (FFM) in Nigerian children with SCD compared to controls. A hypermetabolic state in those with SCD may be responsible for the difference in FFM.
Objective To determine the association between body composition and serum levels of insulin, testosterone, estradiol, total insulin-like growth factor (IGF), free IGF, and IGF binding protein-3 (IGF BP-3) in children and adolescents with SCD and healthy controls.
Study Design Anthropometric measurements and biochemical parameters were measured in 60 male subjects (29 SCD and 31 controls) between 5 and 21 years of age and 102 female subjects (51 SCD and 51 controls) ages 5 to 21 years.
Results Anthropometric measurements showed that male SCD subjects had a significantly lower weight (p = .03) as compared to controls, and female SCD subjects had significantly decreased weight (p < .001), body mass index (p = .01), FFM (p = .02), and body fat (p = .01) as compared to controls. Analysis of serum growth factors revealed that total IGF and free IGF (p = .01 and p = .02, respectively) were significantly lower in male SCD subjects compared to their corresponding controls. The same trend was present in female SCD subjects (total IGF p < .001 and free IGF p = .002) when compared to controls. There were significant correlations between total IGF and FFM (p < .001) and IGF BP-3 and FFM (p = .01) in male SCD subjects as compared to controls.
Conclusion The lower FFM in SCD subjects may be related to their lower levels of total and free IGF.
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