Clinical and Haematologic Correlates of Soluble VCAM‐1 in Adults With Steady‐State Sickle Cell Disease
William Kwesi Ghunney, Eugenia Vicky Asare, John Benaiah Ayete‐Nyampong, Wonder Doku‐Agama, Eric Kyei‐Baafour, Michael Fokou Ofori, George Obeng Adjei, Edeghonghon OlayemiABSTRACT
Background
Endothelial activation contributes to the vasculopathy of sickle cell disease (SCD). We evaluated serum soluble vascular cell adhesion molecule‐1 (sVCAM‐1), a surrogate marker of endothelial activation, and examined its clinical and haematologic correlates in adults with steady‐state SCD.
Methods
This was a cross‐sectional study of 75 adults with steady‐state SCD (HbSS: 86.7%; HbSC: 13.3%) and 75 age‐matched comparison participants with normal adult haemoglobin genotype (HbAA). Associations of clinical and haematologic measures with sVCAM‐1 were evaluated using correlation and multivariable linear regression analyses.
Results
SCD participants had lower systolic blood pressure (SBP), BMI and haemoglobin and elevated leukocyte, platelet, reticulocyte, total bilirubin and LDH levels, compared with HbAA participants (all p < 0.001). Mean sVCAM‐1 was higher in SCD than in HbAA participants (878.8 vs. 507.9 ng/mL; p < 0.001), with no significant difference between HbSS and HbSC. In the combined SCD cohort, sVCAM‐1 correlated positively with absolute reticulocyte count ( r = 0.24, p = 0.034). In HbSS, sVCAM‐1 correlated positively with SBP ( r = 0.264, p = 0.033). In multivariable analysis, higher reticulocyte count (B = 73.39 ng/mL per 100x10 9 /L increase, p = 0.014) and lower BMI (B = −15.3, p = 0.038) were independently associated with higher sVCAM‐1 in SCD. In HbSS, total bilirubin was inversely associated with sVCAM‐1 in the primary model (B = −1.62, p = 0.041), although this association was attenuated in sensitivity analyses.
Conclusion
Higher reticulocyte count was consistently associated with higher sVCAM‐1 in adults with steady‐state SCD. Associations of sVCAM‐1 with BMI, bilirubin and SBP were also observed, but these genotype‐specific findings warrant cautious interpretation, particularly given the small size of the HbSC subgroup. These findings support further prospective evaluation of clinical and haematologic correlates of endothelial activation in SCD.
Trial Registration
The authors have confirmed clinical trial registration is not needed for this submission