Association Between Sickle Cell Trait With Selected Chronic Medical Conditions in U.S. Service Members
| Autor: | Jonathan Goldsmith, Stephanie Shao, Ligong Chen, Darrell E Singer, David W. Niebuhr, Celia Byrne |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Lung Diseases Male medicine.medical_specialty Adolescent Anemia Sickle Cell 030204 cardiovascular system & hematology Rate ratio Feature Article and Original Research Sickle Cell Trait Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus medicine Humans 030212 general & internal medicine Renal Insufficiency Chronic Retrospective Studies Sickle cell trait business.industry Incidence (epidemiology) Incidence Racial Groups Public Health Environmental and Occupational Health Retrospective cohort study General Medicine Venous Thromboembolism medicine.disease Sickle cell anemia United States Diabetes Mellitus Type 2 Chronic Disease Female business Kidney disease Cohort study |
| Popis: | Introduction Sickle cell trait (SCT), the heterozygous carrier state for hemoglobin S, is present in an estimated 1.6% of all newborns and 7.3% in black individuals in the USA. SCT has long been considered a benign condition with anticipated normal life expectancy and no increased risk for chronic diseases. The medical literature is inconclusive on the potential association between SCT and chronic medical conditions (CMC) including chronic kidney disease, venous thromboembolism, and stroke. Studies addressing these questions are lacking particularly in non-Black young adults. Materials and methods We conducted a retrospective cohort study among U.S. active duty, enlisted, service members who entered from 1992 to 2012 using existing Department of Defense (DoD Military Healthcare System databases). SCT positive subjects (1,323) were matched by demographic characteristics to SCT negative subjects (3,136) and followed through 2013 for CMC that included deep vein thrombosis, diabetes mellitus and hematologic, pulmonary, and renal conditions. Results The rate of developing any of the included CMC was higher for those with SCT (incidence rate ratio = 1.71 95% CI 1.61-1.81) compared with those who were SCT negative and their healthcare utilization rate for any of CMC studied was higher for SCT positive compared with negative individuals (URR = 2.45 95% CI 2.41-2.50), with the highest rate ratios observed for hematologic and renal conditions. SCT positive compared with negative individuals were more likely to have encounter diagnoses of sickle cell disease and diabetes Type II and were less likely to have encounter diagnoses of other hemoglobinopathies and diabetes type I. Conclusion SCT in these racially diverse, young adults increased both the incidence of and healthcare utilization for thromboembolism, diabetes mellitus type II, sickle cell disease, pulmonary, and chronic renal conditions. These findings suggest that clinicians treating young adults with SCT should exercise heightened surveillance for these CMC to ensure both early diagnosis and access to treatments. |
| Databáze: | OpenAIRE |
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