Risk Factors
Table 3 shows demographic, baseline disease, disease complication, and treatment variable differences between the three weight status groups: underweight, normal weight, and overweight/obese. There were 193 (24.5%) pediatric patients with SCD identified as overweight or obese. Both hemoglobin (p<0.001) and absolute reticulocyte count (p<0.001) were significantly different values among the three weight status groups, with hemoglobin increasing and absolute reticulocyte count decreasing with increasing weight status.
TABLE 4 shows ORs for potential risk factors for overweight/obesity status in pediatric patients with SCD. Among patients with SCD, those with SC/Sβ+ genotype were 2.59 times more likely to be obese/overweight as patients with the SCD HbSS/HbSβ° [OR: 2.59 (95%CI: 1.85, 3.61)], before adjusting for other potential risk factors. After accounting other risk factors, patients with HbSC/HbSβ+ genotype still had increased odds of being obese or overweight compared to patients with the HbSS/HbSβ° genotype [OR: 1.80 (95%CI: 1.09, 2.99)]. There was also increased risk of being overweight/obese with older age and with increasing hemoglobin levels [OR: 1.22 (95%CI: 1.05, 1.40) and OR: 1.29 (95%CI: 1.13, 1.47) respectively]
After accounting for hydroxyurea use in logistic regression analyses, the odds of being obese/overweight increased slightly, although not significant (p = 0.23). We conducted post-hoc analyses to investigate if hydroxyurea use moderated the relationship between obesity and hemoglobin in pediatric patients with HbSS/HbSβ+ genotypes only. However, we found no significant interactions between hydroxyurea and Hemoglobin [OR: 0.94 (95%CI: 0.69, 1.29), p = 0.70].