Relationship between disease severity and glutathione levels in adult patients with sickle cell disease in Lagos, Nigeria.

Abstract

Recent evidence has begun to highlight the role of oxidative stress in the pathogenesis, clinical course, and rate of complications in sickle cell disease (SCD). Glutathione (GSH) plays a critical role in the body's antioxidant defence system and is involved in various vital metabolic processes. In Nigeria, which has the highest population of patients with SCD globally, it is crucial to understand the potential impact of this relationship on the disease severity in order to help modify the clinical outcomes of these patients. This study evaluated the association between glutathione levels and clinical severity of adult patients with sickle cell disease at a tertiary centre in Lagos, Nigeria. This descriptive cross-sectional study was conducted among adult patients with SCD seen at the Lagos University Teaching Hospital. Data were collected with the aid of a pre-tested, structured interviewer-administered questionnaire. Blood samples were also collected to determine the glutathione levels. All data were then analysed using the IBM SPSS statistics version 28. The level of statistical significance was set at < 0.05 (95% confidence interval).The study participants' mean age (± SD) was 27.4 (± 10.1) years. The median (IQR) value of GSH in participants was 55.19 (51.29) µmol/L, ranging from 14.33 to 233.11µmol/L.  GSH levels were significantly higher in those with a positive history of blood transfusion (p = 0.049) and more frequent crises (p = 0.021). There were no significant associations with clinical severity; the use of hydroxyurea or the presence and absence of chronic complications of SCD and glutathione levels. This study did not find any significant association between SCD disease severity and glutathione levels.  However significant associations were found between glutathione levels and frequency of crises and blood transfusion.