Sickle cell trait not responsible for increased risk of death says study

The long held belief that sickle cell trait increases risk of death has been challenged by a new study involving nearly 50,000 active-duty U.S. Army soldiers.

Stanford University School of Medicine scientists noted in a recently published study that while there have been reports that linked sickle cell trait and deaths of individual patients, those reports were based on evidence that were pretty weak. Researchers point out that even though the evidence were weak, it was believed that sickle cell trait increases the risk of death, of exertional rhabdomyolysis and of heat stroke.

To check whether this belief holds or not, researchers conducted review of health records of 47,944 African-American soldiers who served on active duty between 2011 and 2014 and for whom sickle cell status was known. Scientists got the health records from the Stanford Military Data Repository data set, which included all digitally recorded health encounters at military medical facilities or civilian institutions, general health information and official records of physical performance and mortality of all active-duty U.S. Army soldiers. The data in the repository are de-identified to protect privacy.

Researchers found that the risk of exertional rhabdomyolysis was only 54 per cent higher among African-American soldiers with sickle cell trait than among those without it. A 54 per cent increase might sound like a lot, but it’s far less than the 300 per cent increase caused by some ordinary prescription drugs. And smoking, obesity and increasing age each incur a heightened risk of ER that is about the same as sickle cell trait, the study showed.

People who carry two copies of the sickle cell gene variant have sickle cell disease, which brings a drastically shortened life span of only 40 to 60 years, as well as lifelong bouts of intense pain. In contrast, those carrying just one copy of the gene variant have what’s called sickle cell trait.

Previous studies have suggested that there could be health consequences of sickle cell trait including increased higher mortality; however, in the first of its kind longitudinal cohort study of sickle cell trait, researchers have shown that people with sickle cell trait suffered no increase in mortality. The study is published in the New England Journal of Medicine.

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