Two recent papers draw attention to some clinically significant health risks for patients with sickle cell trait (SCT)—an inherited blood disorder affecting up to 10% of African Americans.
African Americans with SCT have lower levels of hemoglobin A1c—which may place them at risk of delayed or missed diagnosis of diabetes and prediabetes, according to a study in the Journal of the American Medical Association (J Am Med Assoc 2017; 317:507–515).
“These findings suggest that HbA1c may systematically underestimate past glycemia in African American patients with SCT and may require further evaluation,” according to the report by Mary E. Lacy, MPH, and Wen-Chih Wu, MD, of Brown University and colleagues.
The second study, reported in the Journal of the American Society of Nephrology, finds that SCT is associated with a twofold increase in the incidence of end stage renal disease (ESRD). That research was led by by Rakhi P. Naik, MD, MHS, of Johns Hopkins University and Marguerite R. Irvin, PhD, of the University of Alabama at Birmingham (J Am Soc Nephrol 2017; doi: 10.1681/ASN.2016101086).
Because testing for SCT is already widely performed in newborn screening and other settings, Naik, Irvin, and coauthors believe their findings “may have immediate implications for policy and treatment recommendations.”