• MORADEKE BOSEDE AGBOOLA National Postgrduate Medical College of Nigeria (NPMCN)


Assessment of body composition provides a more useful and complete data relating to nutritional
status. Most studies on the size of children with Sickle cell anaemia (SCA) are limited to
composite measures of weight, height, and BMI without reference to body composition. This has
left a gap in the knowledge of the relative impact of the disease on body composition in terms of
Percentage Body Fat, Fat Mass and Fat Free Mass (PBF, FM and FFM).
The aim of the current study was to evaluate body composition of children with sickle cell
anaemia aged 5 – 18 years who attend the Haematology clinics of General Hospital Gbagada and
Massey Street Children’s Hospital.
The present study was descriptive, comparative and cross sectional. It was carried out over a
period of six months (February 2016 to July 2016). A total of 480 children aged five to eighteen
years were recruited following parental consent and assent from the children seven years and
above. Two hundred forty children with SCA in steady state and 240 age and sex matched
children with HbAA controls were studied. All subjects and controls had body composition
measured by bioelectrical impedance analysis (BIA) and from two skin fold thicknesses
(subscapular SFT and triceps SFT). Percentage body fat (PBF), fat free mass (FFM) and fat mass
(FM) were estimated from both methods.
Female children with SCA had significantly higher overall mean PBF (17.64 ± 3.4% vs. 13.45 ±
5.7%: t = 6.916, p < 0.001 –BIA; 13.10 ± 2.1% vs. 7.90 ± 2.1%: t = 11.470, p < 0.0001-SFT) and
mean FM (5.62 ± 2.9kg vs. 3.62 ± 1.3kg: t =15.369, p < 0.0001 - BIA; 4.39 ± 2.9kg vs.2.22 ±
0.6kg: t = 11.384, p < 0.0001-SFT) than their male counterparts for both methods.
Male children with SCA had higher values of overall mean FFM than females with SCA, (25.64 ±
8.7kg vs. 25.20 ± 8.3kg: t = 0.400, p = 0.689 –BIA; 27.04 ± 8.3kg vs. 26.43 ± 8.4kg: t = 0.566, p =
0.572 – SFT) but the difference was not significant by both methods.

The mean PBF and mean FM were directly related to age in female children with SCA by both
methods. In male children with SCA mean PBF was inversely related to age by both methods.
Mean FM was inversely related to age using BIA and directly related with age using SFT in male
children with SCA.
Mean FFM was directly related to age in female and male children with SCA by both methods.
Male children with SCA had comparable mean FFM with their female counterparts.
Children with SCA had significantly lower PBF, FM and FFM compared to HbAA controls by
both methods. The difference was significant (p < 0.05).
In conclusion the age related mean PBF, FM and FFM in male and female children with SCA
followed expected physiologic trend. Children with SCA have a deficit in body composition
parameters compared to age and sex matched HbAA children. It is therefore recommended that
body composition monitoring be a part of the comprehensive care of children with SCA for
identification of body composition deficit.