Evaluation of P-Selectin Level in Sickle Cell Disease Patients with Leg Ulcers in South-South Nigeria

Abstract

Background: Sickle cell leg ulcers (SCLU) contribute to significant morbidity in patients with sickle cell disease (SCD). Nigeria has the highest burden of sickle cell disease (SCD) and about one-third of the patients have leg ulcers. Although several factors contribute to the development of leg ulcer, the role of P-selectin has not been adequately explored globally. Aim: This study aimed at determining the level of P-Selectin in SCD patients with leg ulcers in Benin City, Nigeria. Methods: This was a hospital based comparative study conducted at the University of Benin Teaching hospital (UBTH) between June 2023 and November 2023 among SCD patients and healthy controls. Eighty-eight subjects including 33 SCD patients with leg ulcer, 33 SCD patients without leg ulcers and 22 HbAA controls were recruited. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Results: The mean age (SD) of SCD patients with leg ulcers, SCD controls and HbAA controls were 29±6.6yrs, 29.3±5.9yrs and 29.9±6.7yrs respectively. The differences in mean age across the study groups were not statistically significant (p=0.932). Nineteen (57.6%) SCD individuals with leg ulcers were females and fourteen (42.4%) were males. There was no statistically significant difference in the sex distribution between the case group and controls (p=0.521). The median P-selectin level was lower in SCD patients with leg ulcers compared with SCD patients without leg ulcers (0.21pg/ml vs 0.36pg/ml), while the levels were higher than their age and sex matched HbAA controls (0.21pg/ml vs 0.16pg/ml). The differences were not statistically significant (p=0.063). The study did not find any significant association between the level of p-selectin and the severity of leg ulcer (p=0.442). Conclusion: There was no significant association between P-selectin level and SCLU in our study population.