Sickle cell trait and development of microvascular complications in diabetes mellitus

Clin J Am Soc Nephrol. 2010 Jun;5(6):1015-20. doi: 10.2215/CJN.08841209. Epub 2010 Mar 18.


Background and objectives: Many African Americans (AA) have both sickle cell trait (SCT) and diabetes mellitus. The objective of this study was to determine whether individuals with diabetes mellitus and SCT have higher rates of microvascular complications relative to those without SCT.

Design, setting, participants, & measurements: This was a retrospective study comparing albuminuria, estimated GFR (eGFR), and microvascular complications in AA with diabetes on the basis of presence of SCT. The study included 821 outpatients who underwent hemoglobin A1c (HbA1c) testing, and presence of SCT was determined using the HbA1c assay. Medical record review and telephone interviews were performed for AA participants.

Results: Data were obtained on 376 AA patients (110 with SCT, 245 with neither SCT nor hemoglobin C trait, and 21 with hemoglobin C trait) and 445 European Americans. The mean eGFR and urinary protein excretion were similar between the three AA subgroups. Analysis revealed that 36.3% of AA nontrait and 22.7% of AA SCT participants had retinopathy, peripheral vascular disease, or end-stage kidney disease (P = 0.01). After adjustment for diabetes duration, age, insulin use, and gender, differences in the prevalence of microvascular complications were not observed.

Conclusions: SCT does not increase the risk of microvascular complications in AA with diabetes mellitus.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Albuminuria / etiology
  • Albuminuria / physiopathology
  • Biomarkers / blood
  • Black or African American* / statistics & numerical data
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / ethnology*
  • Diabetes Mellitus / physiopathology
  • Diabetic Nephropathies / ethnology
  • Diabetic Nephropathies / etiology
  • Diabetic Retinopathy / ethnology
  • Diabetic Retinopathy / etiology*
  • Female
  • Glomerular Filtration Rate
  • Glycated Hemoglobin / analysis
  • Humans
  • Kidney Failure, Chronic / ethnology
  • Logistic Models
  • Male
  • Middle Aged
  • North Carolina
  • Peripheral Vascular Diseases / ethnology
  • Peripheral Vascular Diseases / etiology*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sickle Cell Trait / blood
  • Sickle Cell Trait / complications*
  • Sickle Cell Trait / ethnology
  • White People* / statistics & numerical data


  • Biomarkers
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human