Oxidative Stress, Antioxidant Capacity, Dyslipidemia and Cardiovascular Risk in Sickle Cell Disease: A Systematic Review and Meta‐Analysis

Background Sickle cell disease is a human hemoglobinopathy associated with high hemolytic capacity. Hemoglobin S (HbS) polymerization is a primary pathophysiological event in sickle cell anemia. Despite numerous studies conducted to understand the pathophysiology of the disease, including oxidative imbalance and cardiovascular risk, questions still arise. This systematic review and meta‐analysis aimed to evaluate studies linking oxidative stress, lipid profile, and dyslipidemia in sickle cell patients, predisposing them to atherogenic risk. Methods The systematic review of databases and search engines was conducted over 24 years (2000–2024) worldwide, according to the guidelines of PRISMA and the Cochrane Handbook. Research articles were searched in the PubMed and Web of Science databases. Only case‐control articles were retained. Data were extracted from the articles and analyzed using R version 4.3.2, with a common‐effect model for meta‐analyses. Heterogeneity was assessed using I 2 statistics. The standardized mean difference (SMD) was used to assess the extent of the disease on the different parameters studied. Heterogeneity across individual studies was assessed using Higgins’s inconsistency Q statistics and reported as I 2 and p ‐values. ROBINS‐E was used to assess the risk of bias in the included studies. Results A total of 405 studies were initially identified; after the elimination of duplicates and studies not meeting the objectives of the review, 25 studies were finally included in the meta‐analyses. The reported SMDs using a common‐effect model were 1.15 [0.96; 1.34] ( p