HTCT 3098 1–7
Please cite this article in press as: Ferreira WB, et al. Craniofacial geometric morphometrics in the identification of patients with sickle cell
anemia and sickle cell trait. Hematol Transfus Cell Ther. 2019. https://doi.org/10.1016/j.htct.2019.10.003
ARTICLE IN PRESS
HTCT 3098 1–7
hematol transfus cell ther. 2 0 1 9; x x x(x x) :xxx–xxx
www.htct.com.br
Hematology, Transfusion and Cell Therapy
Original article
Craniofacial geometric morphometrics in the
identification of patients with sickle cell anemia
and sickle cell trait
Warli de Brito Ferreira
a
, Lorena Andrade Nunes
a
, Matheus Melo Pithon
a,*
, Q3
Lucianne Cople Maia
b
, Cezar Augusto Casotti
a
a
Universidade Estadual do Sudoeste da Bahia (UESB), Jequié, Bahia, Brazil
b
Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
a r t i c l e i n f o
Article history:
Received 21 February 2019
Accepted 17 October 2019
Available online xxx
Keywords:
Shape
Centroid size
Craniofacial morphology
Sickle cell disease
a b s t r a c t
Objective: The aims of this study were to identify the main characteristics regarding the
shape and size of the craniofacial region in patients with sickle cell anemia (SCA) and sickle
cell trait (SCT) and in unaffected patients using geometric morphometrics and to check the
efficiency of this method.
Material and Methods: A cross-sectional analytical study of 45 patients (15 in each group) was
performed. Lateral radiographs of the skull were used for the analysis. Seventeen landmarks
and semilandmarks were placed for the measurements. The Pocrustes analysis of variance
(ANOVA), regression analysis, multivariate analysis of variance, canonical variate analysis,
Mahalanobis and Procrustes distances and unweighted pair group method with arithmetic
mean (UPGMA) clustering were performed. Allometric effects and sex characteristics were
not statistically significant (p > 0.05).
Results: There were, however, significant differences (p < 0.05) in craniofacial shape among
SCA, SCT and unaffected individuals. Those with SCA showed variations in the shape of the
external auditory meatus and at the base of the occipital bone, in addition to the mandibular
setback and upper incisor inclination, with a tendency towards prognathism. The individ-
uals with SCT exhibited a similar craniofacial shape to those with SCA, but with slighter
variations. Moreover, those with SCT were statistically closer in resemblance to unaffected
individuals, given that SCT is not regarded as a disease.
Conclusion: This demonstrates the efficiency of geometric morphometrics in the categoriza-
tion of the assessed groups.
© 2019 Associac ¸˜ ao Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published
by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
*
Corresponding author at: Av. Otávio Santos, 395, sala 705, Centro Odontomédico Dr. Altamirando da Costa Lima, Bairro Recreio, CEP
45020-750, Vitória da Conquista, BA, Brazil.
E-mail address: matheuspithon@bol.com.br (M.M. Pithon).
https://doi.org/10.1016/j.htct.2019.10.003
2531-1379/© 2019 Associac ¸˜ ao Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. This is an
open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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