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Among 257 SCD participants, we assessed the relationship of subphenotypes with pain sensitivity using quantitative sensory testing to identify heat pain thresholds (HPT) and pressure pain thresholds (PPT). VOC history and sleep, social and emotional functioning were assessed using the Adult Sickle Cell Quality of Life Measurement Information System. The \u2018elbow method\u2019 determined the optimal number of clusters as three. Clustering was performed using K\u2010prototypes. Among clusters 2 and 3, VOC frequency and severity were higher. Clusters 1 and 3 had lower haemoglobin, higher reticulocytes and lactate dehydrogenase and more leg ulcers. In multivariate regression, cluster 3 was associated with approximately 13.6% lower PPT compared to cluster 1, and female sex was associated with decreases in PPT and HPT at the hands and feet (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Hydroxyurea use and unit increases in sleep functioning and age were associated with approximately 20.1% higher foot\u2010PPT, 6.8% higher hand\u2010PPT and 2.5% higher hand\u2010HPT and foot\u2010HPT respectively. Findings suggest that a third subphenotype with mixed VVO and HED features and worse pain sensitization may exist.<\/jats:p>","DOI":"10.1111\/bjh.19667","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T04:29:04Z","timestamp":1722400144000},"page":"1570-1580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring the role of viscosity\u2013vaso\u2010occlusion and haemolysis\u2013endothelial dysfunction in pain sensitization among Jamaicans with sickle cell disease"],"prefix":"10.1111","volume":"205","author":[{"given":"Zachary","family":"Ramsay","sequence":"first","affiliation":[{"name":"Caribbean Institute for Health Research \u2013 Sickle Cell Unit The University of the West Indies, Mona Campus  Kingston Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amza","family":"Ali","sequence":"additional","affiliation":[{"name":"Avicanna, Inc.  Toronto Ontario Canada"},{"name":"Department of Medicine Kingston Public Hospital  Kingston Jamaica"},{"name":"Department of Medicine, Faculty of Medical Sciences The University of the West Indies, Mona Campus  Kingston Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Grant","sequence":"additional","affiliation":[{"name":"Avicanna, Inc.  Toronto Ontario Canada"},{"name":"Department of Pharmacology and Toxicology, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-138X","authenticated-orcid":false,"given":"Monika","family":"Asnani","sequence":"additional","affiliation":[{"name":"Caribbean Institute for Health Research \u2013 Sickle Cell Unit The University of the West Indies, Mona Campus  Kingston Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2006.07.001"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.12.016"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation\u20102010.1.409"},{"key":"e_1_2_12_5_1","unstructured":"International Association for the Study of Pain.IASP Terminology [Internet]. 2020. 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