Assessment of Oxidative Stress Indicators among Patients with Sickle Cell Anaemia versus Non Sickle Cell Iron Deficiency Anaemia: A Case-control Study

Abstract

Introduction: In sickle cell anaemia, haemolysed iron is reutilised, moreover, iron stores are increased owing to the blood transfusions, hence, iron deficiency is less common in sickle cell anaemia. But iron decompartmentalisation, due to unstable haemoglobin, is thought to be the cause for oxidative stress. Hence, iron deficiency anaemia and sickle cell anaemia need to be compared and studied to provide better treatment and awareness. Aim: To compare the oxidative stress, antioxidants and iron indices among patients with Sickle Cell Anaemia (SCA) and Iron Deficiency Anaemia (IDA). Materials and Methods: A case-control study was conducted at Jawaharlal Nehru Medical College, Wardha, Maharashtra, India, from January 2016 to December 2018. Total 240 SCA patients {120 SS (homozygous disease) and 120 AS (heterozygous trait)}, 120 patients with IDA and 120 age-matched and sexmatched controls were included in present study. Oxidative stress markers Malondialdehyde (MDA), Catalase, Superoxide Dismutase (SOD), vitamin C and vitamin E, zinc and iron indices {Iron, Total Iron Binding Capacity (TIBC) and serum ferritin} were analysed. Data was analysed using descriptive and inferential statistics using Analysis of Variance (ANOVA). Results: The mean age of SS patients was 19.01±11.43, AS was 22.01±11.78 years, control was 22.63±12.17 years, and IDA was 18.50±11.46. There was an equal distribution of both males and females in all groups. The mean of haemoglobin in SS was 7.40 g/dL, AS was 10.31 g/dL, IDA was 8.63 g/dL, and control was 14.81 g/dL. The mean value of mean corpuscular volume for SS was 65.71 fL, AS was 65.64 fL, IDA was 72.38 fL, and control was 87.68 fL. Zinc for SS was 82.65 μg/dL, AS was 82.13 μg/dL, IDA was 43.33 μg/dL, and control was 103.99 μg/dL. Conclusion: There is impairment in the oxidant and antioxidant status among patients with sickle cell anaemia with and without IDA.