Evaluation of Iron Status in Adult Sickle Cell Anaemia Patients in Zaria, North Western Nigeria

Abstract

This is a case-controlled study designed to evaluate iron status of adult sickle cell anaemia patients and to compare findings with vaso-occlusive crises in sickle cell anaemia. One hundred and one (101) subjects aged 18-46 years participated in this study and these participants were divided into thirty five (35) sickle cell anaemia subjects in stable state (SS), thirty five (35) sickle cell anaemia subjects with history of vaso-occlusive crises (VOC) in the last preceding three months and thirty one (31) apparently healthy subjects (Hb AA) as control subjects (C) were recruited into the study using simple random sampling. Approximately 4 ml of venous blood samples was collected from each subject into a plain tube, allowed to clot and serum sample separated from it was analysed for serum iron, ferritin, total iron binding capacity (TIBC) and percentage transferrin saturation. The haemoglobin electrophoresis was determined using the alkaline cellulose acetate electrophoresis method Serum iron was analysed using atomic absorption spectrophotometer (AAS). Serum ferritin was determined using Ferritin Enzyme Immunoassay (Genway). TIBC was done using Ferene method and percentage transferrin saturation (%TFS) was derived from serum iron and TIBC. The mean values of serum iron and ferritin were significantly lower (P=0.00, P=0.00) respectively in SCA subjects compared with control. However, there was no significance difference in the mean values of TIBC and %TFS between SCA subject and control (P=0.56, P=0.14) respectively. There was significant difference in the mean values of serum iron and ferritin between SCA in stable state and control subjects (P=0.00, P=0.00) respectively. Also, there was significant difference in the mean values of serum iron and ferritin between SCA subjects with vaso-occlusive crises and control subjects (P=0.00, P=0.00) respectively. However, the comparison of the mean values of TIBC and %TFS between SCA in stable state and control subjects did not show any significance difference (P=0.56, P=0.33) respectively. Also, the mean values of TIBC and %TFS between SCA with vaso-occlusive crises and control subjects did not show any significant difference (P=0.88, P=0.37) respectively. The mean values of serum iron, ferritin, TIBC and %TFS between SS and VOC did not show any significant difference (P=1.00, P=0.99, P=0.79, P=0.97) respectively. The outcome of this work show reduced serum iron and ferritin levels in SCA subjects. Periodic assessment of iron status is therefore suggested in the monitoring and management of sickle cell anaemia.