Serum micronutrient levels and disease severity score in patients with sickle cell anaemia

Abstract

Background Disease severity in patients with sickle cell anaemia (SCA) is accentuated by the risk for infection, which could potentially be influenced by serum levels of micronutrients, particularly those that are components of the antioxidant system of the body. Objective The aim of this study was to evaluate serum levels of the micronutrients zinc, copper, selenium and magnesium in our SCA patients and to compare these with the objective score of disease severity. Patients and methods Twenty-six confirmed (using cellulose acetate electrophoresis, in alkaline pH) homozygous sickle cell patients were prospectively recruited in steady-state conditions. Each participant had 8 ml of venous blood collected for haemoglobin electrophoresis and determination of serum levels of the micronutrients zinc, copper, selenium and magnesium (using atomic absorption spectrophotometry). The objective score of disease severity was calculated as previously described and correlated with serum micronutrient levels using the Pearson's linear regression for bivariate correlation. A P value less than 0.05 was taken as significant. Ethical approval was obtained from the institutional review board and each participant gave informed consent. Results The mean age of study participants was 21.58 ± 9.58 years, and the mean serum level of selenium, copper, magnesium and zinc was 0.60 ± 0.29, 0.13 ± 0.07, 8.76 ± 1.14, and 0.40 ± 0.14 mg/l, respectively. Serum copper was significantly correlated with disease severity score (r = 0.61, P = 0.001), whereas no significant correlation was observed between disease severity score and other micronutrients. Conclusion Serum copper level has the potential to become a surrogate marker of disease severity in steady-state SCA patients.