Serum Iron Levels and Copper-to-Zinc Ratio in Sickle Cell Disease

Antwi‐Boasiako, Charles; Dankwah, Gifty Boatemaah; Aryee, Robert; Hayfron‐Benjamin, Charles; Doku, Alfred; N’guessan, Benoit Banga; Asiedu-Gyekye, Isaac Julius; Campbell, Andrew

doi:10.3390/medicina55050180

Cited by 9 publications

(15 citation statements)

References 26 publications

(38 reference statements)

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“…In agreement with previous reports on pediatric cohorts, 41 , 42 , 43 this study demonstrated that adults with SCD had deficiencies of zinc and vitamins B12 and D that contributed to the severity of SCD. Vitamin D deficiency is highly prevalent in Saudi Arabia due to decreased sun exposure because of the hot climate and traditional wear, covering the entire body.…”

Section: Discussionsupporting

confidence: 93%

Influence of Nutrition on Disease Severity and Health-Related Quality of Life in Adults With Sickle Cell Disease

Kamal

Naghib

Zahrani

et al. 2020

Mediterr J Hematol Infect Dis

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Background & Aims: Sickle cell disease (SCD has a worldwide distribution and causes significant morbidity and mortality in children and adults. Few studies addressed the determinants of SCD severity in adults; therefore, we investigated the impact of nutrition on the outcome of SCD and health-related quality of life (HRQoL) in adult patients, Methods: In this longitudinal study, we recruited and prospectively followed 62 adults with SCD (aged ?18 years) for a median of 93 months. At entry and follow-up, patients provided medical and dietary history, had a physical examination and anthropometric measurements, assessment of protein-energy intake, measurement of micronutrient levels, estimation of SCD severity score, and determination of the HRQoL (SF-26v2). The study outcome was a composite of hospitalization due to SCD crises or death. Results: At baseline, 42 (67.74%) patients had macro and, or micro-undernutrition (Group A), and 20 (32.26%) were well nourished. (Group B). The BMI and most anthropometric measurements were significantly lower in SCD patients compared to control subjects. In several SCD patients, undernutrition resulted from reduced food intake and reduced absorption due to concomitant gastrointestinal disorders. Seventy percent of SCD patients had vitamin D, vitamin B12, and zinc deficiencies. Under-nourished patients had significantly higher SCD severity scores, frequent SCD related hospitalizations, higher mortality rates, and reduced HRQoL compared to well-nourished patients. Protein-energy and micronutrient deficiencies were independent predictors of severe SCD and mortality. Correction of undernutrition and hydroxyurea therapy improved SCD severity scores and HRQoL. Conclusion: Patients with sickle cell disease have various degrees of macro and micro deficiencies, which increase SCD severity and hospitalizations and reduce the health-related quality of life. Early diagnosis and prompt correction of macro and micronutrient deficiencies need to be incorporated in the standard of care of SCD patients to improve the disease outcomes.

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Section: Discussionsupporting

confidence: 93%

Influence of Nutrition on Disease Severity and Health-Related Quality of Life in Adults With Sickle Cell Disease

Kamal

Naghib

Zahrani

et al. 2020

Mediterr J Hematol Infect Dis

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“…The second most common group of studies identi ed involved assessment of biomarkers from serum samples for macronutrients or micronutrients. Most studies were conducted in Nigeria (21/31, 68%); other studies took place in DRC [53], Tanzania [27,54,55], Egypt [56], Kenya [38], Ghana [57], Uganda [58], and Malawi [59]. Nutritional parameters measured included proteins/amino acids, fatty acids, vitamins, and minerals.…”

Section: Resultsmentioning

confidence: 99%

“…Selected minerals were evaluated in eight small studies of SCD patients and compared to healthy controls. Serum iron concentration was reduced in patients compared to controls in all studies that evaluated it [57,[69][70][71]. Serum or plasma zinc was also generally reduced in SCD patients [53,7,[70][71][72][73][74], although zinc was elevated in one population of 59 Nigerian adult SCD patients.…”

Section: Resultsmentioning

confidence: 99%

“…Magnesium levels were either reduced [71,72], elevated [73] or unchanged [69,71,75] in SCD patients compared to healthy controls. Similarly, copper was reduced [72], elevated [57,73,76] or unchanged [69,71] in SCD patients. Other minerals measured in only a few studies included manganese, chromium, selenium, potassium, rubidium, cadmium, and calcium.…”

Section: Resultsmentioning

confidence: 99%

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Nutritional perspectives on sickle cell disease in Africa: A systematic review

Nartey

Spector

Adu‐Afarwuah

et al. 2021

Preprint

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Background: Sickle cell disease (SCD), an inherited blood disorder, predominantly affects individuals in sub-Saharan Africa. Research linking its pathophysiology and nutritional status in African patients has not been previously described. This systematic review aimed to assess the landscape of studies in sub-Saharan Africa focused on nutritional aspects of SCD and highlight gaps in knowledge that could inform priority-setting for future research.Methods: The study was conducted using the Preferred Reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. All original studies involving individuals with any phenotypic variant of SCD and at least one nutritional status outcome; and were conducted between January 1995 and November 2020 in Africa were included. ‘Nutritional status’ was defined by studies on dietary intake, measurements of growth/anthropometry, or nutritional biomarkers. Studies were included if they involved Databases used were Ovid Embase, Medline, Biosis and Web of Science. Results: The search returned 526 articles with 76 studies included in the final analyses. Most investigations (67%) were conducted in Nigeria. Studies were categorized into one of three main categories: descriptive studies of anthropometric characteristics (49%), descriptive studies of macro- or micronutrient intakes (41%), and interventional studies (11%). Findings consistently found growth impairment, especially among children and adolescents from sub-Saharan Africa. Studies assessing macro- and micronutrients generally had small sample sizes and were exploratory in nature. Only four randomized trials were identified, which measured the impact of lime juice, long-chain fatty acids supplementation, ready-to-use supplementary food, and oral arginine on health outcomes. Conclusions: The findings reveal a moderate number of descriptive studies, most with small sample sizes, that focused on various aspects of nutrition and SCD in African patients. There was a stark lack of interventional studies that could be used to inform evidence-based changes in clinical practice. Findings of investigations were generally consistent with data from other regional settings, describing a significant risk of growth faltering and malnutrition among individuals with SCD. There is an unmet need for clinical research to better understand the potential benefits of nutritional-related interventions for patients with SCD in sub-Saharan Africa in order to promote optimal growth and improve health outcomes.

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“…However, copper could act as a prooxidant and promotes free radicals when it presents in high concentration in the state of impaired zinc bioavailability, a condition that has been previously described in various diseases, including SCD. 8,9,12,13 Also, magnesium has a role in the modulation of endothelial inflammation, besides its roles in regulating heart rhythm, immune system functions, and bone metabolism. 14 Several studies provided data on the status of these micronutrients in SCD but these data require further summary and analyses for better accuracy.…”

Section: Introductionmentioning

confidence: 99%

Zinc, Magnesium, and Copper Levels in Patients with Sickle Cell Disease: A Systematic Review and Meta-analysis

Elkhidir

Ali

et al. 2022

Avicenna J Med

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Background Sickle cell disease (SCD) is associated with oxidative stress due to an imbalance between production and elimination of the reactive oxygen species. It has been reported that SCD patients are at risk of multiple micronutrients' deficiencies, including several trace elements involved in the antioxidation mechanisms. We aimed to assess the status of these micronutrients in SCD patients. Methods This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The databases of MedLine, Embase, and PsycInfo were used for the systematic search from time the databases existed until April 2021. A total of 36 studies fulfilled the eligibility criteria. We calculated the pooled standardized mean difference (SMD) of serum zinc, magnesium, or copper levels among patients with SCD and their healthy controls. Results SCD patients had significantly lower zinc (SMD = −1.27 [95% CI: 1.67−0.87, p 0.001]) and magnesium levels (SMD = −0.53 [95% CI: 1.0−0.06, p 0.026] than their controls. Copper level was found to be significantly higher in SCD patients, with SMD = 0.68 (95% CI: 0.05−1.32, p 0.004). Conclusion This review showed that SCD patients may potentially prompt to have lower zinc and magnesium levels and higher copper levels compared with those without the disease. Future research need to be directed to investigate clinical outcome of nutritional difficiencies in patients with SCD, as well as the possibility of implementing nutritional supplement programs which may help minimizing the harmful effects of the disease on human body.

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Serum Iron Levels and Copper-to-Zinc Ratio in Sickle Cell Disease

Cited by 9 publications

References 26 publications

Influence of Nutrition on Disease Severity and Health-Related Quality of Life in Adults With Sickle Cell Disease

Influence of Nutrition on Disease Severity and Health-Related Quality of Life in Adults With Sickle Cell Disease

Nutritional perspectives on sickle cell disease in Africa: A systematic review

Zinc, Magnesium, and Copper Levels in Patients with Sickle Cell Disease: A Systematic Review and Meta-analysis

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