Enas Abdul Kareem Jabbar, Afrah Abid Maktoof, Jamela Jouda
email@example.com , Afrah.firstname.lastname@example.org , email@example.com
Enas Abdul Kareem Jabbar1*, Afrah Abid Maktoof2, Jamela Jouda3
1Department of Medical Basic Science, College of Nursing, University of Thi-Qar.
2Department of Biology, College of Science, University of Thi-Qar.
3Department of Biology, College of Science, Mustansiriyah University.
Volume - 13,
Issue - 10,
Year - 2020
There is not enough literature on trace elements in sickle cell anemia (SCA) in Iraq. Our investigation also revealed that studies scrutinizing iron deficiency anemia (IDA) are also rare all around the world. The aim of this research was to determine metal concentrations and physiological parameters in SCA patients and compare them with IDA patients. In this study, 31 SCA patients, 30 IDA patients, and 28 healthy people (male and female) were recruited from the Center of Genetic Diseases, Thi-Qar, Iraq (age range: 2-45 years). The blood types of all participants were recorded from their profiles. 5ml blood was collected from both patient and healthy groups to determine reticulum cells by slide method; other hematology tests were performed by hematology analyzer. The rest was centrifuged to obtain the serum used to determine ferritin level by minividas, vitamin D by cobas, and metals including copper, zinc, magnesium, and selenium by flame atomic absorption spectrophotometer. The age of IDA group was significantly higher than that of SCA group, while no significant difference was found in the gender of the two groups. In both groups, the highest frequency was found in the O blood type and the lowest in the B blood type. The results of estimated parameters showed that both anemia patients have significantly lower RBC count, Hb level, vitamin D level, and PCV% than those in control. However, ferritin level, reticular cells %, and WBC count were significantly higher in the SCA, and significantly lower in IDA, compared to the control. Copper and selenium levels were significantly higher, while zinc and magnesium levels were significantly lower in both patient groups compared to control. Accordingly, regular laboratory examination of these elements is inevitable.
Cite this article:
Enas Abdul Kareem Jabbar, Afrah Abid Maktoof, Jamela Jouda. Evaluation of Metal levels and Physiological parameters in Sickle cell anemia and their comparison with Iron deficiency anemia. Research J. Pharm. and Tech. 2020; 13(10):4655-4660. doi: 10.5958/0974-360X.2020.00819.7
1. Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N, Lozano R, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. [Meta-Analysis Research Support, Non-U.S. Gov't]. 2014 Jan 30;123(5):615-24.
2. Krayenbuehl PA, Battegay E, Breymann C, Furrer J, Schulthess G. Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration. Blood. [Randomized Controlled Trial Research Support, Non-U.S. Gov't]. 2011 Sep 22;118(12):3222-7.
3. Jimenez K, Kulnigg-Dabsch S, Gasche C. Management of Iron Deficiency Anemia. Gastroenterol Hepatol (N Y). 2015 Apr;11(4):241-50.
4. Tan F, Ghosh S, Mosunjac M, Manci E, Ofori-Acquah SF. Original Research: Diametric effects of hypoxia on pathophysiology of sickle cell disease in a murine model. Exp Biol Med (Maywood). [Research Support, N.I.H., Extramural]. 2016 Apr;241(7):766-71.
5. Pace BS, Goodman SR. Sickle cell disease severity: an introduction. Exp Biol Med (Maywood). [Introductory]. 2016 Apr;241(7):677-8.
6. Peter O, Walter M, Andrew O, Elly O, Otieno CF, Abdallah F. Serum Ferritin Levels In Patients with Sickle Cell Anaemia at the Kenyatta National Hospital. Journal of Dental and Medical Sciences. 2018;11(3):31-40.
7. Okpuzor J, Okochi VI. Micro-nutrients as therapeutic tools in the management of sickle cell anaemia. Afr J Biotechnol. 2009;7(5):416-20.
8. Reed JD, Redding-Lallinger R, Orringer EP. Nutrition and sickle cell disease. Am J Hematol. [Review]. 1987 Apr;24(4):441-55.
9. Kaneko JJ. Clinical Biochemistry of Animals. 4 ed. New York: Academic press.inc; 1999.
10. El Maataoui H, Fahi A, Oukkache B. "Sickle cell trait and haemophilia: a rare association". Pan Afr Med J. [Case Reports]. 2018;29:92.
11. Lanzkron S, Carroll CP, Haywood C, Jr. Mortality rates and age at death from sickle cell disease: U.S., 1979-2005. Public Health Rep. [Comparative Study Research Support, N.I.H., Extramural]. 2013 Mar-Apr;128(2):110-6.
12. Quinn CT, Rogers ZR, McCavit TL, Buchanan GR. Improved survival of children and adolescents with sickle cell disease. Blood. [Multicenter Study Research Support, N.I.H., Extramural]. 2010 Apr 29;115(17):3447-52.
13. Haas JD, Brownlie Tt. Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship. J Nutr. [Research Support, U.S. Gov't, P.H.S. Review Systematic Review]. 2001 Feb;131(2S-2):676S-88S; discussion 88S-90S.
14. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics. [Research Support, U.S. Gov't, P.H.S.]. 2001 Jun;107(6):1381-6.
15. Jawed S, Tariq S, Tariq S, Kamal A. Frequency of nutritional anemia among female medical students of Faisalabad. Pak J Med Sci. 2017;33(2):398-403.
16. Pramanik T, Pramanik S. Distribution of ABO and Rh blood groups in Nepalese medical students: a report. East Mediterr Health J. 2000 Jan;6(1):156-8.
17. Conteras M, Lubenko A. Mmunohaematology: Introduction. In: Hoffbrand AV, Lewis SM, Tuddenham EGD, editors. Postgraduate haematology. 4 ed. London, UK: Arnold Publishers; 2001. p. 165 – 81.
18. Worlledge S, Ogiemudia SE, Thomas CO, Ikoku BN, Luzzatto L. Blood group antigens and antibodies in Nigeria. Ann Trop Med Parasitol. 1974 Sep;68(3):249-64.
19. Khan NS, Luke R, Soman RR, Krishna PM, Safar IP, Swaminathan SK. Qualitative assessment of red blood cell parameters for signs of anemia in patients with chronic periodontitis. J Int Soc Prev Community Dent. 2015 Nov-Dec;5(6):476-81.
20. Antwi-Boasiako C, Ekem I, Abdul-Rahman M, Sey F, Doku A, Dzudzor B, et al. Hematological parameters in Ghanaian sickle cell disease patients. J Blood Med. 2018;9:203-9.
21. Basit S. Vitamin D in health and disease: a literature review. Br J Biomed Sci. [Review]. 2013;70(4):161-72.
22. Al-Elq AH. The status of Vitamin D in medical students in the preclerkship years of a Saudi medical school. J Family Community Med. 2012 May;19(2):100-4.
23. Al-Mogbel ES. Vitamin D status among Adult Saudi Females visiting Primary Health Care Clinics. Int J Health Sci (Qassim). 2012 Jun;6(2):116-26.
24. Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A. Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos. [Observational Study]. 2014;9:190.
25. Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol. [Research Support, N.I.H., Extramural Review Systematic Review]. 2014 Oct;144 Pt A:138-45.
26. Goodman BM, 3rd, Artz N, Radford B, Chen IA. Prevalence of vitamin D deficiency in adults with sickle cell disease. J Natl Med Assoc. [Multicenter Study]. 2010 Apr;102(4):332-5.
27. Nolan VG, Nottage KA, Cole EW, Hankins JS, Gurney JG. Prevalence of vitamin D deficiency in sickle cell disease: a systematic review. PLoS One. [Research Support, Non-U.S. Gov't Review Systematic Review]. 2015;10(3):e0119908.
28. Wykes C, Arasaretnam A, O'Driscoll S, Farnham L, Moniz C, Rees DC. Vitamin D deficiency and its correction in children with sickle cell anaemia. Ann Hematol. 2014 Dec;93(12):2051-6.
29. de Oliveira JF, Vicente NG, Santos JP, Weffort VR. [Vitamin D in children and adolescents with sickle cell disease: an integrative review]. Rev Paul Pediatr. [Review]. 2015 Jul-Sep;33(3):350-5.
30. Okpala I. The intriguing contribution of white blood cells to sickle cell disease - a red cell disorder. Blood Rev. [Review]. 2004 Mar;18(1):65-73.
31. Ahmed SG, Ibrahim UA, Hassan AW. Hematological parameters in sickle cell anemia patients with and without priapism. Ann Saudi Med. 2006 Nov-Dec;26(6):439-43.
32. Ahmed AE, Ali YZ, Al-Suliman AM, Albagshi JM, Al Salamah M, Elsayid M, et al. The prevalence of abnormal leukocyte count, and its predisposing factors, in patients with sickle cell disease in Saudi Arabia. J Blood Med. 2017;8:185-91.
33. Zimmerman SA, Schultz WH, Davis JS, Pickens CV, Mortier NA, Howard TA, et al. Sustained long-term hematologic efficacy of hydroxyurea at maximum tolerated dose in children with sickle cell disease. Blood. [Clinical Trial]. 2004 Mar 15;103(6):2039-45.
34. Platt OS, Thorington BD, Brambilla DJ, Milner PF, Rosse WF, Vichinsky E, et al. Pain in sickle cell disease. Rates and risk factors. N Engl J Med. [Research Support, U.S. Gov't, P.H.S.]. 1991 Jul 4;325(1):11-6.
35. Castro O, Brambilla DJ, Thorington B, Reindorf CA, Scott RB, Gillette P, et al. The acute chest syndrome in sickle cell disease: incidence and risk factors. The Cooperative Study of Sickle Cell Disease. Blood. [Research Support, U.S. Gov't, P.H.S.]. 1994 Jul 15;84(2):643-9.
36. Platt OS, Brambilla DJ, Rosse WF, Milner PF, Castro O, Steinberg MH, et al. Mortality in sickle cell disease. Life expectancy and risk factors for early death. N Engl J Med. [Research Support, U.S. Gov't, P.H.S.]. 1994 Jun 9;330(23):1639-44.
37. Ilesanmi OO. Pathological basis of symptoms and crises in sickle cell disorder: implications for counseling and psychotherapy. Hematol Rep. 2010 Jan 26;2(1):e2.
38. Alder L, Tambe A. Acute Anemia. StatPearls. Treasure Island (FL)2019.
39. Patel C, Jha BM, Jana S, Singh A, Shah H. Iron status in sickle cell disorders. International Journal of Medical Science and Public Health. 2016;5(9):1759-63.
40. Aluoch JR, Aluoch LH. Survey of sickle disease in Kenya. Trop Geogr Med. 1993 Mar;45(1):18-21.
41. Bot YS, Benjamin A, Nyango DY, Ventmack DT, Eunice CB, Etukudu NS, et al. Analyses of Cu and Zn in serum of sickle cell disease patients in Jos. International Journal of Medicine and Medical Sciences. 2015;3(3):207-9.
42. Prasad AS, Schoomaker EB, Ortega J, Brewer GJ, Oberleas D, Oelshlegel FJ, Jr. Zinc deficiency in sickle cell disease. Clin Chem. 1975 Apr;21(4):582-7.
43. Prasad AS. Zinc deficiency in patients with sickle cell disease. Am J Clin Nutr. [Comment Editorial]. 2002 Feb;75(2):181-2.
44. Das AK. A textbook on medicinal aspects of Bio-Inorganic chemistry. 1 ed. India: CBS publishers and distributors; 1990.
45. Prasad AS, Oberleas D, Wolf P, Horwitz HP. Studies on zinc deficiency: changes in trace elements and enzyme activities in tissues of zinc-deficient rats. J Clin Invest. 1967 Apr;46(4):549-57.
46. Ma YL, Rees DC, Gibson JS, Ellory JC. The conductance of red blood cells from sickle cell patients: ion selectivity and inhibitors. J Physiol. 2012 May 1;590(9):2095-105.
47. Zehtabchi S, Sinert R, Rinnert S, Chang B, Heinis C, Altura RA, et al. Serum ionized magnesium levels and ionized calcium-to-magnesium ratios in adult patients with sickle cell anemia. Am J Hematol. [Comparative Study]. 2004 Nov;77(3):215-22.
48. Akenami FO, Aken'Ova YA, Osifo BO. Serum zinc, copper and magnesium in sickle cell disease at Ibadan, south western Nigeria. Afr J Med Med Sci. [Comparative Study]. 1999 Sep-Dec;28(3-4):137-9.
49. Segal JB, Miller ER, 3rd, Brereton NH, Resar LM. Concentrations of B vitamins and homocysteine in children with sickle cell anemia. South Med J. [Research Support, Non-U.S. Gov't]. 2004 Feb;97(2):149-55.
50. Claster S, Wood JC, Noetzli L, Carson SM, Hofstra TC, Khanna R, et al. Nutritional deficiencies in iron overloaded patients with hemoglobinopathies. Am J Hematol. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't, P.H.S.]. 2009 Jun;84(6):344-8.
51. Rayman MP. Selenium and human health. Lancet. [Comparative Study Review]. 2012 Mar 31;379(9822):1256-68.