Relationship between Painful Crisis and Serum Zinc Level in Children with Sickle Cell Anaemia

Abstract

Sickle cell anaemia (SCA) is associated with zinc deficiency; zinc supplementation may ameliorate some of its clinical manifestations including the relief of painful crisis. Subjects and Methods. Serum zinc levels were determined in 71 children with SCA and painful crisis and in equal numbers in steady state. Seventy-one children with AA genotype acted as controls. Qualitative assessment of zinc content of 24-hour dietary recall and the last meal consumed before blood was drawn was taken. Serum zinc was determined using atomic absorption spectrophotometer. Haemoglobin concentration and packed cell volume (PCV) were determined using standard methods. Results. The mean serum zinc concentration in the study was less than international reference range. The controls had significantly higher serum zinc concentrations than the SCA group (42.7 ± 13.6 versus 32.3 ± 14.0 μg/dL, P < .000); this difference was due to the significantly lower values of serum zinc in SCA with painful crisis compared with the remaining two groups F = 30.9, P<.000. There was a positive correlation between serum zinc and haemoglobin concentration only in the control group (r = 0.4; P = .001). Conclusion. The serum zinc levels in this study were low. Painful crisis in SCA may exert greater demand for zinc utilization in children with SCA thereby resulting in lower serum levels.

Nutrient Insufficiencies/Deficiencies in Children With Sickle Cell Disease and Its Association With Increased Disease Severity

“…Our study found that zinc insufficiency/deficiency was significantly associated with increased pain crises at home and increased hospitalization due to VOC. Similarly, children with SCD‐related vaso‐occlusive bone crises have been found to have lower levels of zinc than those whom were not in pain crisis …”

“…More than half of our subjects were zinc insufficient/deficient, concordant with multiple studies indicating that patients with SCD have an increased risk of low zinc levels . There are numerous possible explanations as to why those with SCD have an increased risk of low zinc levels; it has been described that patients with SCD have an increased risk of hyperzincuria .…”

“…More than half of our subjects were zinc insufficient/deficient, concordant with multiple studies indicating that patients with SCD have an increased risk of low zinc levels. [21,[37][38][39] There are numerous possible explanations as to why those with SCD have an increased risk of low zinc levels; it has been described that patients with SCD have an increased risk of hyperzincuria. [38] They also have a higher potential for oxidative damage that increases the risk of recurrent VOCs, [40] and zinc is used to inhibit lipid peroxidation on sickled cells [41] (a form of oxidative damage), which would increase the clearance of zinc from the circulation.…”

“…Similarly, children with SCD-related vasoocclusive bone crises have been found to have lower levels of zinc than those whom were not in pain crisis. [39] 25-Hydroxyvitamin D (calcidiol) is the form used to measure the vitamin D status in patients, while 1,25-dihydroxyvitamin D (calcitriol) is the active form of the vitamin. Unlike calcidiol, calcitriol levels are tightly regulated and do not tend to vary with vitamin D status.…”

The relationship between micronutrients and anthropometric measurements in malnourished children / Relaţia între micronutrienţi şi măsurătorile antropometrice la copiii malnutriţi

“…Instead, in Nepal, Zn deficiency was associated with both sex and age (25). The positive correlation between the Zn and Fe levels and HGB was also described in other studies (26,27). Iron deficiency is mainly reflected through low values of HGB, MCV, MCH, and MCHC, so the positive correlation is explainable (28).…”