Association of serum zinc level with the anthropometric measurements and disease severity of children and adolescents with sickle cell anemia

Abstract: BACKGROUND: Many factors contribute to the alteration of zinc levels in patients with sickle cell anemia (SCA). Furthermore, Zinc deficiency may aggravate many pathophysiologic changes of SCA, contributing for many complications. OBJECTIVES: The study was carried out to assess zinc status in a pediatric cohort with SCA during steady state and its relation with their anthropometric and disease-severity variables. MATERIALS AND METHODS: A prospective case–control research was conducted, including 255 children with SCA (ages 1–15 years) and 271 age- and sex-matched healthy children, in Basrah, Iraq. Anthropometry was evaluated using BMI-for-age (BMIZ) and height-for-age (HAZ) Z-scores. Disease severity was determined based on frequency of vaso-occlusive crises, hospitalizations, blood transfusions, and fetal hemoglobin levels. Laboratory tests included complete blood count, reticulocyte count, and serum zinc and copper measurement. RESULTS: The study revealed that thinness and stunting were significantly higher in SCA patients ( P < 0.01), while overweight was significantly higher in the control group ( P = 0.011). The mean serum zinc level was significantly lower in SCA patients (63.51 ± 14.93 μg/dl) compared to the control group (91.14 ± 14.93 μg/dl), while serum copper was significantly higher among patients (128.93 ± 39.35 μg/dl) than healthy controls (96.86 ± 20.30 μg/dl), P < 0.001. Around 49% of patients exhibited low serum zinc, compared with 0.8% of controls, P < 0.001. Although none of the nutritional and SCA-severity indicators were associated with low serum zinc level in SCA patients, multivariate logistic regression analysis revealed that living in peripheries is associated with low serum zinc (odds ratio: 0.472, 95% confidence intervals: 0.264–0.845). CONCLUSION: Children and adolescents with SCA show markedly lower serum zinc levels. However, the analysis did not reveal significant associations between zinc levels and SCA-severity indicators and nutritional variables among the studied patients.