ejbps, 2017, Volume 4, Issue 10, 855-857. Research Article SJIF Impact Factor 4.

382

European Journal ISSN 2349-8870

Elsukar et al. European of Biomedical
Journal of Biomedical and Pharmaceutical Sciences
Volume: 4
AND Pharmaceutical sciences Issue: 10
855-857
http://www.ejbps.com Year: 2017

DETERMINATION OF SELECTED TRACE ELEMENTS AMONG CHILDREN WITH

SICKLE CELL ANEMIA IN ELOBIED CITY - NORTH KORDOFAN STATE

Akram Hamed Awad Alla Elsukar*1, Waleed Hajmusa Elttahir2, Osman Abd Algadir3 and Reham Elsheihk
Omer4
1,2
University of Kordofan, Faculty of Medicine and Health Sciences, Medical Laboratory Division, Clinical Chemistry
Department.
3
University of Kordofan, Faculty of Medicine and Health Sciences, Medical Laboratory Division and Director of Sickle
Cell Anemia Center in North Kordofan State.
4
Faculty of Medicine and Health Science, Medical Laboratory Sciences, University of Kordofan.

*Corresponding Author: Dr. Akram Hamed Awad Alla Elsukar

University of Kordofan, Faculty of Medicine and Health Sciences, Medical Laboratory Division, Clinical Chemistry Department.

Article Received on 18/08/2017 Article Revised on 07/09/2017 Article Accepted on 28/09/2017

ABSTRACT
Introduction: Sickle cell anemia is a genetic hemoglobin disorder characterized by chronic hemolysis. Severe
hemolysis affect blood component include trace element (zinc & cooper). Objectives: to estimate zinc and copper
minerals in children with sickle cell anemia enrolled in Sudan Sickle Cell Anemia Center in North Kordofan State
during the period from April – August 2016. Materials & Methods: This descriptive cross-sectional study. A
total number of 30 blood samples collected from children with sickle cell anemia aged 5 - 40 months (14 male &
16 female). Zinc and copper estimated by atomic absorption spectrophotometry, and compared with 20 apparently
healthy volunteer as control group age & sex- matched for test group. Statistical package for social science (SPSS
version 15) computer software was used for data analysis. Results: a significant decreased in serum zinc and
copper among test group when compared with control group. (P.value = 0.03 and 0.05) respectively; with no
significant difference between male & female among test group. Conclusion; the current study indicates that
determination of trace elements is of value for children with SCA since their serum levels were significantly
decreased.

KEYWORDS: Trace elements, Sickle cell anemia, Elobied.

INTRODUCTION Zinc is essential trace element for human and it plays an

Sickle cell anemia is the most common monogenic
inherited autosomal recessive disease in the world, it is
a hemoglobinopathy caused by a mutation at position 6
in the beta-globin chain (substitution of valine for
glutamic acid in the sixth position of the globin chain)
that give rise to production of abnormal hemoglobin
molecule called hemoglobin S (Hb S).[1] Protein in red
blood cells that carry oxygen to the tissues of the body,
sickle cell interferes with the delivery of oxygen to the
tissues. The human body has an elaborate system for
managing and regulating the amount of key trace
metals circulating in blood and stored in cells.
Nutrient metals from our diet are incorporated into
blood if blood levels are depleted, transported into
cells if cellular levels are inadequate, or excreted if
blood and cell levels are sufficient or overloaded. When
this system fails to function properly, abnormal levels
and ratios of trace metals can develop. One of the most
common trace-metal imbalances is zinc and copper.[2]
important role in several metabolic pathways. There are
2-4 grams of Zn+2 distributed throughout the human
body. Most zinc is in the brain, muscle, bones, kidney
and liver, with the highest concentrations in the prostate
and parts of the eye, semen is particularly rich in zinc,
which is a key factor in prostate gland function and
reproductive organ grow. It is the second most abundant
transition metal in organisms after iron and it is the only
metal which appears in all enzyme classes.[3] Copper is
an essential trace element that is vital to the health of all
living things (humans, plants, animals and
microorganisms). Copper plays an important role in our
metabolism, largely because it allows many critical
enzymes to function properly. Copper is essential for
maintaining the strength of the skin, blood vessels,
epithelial and connective tissue throughout the body. Cu
plays a role in the production of hemoglobin, myelin,
melanin and it also keeps thyroid gland functioning
normally.[4] Copper is essential for the normal growth
and development of human fetuses, infants, and children.
The human fetus accumulates copper rapidly in its liver

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Elsukar et al. European Journal of Biomedical and Pharmaceutical Sciences

during the third trimester of pregnancy. At birth, a

healthy infant has four times the concentration of copper
than a full-grown adult. Human milk is relatively low in
copper, and the neonate's liver stores falls rapidly after
birth, supplying copper to the fast-growing body during
the breast feeding period. These supplies are necessary to
carry out such metabolic functions as cellular respiration,
melanin pigment and connective tissue synthesis, iron
metabolism, free radical defense, gene expression, and
the normal functioning of the heart and immune systems
in infants.[5]

MATERIALS AND METHODS

This is Quantitative descriptive, cross sectional and
hospital based study conducted in Sudan Sickle Cell
Anemia Center in North Kordofan State, during the
period from April to August 2016. A thirty children
diagnosis with SCA, enrolled as test group, in
comparison to twenty apparently healthy children
selected as control group match for age and sex to test Figures 1: Gender distribution among Sickle cells
group. Blood samples (3ml) were collected by vein anemia patients.
puncture from each subject into a plain container. The
labeled samples were carefully retrieved and spun in a Table 1: Frequency & percentage of the study groups.
bucket centrifuge at a speed of 2500 rpm for 30 minutes Participants Frequency Percent%
having allowed the samples to clot for 15 minutes. The Control 20 40
serum obtained was stored in a chest freezer at a
temperature of -20oCin vials. Serum trace elements Cases 30 60
(Copper and Zinc) levels were measured using atomic
absorption spectrophotometry technique. All data was Total 50 100
recorded in standard sheet then analyzed using the social
packages for statistical studies (SPSS v15.). t -test was Table 2: Comparison of the mean ages (months) of
used for comparison of means and P.value ≤ 0.05 test group and control group enrolled in the study.
considered statistically significant. The precision and Test group Control group
accuracy of the method was used and checked in this Variable P value
n=30 n=20
study using commercially prepared controls. Age
20.4±10.3 21.8±10.2
(months)
RESULTS (5-40) (8-40) 0.84
Range
Figures 1 Shows the gender distribution among children
 The table shows the mean ± SD, range in brackets ( )
with Sickle cells anemia. The prevalence of sickle cell is
and probability (P.value).
more in female than male with percentage 54% and
 t –test was used for comparison.
64%.respectvily.
Table 1 Frequency & percentage of the study groups.  P. value ≤ 0.05 is considered significant.
Table 2 Shows the comparison of the mean ages
(months) of test group and control group enrolled in the Table 3: Comparison of mean of the zinc and copper
study. No significant difference between ages of tow levels in the test and control groups.
group. (P.value 0.8). Control
Variables Test group P.
Table 3 Shows comparison of mean of the zinc and group
n = 30 value
copper levels in the test and control groups. Serum zinc n = 20
and copper were significantly reduced in cases compare Zinc (mg/l)
0.197 ± 0.07 0.66± 0.06
with that of the control group; P.value = 0.03 and 0.05
Range 0.03
for serum zinc and copper respectively. ( 0.07 – 0.34 ) ( 0.54- 0.85 )
Table 4 Comparison of the means of the serum zinc and
copper levels in males and females suffering from Copper
0.29 ± 0.10 0.74 ± 0.4
Sickles cells anemia. P.value = 0.5 and o.6 respectively. (mg/l)
0.05
There was no significant difference in both. ( 0.20 - o.48) ( 0.70 – 0.87)
Range
 The table shows the mean ± SD, range in brackets ( )
and probability (P.value).
 t –test was used for comparison.
 P. value ≤ 0.05 is considered significant.

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Elsukar et al. European Journal of Biomedical and Pharmaceutical Sciences

Table 4: Comparison of the means of the serum zinc
and copper levels in males and females suffering from
Sickles cells anemia.
Male Female
Variables P value
n =14 n= 16
Zinc (mg/l)
0.18 ± 0.60 0.21 ± 0.08
Range 0.52
(0.10-0.34) (0.08-0.40)
Copper
0.30 ± 0.72 0.29 ± 0.06
(mg/l) 0.60
(0.23-0.48) (0.20-0.41)
Range
 The table shows the mean ± SD, range in brackets ( )
and probability (P.value).
 t –test was used for comparison.
 P. value ≤ 0.05 is considered significant.
DISCUSSION
Sickle cell anemia is a hereditary disorder characterize
by formation of abnormal hemoglobin due to mutation in
B- globin chain. Trace element (zinc and copper) are
essential in the body which is found in minute
concentration, but there deficiency can be deleterious
because they are important components of enzyme
system, and important metabolic pathways.[6]
In the current study there are significant difference
between the means of the serum levels of zinc and
copper in test group when compare with that of the
control group, the means in both were significantly
reduced (P. values = 0.03, 0.05) respectively and this
may be due to massive urinary excretion occurred as a
result of impaired kidney function and also may be
because of disturbance of zinc and copper metabolism.
Zinc and copper were antagonized in their metabolism
but trace elements supplementation may interfere the
absorbance of each other. This result agree with previous
study[7,8,9] whose report that zinc levels were significantly
decrease in SCA and disagree with them regarding
copper levels which were significantly increase in their
study. Also in the present study there are insignificant
difference between the serum zinc and copper levels in
male and female among children suffering from sickle
cell anemia P. value = 0.52 and 0.60 respectively.
2. Regular supplementation with trace elements with
proper monitoring for children with sickle cell
anemia.
3. Further trace elements study among children with
sickle cell anemia is required.
REFERENCES
1. Hagar W .Vichinsky E. Advances in clinical
research in sickle cell disease, 2008; 141: 346–356.
2. Scoffern M. John S. the Useful Metals and Their
Alloys. Houlston and Wright, 2009; 591–603.
3. Kharakwal L. Gurjar, S. Zinc and Brass in
Archaeological Perspective. Ancient-asia-
journal.com. Retrieved. 2006; 2014: 139–159.
4. Katherin E, Hashemi F, Paul A. The Copper
Metallome in Eukaryotic Cells. Toxcity to
Essentiality, 2013; 12.
5. Milne, David B. Copper intake and assessment of
copper status. The American Journal of Clinical
Nutrition. 1998: 67: 1041-1045.
6. Heyneman S, Zinc deficiency and taste disorders.
Ann Pharmacotherapy, 1996; 30: 186-187.
7. Bashir N. Serum zinc and cooper levels in sickle cell
anemia patient and B-thalassemia in north Jordan
Ann. Trop Pediatric, 1995; 15(4): 291-3.
8. 29- Pellegrini J, Kerbauy J, Fisberg M. Department
of Pediatric, Federal University of Sao Paulo, E
scola Paulista de Medicina, Brazil, 1995: 198- 203.
9. 30- Akenami F, Aken B. Serum zinc, copper and
magnesium in sickle cell disease at lbadan,
southwestern Nigeria, 1999; 28: 137-9.

CONCLUSIONS
Finally this study it was concluded that; the serum trace
element (zinc & copper) were significantly reduced
among the children with sickle cell anemia in North
Kordofan State. This reduction may be due to in
adequate intake of zinc and copper despite of their
normal diet content may be attributable to loss of
appetite, chronic pain and hemolysis beside the excessive
urinary excretion occurred as a result of renal
insufficiency.

Recommendations
1. Reduction of zinc and copper levels need for special
attention among children with SCA.

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