CC BY-NC-ND 4.0 · Avicenna J Med 2022; 12(02): 045-053
DOI: 10.1055/s-0042-1749612
Review Article

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

1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Shahd S. Ali
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Waad K. Ali
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Hind R. Madani
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Rawya A. Basheir
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Rayan M. Altayeb
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Rayan H. S. Shazali
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Safaa Fadlelmoula
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Wisal M. Eltayeb
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Zeina I. Omar
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Mahmoud Elnil
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
1   Department of Pathology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
› Author Affiliations
Funding None.

Abstract

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.

Authors' Contributions'

S.O.O.M. and I.H.E. conceptualized the research idea and designed the study; R.H.S.S., W.M.E., H.R.M., and R.A.B. undertook articles searching, articles assessment, and review; and S.S.A. and W.K.A.) undertook data extraction and analysis. All authors interpreted the results and drafted the manuscript. All authors revised and approved the final manuscript.


Availability of Data and Material

The dataset generated during this study are available from the corresponding author on reasonable request.




Publication History

Article published online:
02 July 2022

© 2022. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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