The Interactive Roles of Some Toxic Metals, Micronutrients, Antioxidant Vitamin and Sex Hormones in Nigerians with Sickle Cell Disease

Aims: To define the involvement of sex hormones-estradiol, testosterone, toxic metals and micronutrients in individuals with sickle cell disease (SCD).

Study Design: A case control study.

Place and Duration of Study: Departments of Chemical Pathology and Haematology, College of Medicine, University of Ibadan, Ibadan, Haematology Outpatient Clinic, Ring Road State Hospital, Oyo State, Nigeria between Dec 2007 and Jul 2008.

Methodology: One hundred and twenty participants, consisting of 68 with Haemoglobin S (SCD) and 52 with Haemoglobin A aged 17-43 years were recruited for the study. Five ml blood samples were obtained from each participant. Anthropometry and reproductive history were obtained by standard methods. Serum estradiol and testosterone concentrations were estimated using enzyme linked-immunoassay methods, Zinc, Copper, Selenium, Lead and Cadmium by atomic absorption spectrophotometry and vitamin E by High Performance Liquid Chromatography.

Results: The mean Zinc, Copper, Vitamin E concentrations in SCD were significantly lower, while those of lead and Cadmium were significantly higher when compared with the corresponding control values (P <.001). The mean testosterone in male and estradiol in female (SCD) were significantly lower than the corresponding control values (P <.03). The mean age at menarche in SCD was significantly higher than the value in control participants. In female SCD, the serum estradiol was positively correlated with height and negatively correlated with lead in the control (P =.05). The incidence of priapism in male SCD was significantly higher than the value in male control subjects (P <.007). In both male and female SCD, the mean body mass index and body weight were significantly lower than the corresponding values in the control group (P <.006).

Conclusion: A significant number of Nigerians with SCD had priapism and the observed oxidative stress in SCD probably due to hypogonadism, may be amenable to micronutrient supplementation.