Mild Hyperhomocysteinemia, Decreased Vitamins B6, B12 and Folic Acid in Children with Sickle Cell Disease

Background: Hyperhomocysteinemia has been identified as a risk factor for stroke and other vascular diseases in the general population, its role in sickle cell disease (SCD) has not been investigated in children with SCD in Nigeria.

Aim: This study was designed to evaluate plasma homocysteine, B-vitamins, folate and lipid profile in sickle cell disease (SCD) HbSS children in Nigeria.

Methods: Fifty (50) SCD children (12.04±4.17 years) consisting of 30 females and 20 males were selected from Sickle club center Abeokuta. Fifty non SCD (HbAA) children (12.62±4.28 years) consisting of 25 males and 25 females were included as controls. Anthropometric indices and plasma homocysteine, B12, B6, folic acid, lipids and lipoproteins were determined using standard procedures.

Results: The results showed significant decreases in body weight (29.84±10.68 kg) and height (1.37±0.16 m), (p<0.045) in all SCD patients. Plasma total homocysteine (tHcy) (6.40±3.37 µmol/L) was significantly increased (p< 0.05), whereas plasma vitamins B6 (28.81±12.44 nmol/), B12 (184.16±35.13 pmol/L), folic acid (46.73±9.93 µmol/L), total cholesterol (102.42±28.62 mg/dl), low density lipoprotein cholesterol (24.45±5.25mg/dl) (p< 0.01) and triglyceride (71.98±22.61 mg/dl) (p<0.04) were markedly decreased compared with the control values. Plasma high density lipoprotein cholesterol was however not significantly different from the control value. Plasma tHcy) did not correlate with any of the measured parameters.

Conclusion: Increased plasma total homocysteine level and reduced B vitamins as well as lipids profile obtained in this study are prominent features of sickle cell disease in this environment.