Low vitamin B12 blood levels in sickle cell disease: Data from a large cohort study in Tanzania

Author:

Kisali Eka Patricia123ORCID,Iversen Per Ole456ORCID,Makani Julie17,

Affiliation:

1. Muhimbili Sickle Cell Programme, Department of Hematology and Blood Transfusion Muhimbili University of Health and Allied Sciences Dar‐es‐Salaam Tanzania

2. Department of Physiology Muhimbili University of Health and Allied Sciences Dar‐es‐Salaam Tanzania

3. Department of Internal Medicine Radboud University Medical Center Nijmegen the Netherlands

4. Department of Nutrition Institute of Basic Medical Sciences, University of Oslo Oslo Norway

5. Department of Haematology Oslo University Hospital Oslo Norway

6. Division of Human Nutrition Stellenbosch University Tygerberg South Africa

7. Department of Immunology and Inflammation, Center for Haematology Imperial College of London London UK

Abstract

SummarySickle cell disease (SCD) is associated with high rates of undernutrition and stunting. Undernutrition in combination with chronic haemolysis may lead to deficiencies in micronutrients necessary for erythropoiesis. Here we examined selected levels of ferritin, vitamins B2, B6, B9 and B12, and vitamin C that were measured in blood samples from 820 SCD patients from Tanzania with no history of hospital admission, infections or painful episodes in the previous 30 days. We studied children (0–8 years), early adolescents (9–14 years), late adolescents (15–17 years) and adults (≥18 years). Severely low levels of vitamin B12 were observed across the four age groups. Despite the lowered vitamin B12 concentrations, total homocysteine concentrations were normal across both genders in all age groups. We found no significant gender‐related differences between the other measured micronutrients. In this large SCD population, spanning the whole life cycle, a low level of vitamin B12 was consistently found across both genders and all age groups. Given the pivotal role of vitamin B12 in cellular metabolism, particularly in erythropoiesis, more studies are required to unravel how to better detect clinically relevant vitamin B12 deficiency among SCD patients, and thus to identify more precisely those who need supplementation of vitamin B12.

Publisher

Wiley

Subject

Hematology

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