Plasma Homocysteine, Methyl-Malonic Acid, Vitamin B12 and Folate Levels in Adult Nigerian Sickle Cell Anaemia Patients

Abstract

Aims: To compare the mean levels of plasma total Homocysteine (tHct), Methylmalonic acid (MMA), vitamin B12, folate and haematological parameters(PCV, WBC, Platelet counts, MCV, MCH, MCHC) among adult SCA patients in steady state (SS), SCA in (VOC) and age and sex matched controls in order to determine significant differences. Study Design: Case-control study. Place and Duration of Study: Department of Haematology and Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria between March 2012 and July 2012. Methodology: We included 60 SCA patients (30 in VOC, 30 in Steady State; and 30 age and sex matched controls. Plasma tHct, MMA, folate and vitamin B12 were assessed using HPLC and haematological parameters were determined using haematological autoanalyzer (Syxmex Kx21). Results: The mean plasma tHct, MMA, vitamin B12 of SCA patients (VOC and SS) were significantly lower (p=0.000) compared to control population but the mean folate levels were comparable (p=0.085). The SCA (in VOC) had significantly lower (p=0.000) MMA and folate levels compared to SS group but the SS group had significantly lower (p=0.001) tHct level compared to VOC group. While the PCV, Hgb, MCV, and MCH were significantly lower; the WBC, platelet count and the MCH were significantly elevated in SCA patients compared to controls. Conclusion: A larger, better controlled, multicenter study is required to confirm lower tHct and MMA found in SCA groups compared to control group and higher tHct in SCA (VOC) but higher MMA level in SCA (SS) when VOC and SS groups were compared. The haematological parameters in SCA groups were not in keeping with macrocytic anaemia but were indicative of chronic haemolytic and inflammatory process.