Vitamin D status in Sickle cell anaemia patients in Cameroon
Alain Landry Kubong Nguepnkep, Delphine Anye Tangoh, Rosine Endeme Elobo, Moses NgemenyaAbstract
Background
Vitamin D deficiency is common in persons living with sickle cell disease (SCD) and has been implicated in the exacerbation of bone disease (i.e.: osteopenia and osteoporosis) and vaso-occlusive crises (which is associated with tissue ischaemia, pain, and organ damage). In Cameroon, 25-30% of the population carries the sickle gene and 2-3% are estimated to be Hb SS genotype (sickle cell anaemia), but little is known about their vitamin D status.
Methods
5This cross-sectional study assessed vitamin D status and related risk factors among individuals with SCD receiving care at two major referral Centres: Laquintinie Hospital (located in Douala, the country’s major economic hub) and Yaoundé Central Hospital (located in Yaoundé, the political capital of Cameroon). Data and specimen collections took place over 17 months. The serum vitamin D levels were analysed using 100 µl specimens in BioMérieux’s VIDAS system which is based on enzyme linked fluorescent assay (ELFA). Study approval was obtained from Faculty of Health Sciences’ ethical review board.
Results
A total of 158 subjects participated, including 72 (46%) males and 86 (54%) females, all of whom were confirmed to carry the Hb SS genotype. Nearly 40% of subjects were severely underweight and another 12% were underweight. The median of the number of vaso-occlusive crises was 2 over a 4-month period (range 0-10). Only 34% of subjects surveyed demonstrated basic understanding of the importance of vitamin D, and 60% reported adequate sunlight exposure (a major natural source of vitamin D). The median of vitamin D in this population was 19.50 ng/ml (range: 8.00 ng/ml - 45.20 ng/ml); most of the Participants (54%) to be vitamin D deficient, with 4% of those experiencing severe vitamin D deficiency. An additional 35% of participants were vitamin D insufficient and only 11% of participants had normal vitamin D levels. Lower vitamin D level was slightly correlated with vaso-occlusive crises (VOC) although the study was not powered to demonstrate statistical significance.
Conclusions
The findings reveal a widespread suboptimal vitamin D level among SCAP in Cameroon. Furthermore, the observation of weak negative correlation between vitamin D levels and the frequency of Vaso-occlusive crises underscores the potential inflammatory implications of suboptimal vitamin D level in this population.