Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-900, Brazil.
Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil.
Nutrients. 2019 Sep 13;11(9):2211. doi: 10.3390/nu11092211.
Sickle cell disease (SCD) is a genetic hemoglobinopathy characterized by chronic hemolysis. Chronic hemolysis is promoted by increased oxidative stress. Our hypothesis was that some antioxidant micronutrients (retinol, tocopherol, selenium, and zinc) would be determinant factors of the degree of hemolysis in SCD patients. We aimed to investigate the nutritional adequacy of these antioxidants and their relationships to hemolysis. The study included 51 adult SCD patients regularly assisted in two reference centers for hematology in the State of Rio de Janeiro, Brazil. Serum concentrations of retinol, alpha-tocopherol, selenium, and zinc were determined by high-performance liquid chromatography or atomic absorption spectrometry. Hematological parameters (complete blood count, reticulocyte count, hemoglobin, direct and indirect bilirubin, total bilirubin, lactate dehydrogenase) and inflammation markers (leukocytes and ultra-sensitive C-reactive protein) were analyzed. A linear regression model was used to test the associations between the variables. Most patients presented selenium deficiency and low selenium consumption. Linear regression analysis showed that selenium is the main determinant of hemolysis among the antioxidant nutrients analyzed. Thus, data from this study suggest that the nutritional care protocols for patients with SCD should include dietary sources of selenium in order to reduce the risk of hemolysis.
镰状细胞病 (SCD) 是一种遗传性血红蛋白病，其特征为慢性溶血。慢性溶血是由氧化应激增加引起的。我们的假设是，一些抗氧化微量营养素（视黄醇、生育酚、硒和锌）将是 SCD 患者溶血程度的决定因素。我们旨在研究这些抗氧化剂的营养充足性及其与溶血的关系。该研究包括 51 名成年 SCD 患者，他们定期在巴西里约热内卢州的两个血液学参考中心接受治疗。通过高效液相色谱法或原子吸收光谱法测定血清中视黄醇、α-生育酚、硒和锌的浓度。分析血液学参数（全血细胞计数、网织红细胞计数、血红蛋白、直接和间接胆红素、总胆红素、乳酸脱氢酶）和炎症标志物（白细胞和超敏 C 反应蛋白）。使用线性回归模型检验变量之间的关联。大多数患者存在硒缺乏和低硒摄入。线性回归分析表明，在分析的抗氧化营养素中，硒是溶血的主要决定因素。因此，这项研究的数据表明，SCD 患者的营养护理方案应包括硒的膳食来源，以降低溶血的风险。
