Total Serum Magnesium Levels and Calcium-To-Magnesium Ratio in Sickle Cell Disease
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Charles Antwi-Boasiako1, Yaw A Kusi-Mensah2,3, Charles Hayfron-Benjamin2,3
1Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra 00233, Ghana. antwiboasiako@gmail.com.
Insights
Sickle cell disease (SCD) patients exhibit altered magnesium levels and a higher calcium/magnesium ratio, indicating potential complications. Magnesium supplementation may be beneficial for individuals with SCD.
Area of Science:
- Biochemistry
- Hematology
- Clinical Medicine
Background:
- Imbalances in calcium and magnesium ratios are linked to clinical issues in sickle cell disease (SCD).
- Low magnesium levels in SCD are associated with sickling, increased polymerization, and vaso-occlusive events due to cell dehydration.
- Magnesium inhibits K-Cl cotransport, a key factor in sickle cell dehydration.
Purpose of the Study:
- To evaluate total serum magnesium levels in SCD patients and healthy controls.
- To compute and compare the calcium/magnesium ratio between SCD patients and controls.
- To investigate potential differences in magnesium levels and calcium/magnesium ratios between SCD genotypes (HbSS and HbSC).
Main Methods:
- A case-control cross-sectional study involving 120 SCD patients (HbSS and HbSC) and 48 healthy controls.
- Serum samples were analyzed for total magnesium and calcium using Flame Atomic Absorption Spectrometry.
- Calcium/magnesium ratios were calculated for all participants.
Main Results:
- SCD patients showed significantly lower magnesium levels (p = 0.002) and a higher calcium/magnesium ratio (p = 0.031) compared to controls.
- Prevalence of hypomagnesemia and hypocalcaemia was higher in SCD patients (39.17% and 52.50%) than in controls (4.17% and 22.92%).
- Magnesium levels were lower in HbSS patients than in HbSC patients, but this difference was not statistically significant (p = 0.584).
Conclusions:
- Magnesium homeostasis is disrupted in SCD patients, with lower levels observed, particularly in HbSS patients.
- The significantly higher calcium/magnesium ratio in SCD patients suggests a potential link to disease complications.
- Magnesium supplementation could be a therapeutic consideration for managing SCD.
Abstract:
Background and objectives: Imbalance of calcium/magnesium ratio could lead to clinical complications in sickle cell disease (SCD). Low levels of magnesium have been associated with sickling, increased polymerization and vaso-occlusion (VOC) in sickle cell due to cell dehydration. The K-Cl cotransport plays a very important role in sickle cell dehydration and is inhibited by significantly increasing levels of magnesium. The study evaluated total serum magnesium levels and computed calcium/magnesium ratio in SCD patients and "healthy" controls. Materials and methods: The study was a case-control cross-sectional one, involving 120 SCD patients (79 Haemoglobin SS (HbSS)and 41 Haemoglobin SC (HbSC)) at the steady state and 48 "healthy" controls. Sera were prepared from whole blood samples (n = 168) and total magnesium and calcium measured using a Flame Atomic Absorption Spectrometer (Variant 240FS manufactured by VARIAN Australia Pty Ltd., Melbourne, VIC, Australia). Calcium/magnesium ratios were calculated in patients and the controls. Results: The prevalence of hypomagnesemia and hypocalcaemia among the SCD patients was observed to be 39.17% and 52.50% respectively, higher than the controls (4.17% and 22.92%, for hypomagnesemia and hypocalcaemia, respectively). Level of magnesium was significantly lower in the SCD patients compared to their healthy counterparts (p = 0.002). The magnesium level was further reduced in the HbSS patients but not significantly different from the HbSC patients (p = 0.584). calcium/magnesium ratio was significantly higher in the SCD patients (p = 0.031). Although calcium/magnesium ratio was higher in the HbSC patients compared to those with the HbSS genotype, the difference was not significant (p = 0.101). Conclusion: The study shows that magnesium homeostasis are altered in SCD patients, and their levels are lower in HbSS patients. Although calcium/magnesium ratio is significantly higher in SCD patients compared with controls, there is no significant difference between patients with HbSS and HbSC genotypes. Magnesium supplementation may be required in sickle cell patients.
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