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 di erent 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 di erence 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 di erence between
patients with HbSS and HbSC genotypes. Magnesium supplementation may be required in sickle
cell patients.
