Patients with sickle cell disease (SCD) have lower levels of zinc and magnesium and higher levels of copper compared to people without the disease, according to a systematic review and meta-analysis of the literature that was published in the Avicenna Journal of Medicine

This finding is important because it could guide the implementation of nutritional supplement programs to minimize the negative effects of the disease on the body.

For individuals with the disease, “future research needs to be directed to investigate clinical outcome of nutritional deficiencies,” the authors said. Previous research has shown that patients with SCD are at risk of multiple micronutrient deficiencies including those involved in antioxidation mechanisms due to oxidative stress.

Here, a team of researchers from the Department of Pathology, Faculty of Medicine, University of Khartoum in Sudan conducted a literature review to assess the status of these micronutrients in patients with SCD.

Using data from 36 studies, the researchers calculated the pooled standardized mean difference in serum zinc, magnesium, and copper levels in patients with SCD and healthy controls.

Read more about the pathophysiology of SCD

The results showed that serum zinc and magnesium levels were significantly lower in patients with SCD compared to healthy controls. On the contrary, serum levels of copper were significantly higher in patients compared to controls.

The authors said that these differences could be attributed to high physiological demands caused by fast erythrocyte turnover, suboptimal kidney function, glomerular injury, and impaired absorption due to damage to the intestinal mucosa caused by the disease.

SCD is characterized by the presence of sickle hemoglobin caused by a mutation in the gene that encodes the beta-globin chain of hemoglobin. Sickle hemoglobin has a high oxidation rate, which drives hemolysis thereby contributing to the clinical picture of the disease.


Elkhidir IH, Ali SS, Ali WK, et al. Zinc, magnesium, and copper levels in patients with sickle cell disease: a systematic review and meta-analysis. Avicenna J Med. 2022;12(02):045-053. doi:10.1055/s-0042-1749612