Zinc Level is a Poor Predictor of Leg Ulcer in Patients with Sickle Cell Anemia

Abstract

Background: Sickle cell leg ulcers (SCLUs) are a major chronic debilitating complication in patients with sickle cell anemia (SCA). These ulcers lead to stigmatization and depression. Zinc deficiency has been implicated as a cause of SCLU. This study determined the predictability of leg ulcers and zinc levels among SCA patients in Zaria. Methods: This was a case–control study in which 100 participants (50 patients with HbSS and 50 controls with HbAA) were enrolled over a 3‑month period by convenience sampling technique. Semi‑structured questionnaires were used to obtain participants’ ages, gender, and presence or absence of leg ulcers. Serum zinc levels were assayed using spectrophotometry. Data obtained were analyzed using IBM SPSS software version 20.0. Means and standard deviations were used to summarize the data, independent sample t‑test was used to compare means, and logistic regression was used to assess whether zinc levels can predict the prevalence of leg ulcer among patients. P ≤ 0.05 was considered statistically significant. Results: The mean age of the participants was 24.92 ± 6.2 years while that of the control was 22.92 ± 4.9 (p = 0.172) with a range of 18–42 years in both groups. Leg ulcers were present in 10/50 (20.0%) of the patients with SCA. The mean zinc levels of patients with SCA with and without leg ulcers were 12.0 ± 4.0 µmol/l versus 15.5 ± 7.4 µmol/l (t = 2.060, p = 0.050). A binary logistic regression model using zinc as a predictor could explain only 4.7%–7.5% of the variability in leg ulcers but did not improve classification of cases. There was a negative nonsignificant association between zinc levels and leg ulcers, B = −0.098, odds ratio = 0.906, 95% confidence interval (0.789, 1.042), p = 0.167. Conclusion: Serum Zinc level is a poor predictor of leg ulcers in patients with SCA, thus suggesting other yet unstudied factors as likely better predictors.