Concentrations of B vitamins and homocysteine in children with sickle cell anemia

BACKGROUND: Elevated concentration of serum homocysteine contributes to thrombosis, a frequent event in patients with sickle cell anemia. We aimed to test whether children with sickle cell anemia have elevated concentrations of serum homocysteine with diminished levels of folate or B vitamins from accelerated blood cell turnover. METHODS: We conducted a case-control study of children with homozygous sickle cell anemia (n = 17) and unaffected children (n = 11). We measured serum and red blood cell folate, vitamin B6, vitamin B12, and homocysteine concentrations, and assessed micronutrient intake. RESULTS: Children with sickle cell anemia had concentrations of homocysteine slightly higher than those of unaffected children. They had lower vitamin B6 concentrations and comparable concentrations of folate and vitamin B12. Homocysteine concentration was inversely related to vitamin B12 concentration and was not independently associated with levels of vitamin B6 or folate. CONCLUSION: Despite comparable intake, children with sickle cell anemia had lower concentrations of vitamin B6 than unaffected children. Larger studies are needed to determine if chronically low serum vitamin B6 concentration contributes to hyperhomocysteinemia in this population.