EFFECTS OF SELENIUM SUPPLEMENTATION ON APOLIPOPROTEINS AND LIPID PROFILE IN STEADY-STATE SICKLE CELL DISEASE PATIENTS IN SOUTHEASTERN NIGERIA

Abstract

Sickle Cell Disease (SCD) is the most prevalent hereditary hemoglobinopathy characterized by chronic oxidative stress, inflammation and metabolic disturbances that causes long-term disability requiring daily care. Sickle cell disease affects about 4.4 million people globally. Selenium (Se), an essential micronutrient with antioxidant properties, may influence oxidative balance and lipid metabolism in SCD. However, there is paucity of data, especially in sub-Saharan Africa, on the effect of Se supplementation on apolipoproteins and lipid profile in SCD. This study assessed the effect of Se supplementation on levels of serum Se, apolipoproteins A1 and B (apo A1 and apo B), and other lipid profile markers among individuals with different HB genotype blood groups. One hundred and fifty (150) aged-matched adult (18-60years) attending routine clinic in the Hematology department of the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, were randomly recruited and grouped according to hemoglobin genotype: group 1= HbAA (n=50), group 2= HbAS (n=50) and group 3= HbSS (n=50). Participants in group 3 received oral Se supplementation (200 µg/day) for 90 days. Blood samples were collected at baseline and after 90 days (post supplementation). Serum Se was measured using atomic absorption spectrophotometry method (AAS) while apolipoproteins and lipid profile were determined using enzymatic spectrophotometric method. Questionnaires were administered to participants for relevant data. At baseline, the study showed that there were significant variations in the levels of apo A1, Apo B, TG, HDL-C, LDL-C and VLDL-C concentrations among the three groups (p< 0.001). However, after Se supplementation in the HbSS group, apo A1 and B levels increased significantly (p= 0.003 and 0.001, respectively). Likewise, HDL-C and TG concentrations were significantly elevated (p < 0.001), whereas total cholesterol and LDL-C levels showed no significant changes post-supplementation. The findings from this study suggest that dyslipidemia and oxidative stress persist in steady-state SCD. Low level of Se is indicative of a weakened antioxidant defense even in individuals with steady-state SCD. Selenium supplementation in SCD patients in this study appears to improve selected lipid and apolipoprotein parameters, suggesting its potential therapeutic value in the management of SCD.