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 B ₁₂, 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.