Study of zinc and copper in patients with Beta Thalassemia major and splenctomized in Kirkuk city

Beta thalassemia major is one of the common diseases in the world; it is one of health problems among children in Iraq. The disease leads to hemolytic anemia due to reduction of beta globin chains. Zinc and copper are important trace elements for synthesis of metalloproteins of hemoglobin enzymes. As zinc and copper are essential trace for synthesis of DNA; it is important to show their effect on severity of the disease among thalassemic patients. This study was performed during the period from November 2014 to June 2015. A total of 100 β-thalassemia major patients were enrolled in the current study; and patients were from the Thalassemia center in Azadi Teaching Hospital and 30 healthy children were taken as a control group. The blood samples were collected from 46 males and 54 females of different ages, ranging from (1-18) years. The level of serum zinc and copper were measured using spectrophotometer method. Comparison between thalassemic patients with control group; the results shown that there was high significant increased (p>0.01) in serum level of copper (148.69±28.90) while in serum level of zinc was decreased in thalassemic patients (60.52±10.63). Statistically there was no significant difference between different age groups and gender. The copper and zinc values decreased in splenctomized patients in comparison with non-splenctomized patients. The present study concluded that the level of serum copper increased while the level of serum zinc decreased in β-thalassemia major patients, this is also confirmed by other studies.


‫في‬ ‫الطحال‬ ‫ومستئصمي‬ ‫الكبرى‬ ‫الثالسيميا‬ ‫مرضى‬ ‫لدى‬ ‫النحاس‬ ‫و‬ ‫الزنك‬ ‫اسة‬
Thalassemia is one of the most common cause of anemia in human beings; it was first reported by Cooley and Lee [1,2]. About 150 million people carry the Thalassemia gene throughout the world; it is widely separated in Mediterranean countries than the other parts of the world [3,4]. It is derived from Greek [5]. In Iraq; it is common among population with ]uction of β-globin chains towards higher production of α-chain, which converts hemoglobin function into toxic inclusion bodies causing peripheral erythrocyte hemolysis [10]. Trace elements as copper and zinc are essential for human body; in addition to iron have an important role in pathogenesis. The alteration of these elements combined with excess amounts of hemoglobin subunits enhance the generation of oxygen radicals that leading to early death of the red blood cells and hemolysis [11].
The copper that present in human body; it mostly forms metalloproteins which act as enzymes; and it is a major component of hemoglobin responsible for oxygen transport in blood cells [12]. It plays an integral role in many physiological processes including maintaining a healthy heart, liver, bone strength and brain development, the concentration of copper is highest in the brain and the liver, the central nerves system and the heart have high . It is absorbed from small intestine and found in the blood bound to albumin. Impaired growths and loss of weight are few of the associated complications due to deficiency of zinc which is one of the factors responsible for growth and puberty disorders in thalassemic patients; which has been well recognized for its role in human health [16,17,18,19]. It is important to assess the status of zinc among the general population, preferably in children [20]. The aim of the present study was planned to evaluate the serum zinc and copper levels in thalassemic patients.

Materials and Methods
The study was carried out attending Azadi Teaching Hospital from November 2014 to September 2015. One hundred patients were attended β-thalassemia center (46 males and 54 females), their age were ranging from (1-18) years old. Four ml of blood were collected from

Statistical Analysis
The collected data were analyzed using SPSS software (version 17, SPSS Inc.USA). The results were expressed as mean±SD for quantitative variables, Analysis ovarian (ANOVA) and students t-test were applied to show significant differences between groups. Data were considered statistically significant at p>0.05.

Results
A total of 100 patients with β thalassemia major were enrolled. Among these patients (46 males and 54 females) and thirty healthy individuals control were enrolled in the present study.

Discussion
The results from present study showed; the level of serum zinc was lower in thalassemia major patients than controls, but this reducing in zinc level did not differ statistically with 042 difference between sexes. This finding is also reported among β-thalassemia major patients [28]. The splenectomy is one of the treatment lines in thalassemia major in addition to red blood cells transfusion [29]. There was insignificant difference between these groups in the level of serum copper; there was lower level in splenectomic patients than non-splenectomic patients. This result is also in agreement with the finding of [28,30]. Although the level of serum zinc and copper in splenectomized and non-splenectomized recorded in significant difference between them, there was lower level in splenectomic patients than nonsplenectomic patients [31]. Table (4) demonstrated that there was no significant difference in all parameters investigated among four age groups. This finding is in agreement with that reported by [32]. Who stated that copper is necessary in human nutrition for red blood cells formation [33]. The lowest zinc level was among age group below 6 years old; which might be related to malnutrition [1,3]. While other they did not find zinc level affected in children with thalassemic patients [34].
The high level of serum copper among thalassemic patients than control, this study is not in agreement with that reported by [28]. The highest level of copper was among the group less than 18 years is also against that found by Abdulkhader [28].