Evaluating the Role of Zinc in Beta Thalassemia Major: A Prospective Case-Control Study from a Tertiary Care Teaching Hospital in India

Background Thalassemia is a common hereditary anemia in humans, and beta thalassemia represents a group of recessively inherited hemoglobin disorders first described by Cooley and Lee and characterized by the abnormal synthesis of β-globin chain. The homozygous state results in severe anemia, which needs regular blood transfusion. Although such treatments increase the patient's life span, a variety of complications, including endocrine, metabolic, skeletal, and growth disorders are being observed due to increased iron storage in the body. Objective There are some reports emphasizing the role of zinc deficiency and its associated outcomes among thalassemia patients, but none from this part of the world. The aim of this study was to determine the serum zinc levels in children with beta thalassemia major. Methods This is a prospective case-control study, which included 35 children between the ages five and 15 years, who were diagnosed as suffering from beta thalassemia major. An equal number of age matched healthy subjects were recruited as controls. The study was carried out at the thalassemia center attached to the Prathima Institute of Medical Sciences (PIMS), Karimnagar, Telangana, India, during the year 2016. Blood samples were collected from both the cases and control subjects and serum zinc activities were analyzed using a semi-automated analyzer. Statistical Package for the Social Sciences (SPSS, Version 15.0) (SPSS Inc., Chicago, USA) was used to calculate the unpaired and independent Student's t-test (p value) to find the significance of the results. Results The mean concentrations of serum zinc among the cases and the controls were 39.25 ± 13.45 and 85.31 ± 13.53 (p <0.0001), respectively. Among the cases, 26 (65%) thalassemia patients had zinc concentration below 60 μg/dl, confirming hypozincemia.  Conclusion This study revealed that hypozincemia was prevalent in beta thalassemia major patients. Further evaluation regarding the role of zinc in the development and progression of thalassemia is recommended.