Article Copper-to-Zinc Ratio Correlates with an Inflammatory Marker in Patients with Sickle Cell Disease (Version 1) Mathias Abiodun Emokpae * and Emmanuel Babatunde Fatimehin Department of Medical Laboratory Science, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin City, Nigeria * Correspondence: mathias.emokpae@uniben.edu Received: 13 June 2019; Accepted: 20 June 2019; Published: 4 July 2019 First Version Published: 4 July 2019 (doi:10.3390/sci020034)   Abstract: Sickle cell disease (SCD) is an inherited disorder of major health challenge in Nigeria. Micronutrients deficiencies often associated with the disorder may cause inflammation and abnormal metabolisms in the body. The copper-to-zinc ratio is a more important assessment than the concentrations of either of the metals in clinical practice. This study seeks to evaluate serum levels of c-reactive protein (CRP), copper, zinc and copper-to-zinc ratio and to correlate copper-to-zinc ratio with CRP in adult subjects with SCD. Serum copper, zinc, CRP and plasma fibrinogen were assayed in 100 confirmed SCD patients in steady clinical state and 100 age and sex matched subjects with normal haemoglobin. Serum copper and zinc were assayed by colorimetric method using reagents supplied by Centronic, Germany while CRP and fibrinogen were assayed using reagents supplied by Sigma (St. Louis, MO, USA) and Anogen (Ontario, Canada), respectively. The copper to zinc ratio was calculated from serum levels of copper and zinc. The measured parameters were compared between the groups using Students t-test and Pearson correlation coefficient was used to relate CRP with the other parameters. Serum copper, CRP, fibrinogen and copper-to-zinc ratio were significantly higher (p < 0.001) while zinc level was lower in SCD patients than controls. Serum CRP concentration correlated with copper (r = 0.10; p < 0.02), zinc (r = −0.199; p < 0.05) and Copper-to-zinc ratio (r = 0.312; p < 0.002) but the correlation between CRP and fibrinogen was not significant. Inflammatory condition may modulate copper and zinc homeostasis and copper-to-zinc ratio may be used as marker of nutritional deficiency and inflammation in SCD patients. Keywords: Copper; c-reactive protein; inflammation; sickle cell disease; zinc 1. Introduction Sickle cell disease (SCD) is an inherited disorder of major health challenge in sub-Saharan African including Nigeria. The condition is characterized by hemolytic anemia and periodic painful crisis as a result of occlusion of small blood vessels due to spontaneous intravascular red blood cells polymerization at reduced oxygen tension [1]. The associated complications of SCD include growth retardation, impaired immune function, acute chest syndrome, abdominal pain [2], proteinuria [3], increased oxidative stress and damage to cell membranes [4]. Micronutrients deficiencies have been reported in patients with SCD [5]; a situation made worse by proteinuria [6]. Some authors have suggested that dietary habits of subjects with SCD met or even exceed the recommended dietary allowance (RDA) and not different from the general population [7]. The deficiency may be due to abnormal metabolisms of key trace elements in the body which are very important for the maintenance of red blood cell membrane, growth and development of the body [7]. Sci 2019, 1, 34; doi:10.3390/sci1020034 www.mdpi.com/journal/sci