Abstract

Theoretical suggestion that the metabolism and plasma levels of some hexoses (glucose and fructose) in sickle cell anaemia could be altered was investigated.  The levels were determined for 35 normal (HbAA) and for the three sickle cell states (32 HbAS; 35 HbSS, and 33 HbSS-in-crisis, HbSSc). The enzymatic glucose-oxidase method was employed in glucose estimation. The reaction of fructose with indole-3-acetic acid to yield a coloured product was exploited in the estimation of fructose.  Mean plasma glucose was found to be highest in the HbSSc state (84.80 ± 4.10 mg/dl), followed by HbSS (78.59 ± 4.20 mg/dl), HbAS (74.80 ± 6.20 mg/dl) and lowest in HbAA (70.10 ± 0.05 mg/dl). The differences between the normal and all the disease states are significant (between HbAS and HbAA, for example: t = 2.2717; df = 65; p < 0.05). The reverse order was observed with respect to fructose concentrations: lowest in HbSSc (0.99 ± 0.05 mg/dl), HbSS (1.09 ± 0.05 mg/dl), HbAS (1.25 ± 0.05 mg/dl), and highest in HbAA (1.32 ± 0.08 mg/dl).  Regression of glucose on fructose showed positive correlation in the HbAA group (r = 0.7900; df = 33; p < 0.001), no correlation in the HbAS group (r = - 0.0193; df = 30; p > 0.20), and negative correlation in the HbSS group (r = - 0.3191; df = 65; p < 0.001). The differences between the ‘Glucose-to-Fructose Ratio’ for the different states are very significant (p<0.001) and could serve as biomarker of sickle cell anaemia intensity.     

Key words: Hexose, anergy, glucose, fructose, spermatozoa, energy metabolism, metabolic control, sickle cell anaemia, glucose-to-fructose ratio.