Vitamin E correlates inversely with non-transferrin-bound iron in sickle cell disease

Decreased serum vitamin E levels are found in homozygous sickle cell disease (SCD). Excessive transfusions may lead high non-transferrin-bound iron (NTBI). Hypothesizing a relationship between the two, vitamin E (measured using high performance liquid chromatography) was significantly lower in 30 SCD patients than in 30 age-/sex-matched controls (P < 0·001), but NTBI (bleomycin assay) was higher (P < 0·001). Vitamin E was lower in 10 transfused patients than in 20 non-transfused patients (P < 0·001) with a significant inverse correlation between the NTBI and vitamin E (r = −0·58, P < 0·001). NTBI associated with iron overload in SCD may increase the potential for oxidative damage and low vitamin E activity may compound this effect.