Impact of Omega-3 Deficiency on Inflammation and Hemolysis in Sickle Cell Anemia Patients in Basrah, Iraq

Background: Although the benefits of omega-3 fatty acids in inflammatory and hemolytic disorders other than sickle cell anemia (SCA) are well established, their role is underexplored in this population. This study aimed to investigate the impact of omega-3 fatty acid deficiency on clinical outcomes, including inflammation, hemolysis, and vasoocclusive crisis (VOC) frequency in patients with SCA.
Methods: A cross-sectional study was conducted among 110 SCA patients in Iraq. Participants were categorized as omega-3 deficient (<3% total plasma fatty acids) or sufficient (≥3% total plasma fatty acids) based on plasma level determined by gas chromatography-mass spectrometry (GC-MS). Clinical data, including VOC frequency, inflammatory biomarkers of interleukin-6 (IL-6), tumor necrosing factor-alpha (TNF-α) and C-reactive protein (CRP), and hemolysis markers of lactate dehydrogenase (LDH) and hemoglobin were analyzed.
Results: Omega-3 deficient patients (n=62) had significantly higher levels of inflammatory biomarkers compared to omega-3 sufficient patients (n=48), including IL-6 (15.1±3.2 vs. 9.5±2.7 pg/mL, p<0.001) and TNF-α (21.3±4.1 vs. 12.4±3.5 pg/mL, p<0.001). Hemolysis markers, such as LDH (588±72 vs. 465±58 U/L, p<0.001), were also elevated in the deficient group. The frequency of VOCs was significantly higher among omega-3 deficient patients (3.4±1.3 vs. 2.1±1.1 episodes/year, p<0.001). Multivariable regression analysis identified omega-3 level as an independent predictor of VOC frequency (β=-0.384, p<0.001).
Conclusion: Omega-3 deficiency was shown to be associated with an increased inflammation, exacerbated hemolysis, and a higher VOC frequency in SCA patients suggesting that omega-3 supplementation may be a valuable adjunctive therapy for managing SCA.