title: Reduced insulin secretion in normoglycaemic patients with beta-thalassaemia major.
abstract: OBJECTIVE
  To assess insulin sensitivity and secretion in the fasting state in regularly transfused patients with beta-thalassaemia major with normal glucose response during an oral glucose tolerance test and to estimate its possible relation to iron overload.
  
  
  METHODS
  We measured fasting glucose, insulin and C-peptide levels in 24 patients with beta-thalassaemia major and 18 control subjects matched for age and body mass index. Insulin sensitivity and insulin release index were calculated according to the homeostasis model assessment (HOMA). Correlations with age, body mass index and serum ferritin were also calculated.
  
  
  RESULTS
  Fasting glucose levels in patients were increased compared with control subjects (5.5 +/- 0.12 vs. 4.7 +/- 0.13 mmol/l, mean +/- SEM, P < 0.001). Pancreatic B-cell insulin secretion in the fasting state (estimated by SC(HOMA)) was lower in thalassaemic patients (SC(HOMA) 88.5 +/- 11.11 vs. 184.3 +/- 23.72 in control subjects, P < 0.001). Patients were then divided into those with impaired (IFG) and normal (NFG) fasting glucose. SC(HOMA) was higher in the patients with NFG compared with those with IFG patients (110.6 +/- 17.63 vs. 66.3 +/- 10.88, respectively, P < 0.05) but estimated insulin sensitivity (ISI(HOMA)) was similar. Plasma values of C-peptide correlated positively with ferritin (r = 0.42, P = 0.04) and SC(HOMA) (r = 0.45, P = 0.02) and negatively with ISI(HOMA) (r = -0.43, P = 0.03).
  
  
  CONCLUSIONS
  These results support the concept that impaired B-cell function, as reflected by a reduction in the insulin secretion index, is present in beta-thalassaemic patients with normoglycaemia before changes in oral glucose tolerance tests are apparent.
authors.affiliation: Endocrine Department, Hippokrateion Hospital of Athens, Athens, Greece. drangelnick@hotmail.com
authors.forename: N G
authors.initials: NG
authors.lastname: Angelopoulos
authors.forename: A
authors.initials: A
authors.lastname: Zervas
authors.forename: S
authors.initials: S
authors.lastname: Livadas
authors.forename: I
authors.initials: I
authors.lastname: Adamopoulos
authors.forename: D
authors.initials: D
authors.lastname: Giannopoulos
authors.forename: A
authors.initials: A
authors.lastname: Goula
authors.forename: G
authors.initials: G
authors.lastname: Tolis
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000378:metabolism; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000172:deficiency / Q000378:metabolism*; D000078790:Insulin Secretion; D008297:Male; D008954:Models, Biological; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications*
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin