Abnormal glucose tolerance in beta-thalassemia: assessment of risk factors.
In beta-thalassemia (beta-thal) major, the pathogenetic mechanisms leading from siderosis to diabetes are poorly understood. We assessed the glycometabolic status in transfusion-dependent Egyptian beta-thal patients and evaluated their possible risk factors for abnormal glucose tolerance (AGT). An oral glucose tolerance test (OGTT) was done on 54 multi-transfused patients and 28 age-matched normal controls, measuring their serum insulin levels at 0 and 120 min. Insulin sensitivity and insulin release indices were calculated. Indicators of iron overload and liver status were recorded. Thirteen patients (24.1%) had AGT. Cases with AGT had significantly higher mean postprandial insulin, fasting insulin resistance index (FIRI) and homeostasis model assessment (HOMA) insulin resistance (IR), p = 0.0001 for all, and significantly lower mean HOMA beta cell, p = 0.007, when compared with normal glucose tolerance (NGT) cases. Abnormal glucose tolerance is common in multi-transfused beta-thal major patients and could be attributed to early impaired beta-cell function with increasing IR.
Hafez
Mona
M
Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Youssry
Ilham
I
El-Hamed
Fayza Abd
FA
Ibrahim
Amany
A
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001803:Blood Transfusion; D002648:Child; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D012307:Risk Factors; D055815:Young Adult; D017086:beta-Thalassemia / Q000150:complications*
D001786:Blood Glucose; D007328:Insulin