title: Zinc status affects glucose homeostasis and insulin secretion in patients with thalassemia.
abstract: Up to 20% of adult patients with Thalassemia major (Thal) live with diabetes, while 30% may be zinc deficient. The objective of this study was to explore the relationship between zinc status, impaired glucose tolerance and insulin sensitivity in Thal patients. Charts from thirty subjects (16 male, 27.8 ± 9.1 years) with Thal were reviewed. Patients with low serum zinc had significantly lower fasting insulin, insulinogenic and oral disposition indexes (all p < 0.05) and elevated glucose response curve, following a standard 75 g oral load of glucose compared to those with normal serum zinc after controlling for baseline (group × time interaction p = 0.048). Longitudinal data in five patients with a decline in serum zinc over a two year follow up period (-19.0 ± 9.6 μg/dL), showed consistent increases in fasting glucose (3.6 ± 3.2 mg/dL) and insulin to glucose ratios at 120 min post glucose dose (p = 0.05). Taken together, these data suggest that the frequently present zinc deficiency in Thal patients is associated with decreased insulin secretion and reduced glucose disposal. Future zinc trials will require modeling of oral glucose tolerance test data and not simply measurement of static indices in order to understand the complexities of pancreatic function in the Thal patient.
authors.affiliation: Department of Hematology/Oncology at the UCSF Benioff Children's Hospital, 747 52nd Street Oakland, CA 94609, USA. efung@mail.cho.org.|Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr Way, Oakland, CA 94609, USA. efung@mail.cho.org.
authors.forename: Ellen B
authors.initials: EB
authors.lastname: Fung
authors.affiliation: The Pediatric Clinical Research Center, 747 52nd Street Oakland, CA 94609, USA. ggildengorin@mail.cho.org.
authors.forename: Ginny
authors.initials: G
authors.lastname: Gildengorin
authors.affiliation: Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr Way, Oakland, CA 94609, USA. talwarsiddhant@hotmail.com.
authors.forename: Siddhant
authors.initials: S
authors.lastname: Talwar
authors.affiliation: Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr Way, Oakland, CA 94609, USA. indystar23@gmail.com.
authors.forename: Leah
authors.initials: L
authors.lastname: Hagar
authors.affiliation: Department of Hematology/Oncology at the UCSF Benioff Children's Hospital, 747 52nd Street Oakland, CA 94609, USA. alal@mail.cho.org.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Lal
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D015032:Zinc / Q000008:administration & dosage / Q000097:blood*; D017086:beta-Thalassemia / Q000097:blood* / Q000188:drug therapy
chemical_list: D001786:Blood Glucose; D007328:Insulin; D015032:Zinc
keywords: Diabetes; Glucose intolerance; Thalassemia; Zinc