Anti-Thyroid Peroxidase Antibodies and Male Gender Are Associated with Diabetes Occurrence in Patients with Beta-Thalassemia Major.
BACKGROUND
Intensive transfusion schedule and iron-chelating therapy prolonged and improved quality of life in patients with β-thalassemia (β-T) major. However, this led to an increased risk of developing impaired glucose tolerance or diabetes. In this study we analyzed variables associated with the occurrence of impaired glucose tolerance or diabetes in patients with β-T major.


METHODS
388 Sardinian patients were included. Age, gender, duration of chelation therapy, body mass index, and markers of pancreatic and extrapancreatic autoimmunity were analyzed.


RESULTS
Multiple logistic regression analysis showed that anti-thyroid peroxidase (TPO) antibodies (Ab) (OR = 3.36; p = 0.008) and male gender (OR = 1.98; p = 0.025) were significantly associated with glucose impairment, while the other variables were not. Ferritin levels were significantly higher in TPOAb positive compared to TPOAb negative patients (4870 ± 1665 μg/L versus 2922 ± 2773 μg/L; p < 0.0001).


CONCLUSIONS
In patients with β-T major a progressive damage of insulin-producing cells due to secondary hemosiderosis appears to be the most reasonable mechanism associated with glucose metabolism disorders. The findings need to be confirmed with additional well designed studies to address the question of whether TPOAb may have a role in the management of these patients.
Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy.
Giovanni M
GM
Pes
Endocrinology Unit, Azienda Ospedaliero-Universitaria, 07100 Sassari, Italy.
Francesco
F
Tolu
Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; Baylor College of Medicine, Houston, TX 77030, USA.
Maria P
MP
Dore
D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005293:Ferritins / Q000097:blood; D006486:Hemosiderosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D007502:Iron Chelating Agents / Q000009:adverse effects*; D033862:Iron-Binding Proteins / Q000276:immunology*; D007558:Italy; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D065227:Transfusion Reaction; D017086:beta-Thalassemia / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*
D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D001786:Blood Glucose; D007502:Iron Chelating Agents; D033862:Iron-Binding Proteins; C056626:thyroid microsomal antibodies; D005293:Ferritins; C056658:TPO protein, human; D007453:Iodide Peroxidase