title: Effect of Iron Chelation Therapy on Glucose Metabolism in Non-Transfusion-Dependent Thalassaemia.
abstract: OBJECTIVE
  To compare insulin sensitivity, β-cell function and iron status biomarkers in non-transfusion-dependent thalassaemia (NTDT) with iron excess during pre- and post-iron chelation.
  
  
  METHODS
  Subjects with NTDT, aged older than 10 years, with serum ferritin >300 ng/ml, were included. Iron chelation with deferasirox (10 mg/kg/day) was prescribed daily for 6 months.
  
  
  RESULTS
  Ten patients with a median age of 17.4 years were enrolled. The comparison between pre- and post-chelation demonstrated significantly lower iron load: median serum ferritin (551.4 vs. 486.2 ng/ml, p = 0.047), median TIBC (211.5 vs. 233.5 µg/dl, p = 0.009) and median non-transferrin binding iron (5.5 vs. 1.4 µM, p = 0.005). All patients had a normal oral glucose tolerance test (OGTT) both pre- and post-chelation. However, fasting plasma glucose was significantly reduced after iron chelation (85.0 vs.79.5 mg/dl, p = 0.047). MRI revealed no significant changes of iron accumulation in the heart and liver after chelation, but there was a significantly lower iron load in the pancreas, assessed by higher T2* at post-chelation compared with pre-chelation (41.9 vs. 36.7 ms, p = 0.047). No adverse events were detected.
  
  
  CONCLUSIONS
  A trend towards improving insulin sensitivity and β-cell function as well as a reduced pancreatic iron load was observed following 6 months of iron chelation (TCTR20160523003).
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Ampaiwan
authors.initials: A
authors.lastname: Chuansumrit
authors.forename: Pimprae
authors.initials: P
authors.lastname: Pengpis
authors.forename: Pat
authors.initials: P
authors.lastname: Mahachoklertwattana
authors.forename: Nongnuch
authors.initials: N
authors.lastname: Sirachainan
authors.forename: Preamrudee
authors.initials: P
authors.lastname: Poomthavorn
authors.forename: Witaya
authors.initials: W
authors.lastname: Sungkarat
authors.forename: Praguywan
authors.initials: P
authors.lastname: Kadegasem
authors.forename: Patcharin
authors.initials: P
authors.lastname: Khlairit
authors.forename: Pakawan
authors.initials: P
authors.lastname: Wongwerawattanakoon
mesh_terms: D000293:Adolescent; D001565:Benzoates / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D001803:Blood Transfusion; D015913:Chelation Therapy / Q000379:methods*; D000077588:Deferasirox; D004334:Drug Administration Schedule; D005215:Fasting; D005260:Female; D005293:Ferritins / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D007501:Iron / Q000378:metabolism*; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008099:Liver / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D011446:Prospective Studies; D013789:Thalassemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D001565:Benzoates; D001786:Blood Glucose; D007502:Iron Chelating Agents; D014230:Triazoles; D005293:Ferritins; D007501:Iron; D000077588:Deferasirox