title: Insulin Secretion and Resistance in Normoglycemic Patients with Sickle Cell Disease.
abstract: Diabetes mellitus has been described in chronic hemolytic anemias, but data are scarce regarding glucose metabolism in normoglycemic patients. To address this issue, we evaluated insulin sensitivity and secretion in patients with sickle cell disease (SCD) and normal oral glucose tolerance test (OGTT). Forty-five adult patients with homozygous sickle cell disease and Hb S/β-thalassemia (β-thal) (mean age 42.5 ± 9.5 years) and 45 healthy individuals matched for age and body mass index (BMI) were included in the study. All participants underwent an oral glucose tolerance test (OGTT) after an overnight fast. All patients had normal OGTT. Fasting glucose values did not differ significantly between groups, however, fasting insulin levels were significantly lower in the patient group compared to the control group (5.1 ± 2.7 μUI/mL vs. 11.3 ± 6.6 μUI/mL, p <0.005, respectively). Pancreatic β-cell insulin secretion index in the fasting state was significantly lower in patients with sickle cell disease compared with controls as assessed by calculations of the homeostatic model assessment for β-cell function (HOMA β%) (77.0 vs. 106.0%, respectively, p <0.001), while HOMA insulin resistance (HOMA IR), was lower in the sickle cell disease patients, albeit not statistically significant (0.8 vs. 1.1, respectively, p = 0.054). The HOMA β% was significantly correlated with ferritin levels (r = -526, p <0.001) (negative correlation) and with 25-hydroxy (OH)-vitamin D levels (r = 0.479, p <0.001) (positive correlation), even when adjusted for serum ferritin levels. Normoglycemic patients with sickle cell disease demonstrated impaired β-cell function with reduced insulin secretion even before OGTT was impaired.
authors.affiliation: a Division of Endocrinology and Metabolism, 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University of Thessaloniki (AUTH) , Thessaloniki , Greece.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Yavropoulou
authors.affiliation: b Hypertention Excellence center, 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University of Thessaloniki (AUTH) , Thessaloniki , Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Pikilidou
authors.affiliation: c Division of Hematology and Thalassemia Unit, 1st Department of Internal Medicine , AHEPA University Hospital , Thessaloniki , Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Pantelidou
authors.affiliation: d Department of Informatics and Telecommunication Engineering , University of Western Macedonia , Kozani , Greece.
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Tsalikakis
authors.affiliation: a Division of Endocrinology and Metabolism, 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University of Thessaloniki (AUTH) , Thessaloniki , Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Mousiolis
authors.affiliation: c Division of Hematology and Thalassemia Unit, 1st Department of Internal Medicine , AHEPA University Hospital , Thessaloniki , Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Chalkia
authors.affiliation: a Division of Endocrinology and Metabolism, 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University of Thessaloniki (AUTH) , Thessaloniki , Greece.
authors.forename: John G
authors.initials: JG
authors.lastname: Yovos
authors.affiliation: b Hypertention Excellence center, 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University of Thessaloniki (AUTH) , Thessaloniki , Greece.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Zebekakis
mesh_terms: D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D015415:Biomarkers; D001786:Blood Glucose; D016022:Case-Control Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin
keywords: insulin resistance; insulin sensitivity; oral glucose load; sickle cell disease; vitamin D deficiency; β-Cell index