Indicators of glucose dysregulation and the relationship with iron overload in Chinese children with beta thalassemia major

Abstract

Introduction: Patients with beta thalassemia major (TM) have a higher risk of diabetes and an abnormal oral glucose tolerance test (OGTT), but there is no single agree monitoring parameter that reflects glycemic status. The possible mechanisms include iron overload and blood transfusion, but they require further investigation.Purpose: This study explored the role of glycated hemoglobin A1c (HbA1c), fructosamine, and glycated albumin (GA) in evaluating the glucose dysregulation and to determine the potential relationship between iron deposition and glucose metabolism disorder in beta TM. Methods:A cross-sectional study was performed on 118 patients with beta TM and the control group consisted of 33 healthy children with no statistical differences in age, sex, and body mass index (BMI). Fast plasma glucose (FPG), fast insulin (FINS), insulin resistance index (HOMA-IRI), and insulin sensitivity index (HOMA-ISI) were compared between the patient and control groups. HbA1c, GA, fructosamine, and serum ferritin (SF) were measured in the patient group. OGTT, as well as heart and liver magnetic resonance imaging (MRI) T2*, was performed. For all statistical analyses, SPSS 21.0 was used and p < 0.05 was accepted as statistically significant.Results: FPG, FINS, and HOMA-IRI were significantly increased while HOMA-ISI decreased in the beta TM patients when compared with those in the control group.In patients with beta TM, 17 (14.41%) of patients had been diagnosed with diabetes, while 48 (40.68%) had both impaired fasting glucose and impaired glucose tolerance. HbA1c, GA, and fructosamine were increased according to the degree of abnormal glucose metabolism. Statistically significant differences were found in age, SF, and cardiac T2* between the abnormal and normal OGTT groups.Conclusion: HbA1c may be used as a significant measure for monitoring glycemic levels in patients with beta TM. Furthermore, GA and fructosamine were alternative indicators of glucose status. Patients with heart iron deposition or an SF > 4000 μg/L

Assessment of glucose metabolism in thalassemia patients with type two diabetes in Thi-Qar/ Southern of Iraq

“…The current study recorded a significant increase of diabetic parameters and liver function parameters in thalassemia male and female patients compared with control group, while the results not recorded a significant difference between thalassemia patients according to age, with except ALP scored a significant difference with increasing age. A similar finding to our result recorded by recent study performed by Zhang et al (2021), their study recorded a significant in mean age and diabetic parameters in thalassemia patients and the percent of diabetic among thalassemia patients in Chines population 14.41%, also noted the thalassemia patients with high BMI have lower age mean and high diabetic parameters mean compare with normal BMI patients. In my opinion, the reason for the high rates of diabetes and the decrease in life expectancy for patients with high BMI may be due to the synergistic effect between the amounts of blood transfused and the consequent deposition of iron and to the effect of body mass on glucose metabolism.…”

Beta vulgaris subsp. maritima: A Valuable Food with High Added Health Benefits

“…The fructosamine assay was tested after 28 days of incubation. Fructosamine reduces NBT and produces coloration, which had an absorption at 530 nm [19]. In brief, 40 µL of the glycated BSA was incubated with 160 µL of 0.3 mM NBT in sodium carbonate buffer (100 mM, pH 10.35) at 37 • C for 30 min.…”

New Entity—Thalassemic Endocrine Disease: Major Beta-Thalassemia and Endocrine Involvement

“…It is indicated for a selective high-risk subgroup of patients [ 72 ]. Glucose anomalies in major BTH include IGF, IGT and DM [ 73 , 74 , 75 ]. Annual screening of glucose profile potential damage starts by the age of 10 y [ 73 , 74 , 75 ].…”

“…Glucose anomalies in major BTH include IGF, IGT and DM [ 73 , 74 , 75 ]. Annual screening of glucose profile potential damage starts by the age of 10 y [ 73 , 74 , 75 ]. OGTT is a useful method, but it is more difficult to assess when compared with simple fasting glycaemia [ 73 , 74 , 75 ].…”

“…Annual screening of glucose profile potential damage starts by the age of 10 y [ 73 , 74 , 75 ]. OGTT is a useful method, but it is more difficult to assess when compared with simple fasting glycaemia [ 73 , 74 , 75 ]. HbA1c is less practical in this disorder, but it may be used; fructosamine and glycated albumin represent some potential alternatives [ 73 , 74 , 75 ].…”