Insulin Resistance and<b>β</b>Cell Function in Patients with<b>β</b>-Thalassemia Major

Ghergherehchi, Robabeh; Habibzadeh, Afshin

doi:10.3109/03630269.2014.999081

Cited by 17 publications

(21 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the cohort studied the overall frequency of glucose metabolism impairment was 25% of which 16.5% was due to overt diabetes and 8.5% was due to OGTT-ascertained impaired glucose tolerance. These findings are comparable to that of other studies [ 8 , 9 , 11 – 14 , 21 ] and are far below the prevalence reported recently in a UK cohort [ 13 ]. The frequency of positivity for GAD65Ab, defined according to a 99th percentile cut-off, in thalassemic patients with NGT or IGT was not different from the frequency in the general population.…”

Section: Discussionsupporting

confidence: 89%

“…Progressive glucose intolerance or overt diabetes is the main metabolic complication in a significant proportion of patients with β -T major and contributes to overall morbidity [ 6 – 8 ]. However, the pathogenetic mechanisms leading to diabetes are still poorly understood, and most authors currently believe that iron deposition in the pancreatic β -cells is the leading cause [ 6 , 9 , 10 ]. This hypothesis is supported by the increased incidence of diabetes observed in idiopathic hemochromatosis [ 10 ] and in posttransfusional iron overload [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anti-Thyroid Peroxidase Antibodies and Male Gender Are Associated with Diabetes Occurrence in Patients with Beta-Thalassemia Major

Pes

Tolu

Dore

2016

Journal of Diabetes Research

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Anti-Thyroid Peroxidase Antibodies and Male Gender Are Associated with Diabetes Occurrence in Patients with Beta-Thalassemia Major

Pes

Tolu

Dore

2016

Journal of Diabetes Research

View full text Add to dashboard Cite

show abstract

“…Two significant mechanisms (insulin resistance due to hepatic and muscle iron deposition, and β‐cell hypofunction secondary to pancreatic iron overload) play an essential role in the pathogenesis of glucose intolerance and DM in TDT patients . The prevalence of DM varied from 4.2% to 26.8% among young adults depending on the population being studied …”

Section: Introductionmentioning

confidence: 99%

“…2 The prevalence of DM varied from 4.2% to 26.8% among young adults depending on the population being studied. 1,[3][4][5][6][7][8][9][10] Patients with TDT often develop iron overload because they receive regular blood transfusions from early childhood, and they typically require concomitant iron chelation therapy to prevent permanent organ damage. 11 In contrast, patients with non-transfusion-dependent thalassemia (NTDT) are less prone to the development of iron overload in early life.…”

Section: Introductionmentioning

confidence: 99%

Early development of decreased β‐cell insulin secretion in children and adolescents with hemoglobin H disease and its relationship with levels of anemia

Nakavachara

Kajchamaporn

Pooliam

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background Diabetes mellitus (DM) associated with iron overload has been reported among adults with transfusion‐dependent thalassemia and those with non‐transfusion‐dependent thalassemia (NTDT), especially in β‐thalassemia disease. However, little is known about glucose metabolism and how early its dysregulation can develop in α‐thalassemia hemoglobin H (Hb H) disease, which is one of the most common types of NTDT worldwide. Procedure We prospectively calculated glucose metabolism index in 40 patients (aged 10–25 years) with Hb H disease. Glucose metabolism data were compared between patients with deletional versus nondeletional Hb H, and between patients with normal versus abnormal insulin secretion/sensitivity. Results Despite normal glucose tolerance in all patients, 52.5% had abnormal insulinogenic index indicating decreased β‐cell insulin secretion. Patients with functional hemoglobin < 8 g/dL had significantly higher percentages of abnormal insulinogenic index. There was no significant difference in abnormal insulinogenic index between deletional and nondeletional Hb H. Conclusion Decreased β‐cell insulin secretion is highly prevalent among children and adolescents with Hb H disease, and it is associated with levels of functional anemia at baseline, but not with the type of Hb H disease. This result warrants heightened awareness among hematologists due to potentially increased risk of DM later in life.

show abstract

“…In animal studies, intravenous iron loading was shown to lead to pancreatic necrosis by free radical oxygen species through a Fenton reaction ( 1 , 2 ). Glucose dysregulation, secondary to increased insulin resistance and pancreatic b-cell dysfunction, has been widely reported in thalassemia major patients with iron overload ( 3 , 4 ). Furthermore, adverse effects of iron overload on insulin sensitivity and insulin secretion varied, depending on the degree of iron excess and may be reversible after reduction of tissue iron accumulation.…”

Section: Introductionmentioning

confidence: 99%

Acute Effects of Blood Transfusion on Insulin Sensitivity and Pancreatic β-Cell Function in Children with β-Thalassemia/Hemoglobin E Disease

Wankanit¹,

Chuansumrit²,

Poomthavorn³

et al. 2018

Jcrpe

View full text Add to dashboard Cite

Objective:To assess the acute effects of blood transfusion on insulin sensitivity and pancreatic β-cell function in thalassemia patients.Methods:Fifty children and adolescents with β-thalassemia/HbE disease were enrolled in a prospective cohort study. Hemoglobin, serum ferritin and oral glucose tolerance test (OGTT) were performed prior to, and one week after blood transfusion. Insulin sensitivity indices [homeostatic model assessment (HOMA) of insulin resistance (HOMA-IR), whole body insulin sensitivity index (WBISI)] and β-cell function indices [HOMA of β-cell function (HOMA-β), insulinogenic index (IGI), and disposition index (DI)] were calculated from glucose and insulin levels obtained during the OGTT.Results:Following blood transfusion, hemoglobin and serum ferritin increased significantly; 8.5 to 10.1 g/dL (p<0.001) and 1764 to 2160 ng/mL (p<0.001), respectively. β-Cell function indices also increased significantly [median HOMA-β: 74.3 vs. 82.7 (p=0.033); median IGI: 59.6 vs. 79.3 (p=0.003); median DI: 658 vs. 794 (p=0.01)]. However, the insulin sensitivity index (WBISI) tended to decrease and the insulin resistance index (HOMA-IR) tended to increase although this did not reach significance. Multivariate analysis showed that pre-transfusion serum ferritin was the major factor negatively associated with WBISI and positively associated with HOMA-IR, but pre-transfusion hemoglobin had no significant association with insulin sensitivity indices post-transfusion.Conclusion:This study demonstrated that acute increases in serum ferritin and hemoglobin following blood transfusion in patients with thalassemia might contribute to an increase in insulin secretion and to a trend towards increased insulin resistance.

show abstract

Insulin Resistance andβCell Function in Patients withβ-Thalassemia Major

Cited by 17 publications

References 25 publications

Anti-Thyroid Peroxidase Antibodies and Male Gender Are Associated with Diabetes Occurrence in Patients with Beta-Thalassemia Major

Anti-Thyroid Peroxidase Antibodies and Male Gender Are Associated with Diabetes Occurrence in Patients with Beta-Thalassemia Major

Early development of decreased β‐cell insulin secretion in children and adolescents with hemoglobin H disease and its relationship with levels of anemia

Acute Effects of Blood Transfusion on Insulin Sensitivity and Pancreatic β-Cell Function in Children with β-Thalassemia/Hemoglobin E Disease

Contact Info

Product

Resources

About