<p>Prevalence of abnormal glucose homeostasis in Chinese patients with non-transfusion-dependent thalassemia</p>

Abstract

Purpose: To determine the prevalence and underlying pathology of abnormal glucose homeostasis in Chinese patients with non-transfusion-dependent thalassemia (NTDT). Patients and methods: In this study, we enrolled 211 patients aged 4–63 years with NTDT, including 79 β thalassemia intermedia patients, 114 Hb H disease patients and 18 Hb E/β thalassemia patients. All had oral glucose tolerance test, serum ferritin (SF), homeostasis model assessment (HOMA) and liver iron concentration (LIC) measurement. One hundred and twenty healthy age-matched controls were also used for the comparative purpose. Iron load was assessed by using SF and hepatic load by LIC using validated MRI techniques. Results: The 211 patients were divided into three groups according to their fasting and 2 hrs postprandial blood glucose levels: hypoglycemic, normal glucose tolerance (NGT) and hyperglycemic groups. In this study, 149 patients had NGT, 33 had hypoglycemia, 4 had diabetes and 25 had impaired glucose tolerance (IGT). None had impaired fasting glucose. There was a significant correlation between 2 hrs postprandial blood glucose levels and age, PINS120, HOMA-IR, alanine aminotransferase and LIC ( P <0.05). Risk factors for IGT in NTDT patients were older age (≥24 years) and SF concentration of ≥2,500 ng/mL. Conclusion: Age ≥24 years and SF ≥2,500 ng/mL of NTDT patients were at a greater risk for impaired glucose tolerance.

The effects of iron overload, insulin resistance and oxidative stress on metabolic disorders in patients with β- thalassemia major

“…Increase in hydroxyl free radicals production by the Fenton reaction and iron overload are mentioned as the causes of IMA formation in patients with thalassemia [13]. Increase in FBS and higher rate of insulin resistance was observed in our patients with β-TM, which are in agreement with the results reported by several previous studies [9,25]. As expected and in agreement with many previous studies [26], evaluation of liver function test in our patients showed abnormalities in all aspects of normal liver function.…”

“…In order to better predict CHD risk, several indices of dyslipidemia including LDL: HDL ratio ( atherogenic index; AI), log TG: HDL ratio (atherogenic index of plasma; AIP), TC: HDL ratio (coronary risk index ; CRI) are used to describe the significance of dyslipidemia in increasing risk of CHD in patients with β-TM [8]. Hyperglycemia, glucose intolerance, decreased beta cell activity and insulin insensitivity were reported in patients with β-TM [9]. OS due to decrease in antioxidant defense system and increase iron-induced ROS production as well as the benefits of antioxidant administration to overcome these disorders were implicated in patients with β-TM [10].…”

The prevalence and outcomes of α- and β-thalassemia among pregnant women in Hubei Province, Central China

“…It is noticeable that the proportion of pregnancy-induced diabetes was as high as 16.58% and 17.86% among pregnant α- and β-thalassemia carriers, respectively, which was largely higher than what was reported in thalassemia major patients (6.54–9.0%) [30,31] . Another study focused on Chinese populations reported that the prevalence of diabetes was 1.90% (4/211) among patients with non-transfusion-dependent thalassemia [32] . Attention should be paid to pregnancy-induced diabetes in thalassemia patients.…”

“…[30,31] Another study focused on Chinese populations reported that the prevalence of diabetes was 1.90% (4/211) among patients with non-transfusion-dependent thalassemia. [32] Attention should be paid to pregnancy-induced diabetes in thalassemia patients. It should also be noted that a-thalassemia carriers might have worse pregnancy outcomes compared with b-thalassemia, especially for pregnancy-induced hypertension and eclampsia/ preeclampsia.…”

Whole-exome sequencing analysis of amniotic fluid cells in 5 pregnant women with thalassemia: Case report

“…Impaired glucose tolerance in symptomatic diabetes mellitus was substantiated for thalassemic patients. [ 16 ] An excess of deformed globin chains in thalassemic erythrocytes are deposited on the erythrocyte membrane, leading to membrane protein aggregation and binding to autoantibodies and complement, and this in turn promotes the rapid clearance of erythrocytes in the circulation. [ 17 ] Abnormalities of the innate immune system associated with thalassemia were reported including reduced absorption and phagocytic ability of polymorphonuclear neutrophils, and altered intracellular metabolic processes.…”