Relationship between beta-globin gene carrier state and insulin resistance

Abstract

ObjectiveTo assess the relationship between being beta globin gene carrier and developing insulin resistance.MethodsThis study was conducted on 164 subjects including 82 healthy ones and 82 patients with beta thalassemia minor (microcytosis (MCV <80 fl) and hypochromia (MCH <25 pg) and HbA2 ≥ 3.5% using HPLC). Fasting blood glucose (FBS) values of 100–125 mg/dl were considered as impaired fasting glucose, and above 125 mg/dl as diabetes mellitus. Two hours After 75 gram glucose load(GTT), blood sugar level of 140–199 mg/dl was considered as impaired glucose tolerance and above 199 mg/dl as diabetes mellitus. Insulin resistance was diagnosed based on homeostasis model assessment method (HOMA).ResultsAccording to FBS and BS2hPG values, the percentages of diabetes mellitus, pre diabetes, and normal glucose tolerance in case group was 8.5%, 9.8% and 81.7%, respectively. There was no case of diabetes mellitus in control group and 6.1% of this group were pre diabetic and 93.9% of them had normal glucose tolerance test (P = 0.02). Relative risk for diabetes mellitus and insulin resistance in the cases with minor thalassemia was 2 (95% CI: 1.8-2.5) and 2.02 (95% CI: 1.7-2.4), respectively.ConclusionThe risk of developing diabetes and insulin resistance in patients with thalassemia minor is two times greater than the general population. Considering the high serum levels of CRP in these cases, the inflammation noted in liver cells could be considered as the underlying cause of insulin resistance, impaired glucose tolerance and diabetes in these patients.

Intraocular pressure in subjects with beta-thalassemia minor

“…BTM is associated with various metabolic disturbances (12)(13)(14) , including insulin resistance (12,13) . Research suggests that chronic microcytic erythrocytic hemolysis in BTM patients leads to oxidative stress and liver inflammation, which then lead to insulin resistance (12,14) . Gozashti et al noted BTM is associated with high prevalence of carbohydrate-related metabolic disorders which result liver inflammation and subsequent insulin resistance (15) .…”

“…Additionally, excessive IOP has also been reported to be associated with other conditions such as diabetes, hypertension, obesity and metabolic syndromes (6)(7)(8)(9) . Metabolic syndromes and its components in turn, further exacerbate these conditions as it is strongly associated with insulin resistance, which plays a vital role in the development of diabetes, hypertension and obesity, and has been demonstrated in patients with BTM (12,13) . Hence, studies are required to investigate the various regulatory systems mediating IOP to understand the mechanisms underlying glaucoma.…”

Better Renal Resistive Index Profile in Subjects with Beta Thalassemia Minor

“…As a common and mostly symptomless disease [2], BTM is usually diagnosed when a complete blood count has been obtained for other reasons. Besides, BTM is found to be associated with some cardiovascular risk factors such as insulin resistance and diabetes mellitus [7,8]. On the other hand, RRI is a good indicator of intrarenal hemodynamics and it has been also found to be associated with diabetes mellitus and insulin resistance [5,6,9].…”

“…This pathophysiologic mechanism may be responsible for insulin resistance and diabetes in these subjects [8]. A study on 82 BTM subjects and 82 healthy subjects showed that the development of diabetes and insulin resistance in subjects with BTM was 2 times greater than in the general population [8]. Additionally, high fasting insulin levels and insulin resistance have been reported in BTM subjects with a normal glucose tolerance [17] and high levels of fasting glucose and insulin levels have been shown in subjects with BTM [17].…”

“…Chronic hemolysis of microcytic erythrocytes leads to increased oxidative stress and liver inflammation in subjects with BTM. This pathophysiologic mechanism may be responsible for insulin resistance and diabetes in these subjects [8]. A study on 82 BTM subjects and 82 healthy subjects showed that the development of diabetes and insulin resistance in subjects with BTM was 2 times greater than in the general population [8].…”