Prevalence of abnormal glucose homeostasis in Chinese patients with non-transfusion-dependent thalassemia

Abstract

Yunchen Luo,1 Rekha Bajoria,2 Yongrong Lai,3 Hongfei Pan,4 Qiaochuan Li,3 Zhongming Zhang,3 Pijian Yang,5 Ratna Chatterjee,2 Yuzhen Liang11Department of Endocrinology and Metabolism, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 2Reproductive Medicine, Institute for Women’s Health, Haematology Unit, University College Hospitals and Royal Free Hospital, London, UK; 3Department of Haematology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 4Department of Paediatrics, Affiliated Hospital of Youjiang Medical College for Nationality, Nanning, Guangxi, People’s Republic of China; 5Department of Geriatric Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaPurpose: 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.Keywords: glucose homeostasis, non-transfusion-dependent thalassemia, liver iron overload, post prandial hyperglycaemia

Keywords

• glucose homeostasis
• Non-transfusion-dependent thalassemia
• liver iron overload
• post prandial hyperglycaemia