TY - JOUR
T1 - A retrospective study of glucose homeostasis, insulin secretion, sensitivity/resistance in non- transfusion-dependent β-thalassemia patients (NTD- β Thal)
T2 - reduced β-cell secretion rather than insulin resistance seems to be the dominant defect for glucose dysregulation (GD)
AU - De Sanctis, Vincenzo
AU - Daar, Shahina
AU - Soliman, Ashraf
AU - Tzoulis, Ploutarchos
AU - Yassin, Mohamed
AU - Kattamis, Christos
N1 - Publisher Copyright:
© Mattioli 1885.
PY - 2023/12/5
Y1 - 2023/12/5
N2 - AIMS: Non-transfusion - dependent β-thalassemias (NTD-βThal) can cause iron overload and serious iron-related organ complications as endocrine dysfunction, including glucose dysregulation (GD). PATIENTS AND METHODS: We retrieved data of all NTD- β Thal patients referred consecutively to a single Outpatient Italian Clinic from October 2010 to April 2023. All patients underwent a standard 3-h oral glucose tolerance test (OGTT) for analysis of glucose homeostasis, insulin secretion and sensitivity/resistance (IR), using conventional surrogate indices derived from the OGTT. The collected data in NTD- β Thal patients were compared to 20 healthy subjects. RESULTS: Seventeen of 26 (65.3 %) NTD- β Thal patients (aged: 7.8 -35.1 years) had normal glucose tolerance, 1/26 (3.8 %) had impaired fasting glucose (IFG), 5/26 (19.2 %) impaired glucose tolerance (IGT), 1/26 (3.8%) IFG plus IGT and 2/26 (7.6%) plasma glucose (PG) level ≥155 mg/dL 1-h after glucose load. GD was observed exclusively in young adult patients; none of them had diabetes mellitus (DM). These findings were associated with a low insulinogenic index (IGI) and oral disposition index. HOMA-IR and QUICKI were not significantly different compared to controls. Interestingly, in young adult patients, ISI-Matsuda index was statistically higher compared to the control group, suggesting an increased insulin sensitivity. CONCLUSIONS: This study reported a high prevalence of GD in young adults with NTD- β Thal. The documented reduction of IGI rather than the presence of IR, indicates reduced insulin secretory capacity as the pathophysiological basis of dysglycemia that may represent a novel investigational path for future studies on the mechanism(s) responsible for GD in NTD- β Thal patients.
AB - AIMS: Non-transfusion - dependent β-thalassemias (NTD-βThal) can cause iron overload and serious iron-related organ complications as endocrine dysfunction, including glucose dysregulation (GD). PATIENTS AND METHODS: We retrieved data of all NTD- β Thal patients referred consecutively to a single Outpatient Italian Clinic from October 2010 to April 2023. All patients underwent a standard 3-h oral glucose tolerance test (OGTT) for analysis of glucose homeostasis, insulin secretion and sensitivity/resistance (IR), using conventional surrogate indices derived from the OGTT. The collected data in NTD- β Thal patients were compared to 20 healthy subjects. RESULTS: Seventeen of 26 (65.3 %) NTD- β Thal patients (aged: 7.8 -35.1 years) had normal glucose tolerance, 1/26 (3.8 %) had impaired fasting glucose (IFG), 5/26 (19.2 %) impaired glucose tolerance (IGT), 1/26 (3.8%) IFG plus IGT and 2/26 (7.6%) plasma glucose (PG) level ≥155 mg/dL 1-h after glucose load. GD was observed exclusively in young adult patients; none of them had diabetes mellitus (DM). These findings were associated with a low insulinogenic index (IGI) and oral disposition index. HOMA-IR and QUICKI were not significantly different compared to controls. Interestingly, in young adult patients, ISI-Matsuda index was statistically higher compared to the control group, suggesting an increased insulin sensitivity. CONCLUSIONS: This study reported a high prevalence of GD in young adults with NTD- β Thal. The documented reduction of IGI rather than the presence of IR, indicates reduced insulin secretory capacity as the pathophysiological basis of dysglycemia that may represent a novel investigational path for future studies on the mechanism(s) responsible for GD in NTD- β Thal patients.
KW - insulin secretion
KW - insulin sensitivity/resistance
KW - non–transfusion-dependent thalassemia (NTDT)
KW - oral glucose tolerance test (OGTT)
KW - Humans
KW - Homeostasis
KW - Glucose
KW - beta-Thalassemia/complications
KW - Glucose Intolerance
KW - Young Adult
KW - Blood Glucose/analysis
KW - Adolescent
KW - Adult
KW - Insulin Resistance/physiology
KW - Prediabetic State
KW - Retrospective Studies
KW - Diabetes Mellitus, Type 2
KW - Child
KW - Insulin Secretion
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UR - https://www.mendeley.com/catalogue/cd29d0f9-b545-3e59-ba74-effc2004f4b4/
U2 - 10.23750/abm.v94i6.15001
DO - 10.23750/abm.v94i6.15001
M3 - Article
C2 - 38054678
AN - SCOPUS:85178850461
SN - 0392-4203
VL - 94
SP - e2023262
JO - Acta bio-medica : Atenei Parmensis
JF - Acta bio-medica : Atenei Parmensis
IS - 6
M1 - e2023262
ER -