Mowla Ashkan, Karimi Mehran, Afrasiabi Abdolreza, De Sanctis Vincenzo
Hemostasis and Thrombosis Unit, Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Pediatr Endocrinol Rev. 2004 Dec;2 Suppl 2:282-4.
Impaired glucose tolerance and diabetes are well known complications in beta-Thalassaemic multitransfused patients (beta-Th). Iron overload and chronic liver disease, viral infections and/or genetic factors may play an important role in the development of glucose intolerance. The present study aimed to investigate whether in beta-thalassemic patients the hepatitis C virus (HCV) infection may be an additional risk factor for the development of diabetes mellitus.
The study included 98 beta-Th multitransfused patients, 50 females and 48 males (mean age 15.9 -/+ 4 years; range: 8-32 years). Forty six (47%) patients were seropositive for HCV by ELISA. Six patients were diagnosed as diabetic before the present study. In the remaining oral glucose tolerance test was performed according to the recommendations of National Diabetes Data Group. Prevalence of diabetes and impaired glucose tolerance were compared in HCV-seropositive and HCV-seronegative groups.
The prevalence of diabetes in HCV (+) adult beta-Th patients was higher compared to HCV (-) patients (15.2% vs. 1.9%, p: 0.02). No difference was observed in HCV-RNA (-) in the younger group of beta-Th patients.
The prevalence of diabetes in adult thalassemic patients is significantly increased by HCV infection, but there is no difference between HCV(+) group and HCV(-) group in age range of 8-15 years. It is probable that the existence of hemosiderosis makes the effect of HCV infection on glucose metabolism clinically more evident.
糖耐量受损和糖尿病是β地中海贫血多次输血患者(β-Th)中众所周知的并发症。铁过载、慢性肝病、病毒感染和/或遗传因素可能在糖耐量异常的发生中起重要作用。本研究旨在调查丙型肝炎病毒(HCV)感染在β地中海贫血患者中是否可能是糖尿病发生的另一个危险因素。
该研究纳入了98例β-Th多次输血患者,50例女性和48例男性(平均年龄15.9±4岁;范围:8 - 32岁)。通过酶联免疫吸附测定法(ELISA),46例(47%)患者HCV血清学阳性。在本研究之前,有6例患者被诊断为糖尿病。其余患者根据美国国家糖尿病数据组的建议进行口服葡萄糖耐量试验。比较HCV血清学阳性组和HCV血清学阴性组中糖尿病和糖耐量受损的患病率。
HCV(+)的成年β-Th患者中糖尿病的患病率高于HCV(-)的患者(15.2%对1.9%,p:0.02)。在较年轻的β-Th患者组中,HCV-RNA(-)未观察到差异。
HCV感染显著增加了成年地中海贫血患者中糖尿病的患病率,但在8 - 15岁年龄范围内,HCV(+)组和HCV(-)组之间没有差异。可能是血色素沉着症的存在使HCV感染对糖代谢的影响在临床上更加明显。