Mashhadi Mohammad Ali, Sepehri Zahra, Heidari Zahra, Kaykhaei Mahmoud Ali, Sargazi Aliyeh, Kohan Farhad, Heidari Hanieh
Hematology/Oncology Department, Zahedan University of Medical Sciences, Zahedan, Iran.
Internal Medicine Department, Zabol University of Medical Sciences, Zabol, Iran.
Int J Hematol Oncol Stem Cell Res. 2017 Oct 1;11(4):273-280.
Endocrinopathies and diabetes mellitus are prevalent in patients with beta-thalassemia major Recently some studies demonstrate a link between low levels of serum zinc level and higher prevalence of diabetes. The aim of this study was to evaluate the glucose tolerance in patients suffered from beta-thalassemia major and determine the association of Homeostasis Model Assessment (HOMA) parameters with zinc status among these patients. In this cross sectional study, clinical data of patients who were suffered from thalassemia major, aged≥10 years were collected. Serum ferritin concentration, fasting blood sugar, fasting blood insulin and serum zinc level were assessed after overnight fasting. Moreover, oral glucose tolerance test was performed. Homeostasis Model Assessment (HOMA-2) was used for calculating beta-cell function, insulin resistance and sensitivity for normoglycemic and pre-diabetic subjects. of the 163 patients diagnosed with beta-thalassemia major, 10%, 53% and 37% were diabetic, pre-diabetic and normal, respectively. Mean serum zinc concentration was equal to 18.90±10.93µg/dl, and it was not significantly different across diabetic, pre-diabetic and normal groups. Pre-diabetic patients had significantly lower beta-cell function compared to normal subjects (P=0.0001). An inverse relation was documented between beta-cell function on one hand and total units of blood transfusion and ferritin level on the other hand (r=-0.29, P=0.004 and r=-0.27, P=0.03, respectively). The analysis adjusted for multiple possible confounders showed that there is no significant association between HOMA parameters and serum zinc level. Impaired glucose metabolism and low serum zinc level were quite common among our study participants. The findings of the study also signifies the substantial role of follow-up in early detection and appropriate treatment.
内分泌疾病和糖尿病在重型β地中海贫血患者中很常见。最近一些研究表明血清锌水平低与糖尿病患病率较高之间存在联系。本研究的目的是评估重型β地中海贫血患者的葡萄糖耐量,并确定这些患者中稳态模型评估(HOMA)参数与锌状态之间的关联。在这项横断面研究中,收集了年龄≥10岁的重型地中海贫血患者的临床数据。过夜禁食后评估血清铁蛋白浓度、空腹血糖、空腹血胰岛素和血清锌水平。此外,进行了口服葡萄糖耐量试验。稳态模型评估(HOMA-2)用于计算血糖正常和糖尿病前期受试者的β细胞功能、胰岛素抵抗和敏感性。在163例被诊断为重型β地中海贫血的患者中,糖尿病患者、糖尿病前期患者和正常患者分别占10%、53%和37%。血清锌平均浓度等于18.90±10.93µg/dl,在糖尿病组、糖尿病前期组和正常组之间无显著差异。与正常受试者相比,糖尿病前期患者的β细胞功能显著降低(P=0.0001)。一方面记录了β细胞功能与另一方面的输血总量和铁蛋白水平之间存在负相关(r=-0.29,P=0.004和r=-0.27,P=0.03)。对多个可能的混杂因素进行校正后的分析表明,HOMA参数与血清锌水平之间无显著关联。在我们的研究参与者中,糖代谢受损和血清锌水平低相当常见。该研究结果还表明了随访在早期发现和适当治疗中的重要作用。