ECE2022 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (318 abstracts)
Surrogate measures of insulin secretion and sensitivity (IS) in young children with beta thalassemia major on repeated blood transfusion and iron chelation therapy.
Vincenzo De Sanctis 1 , Shahina Daar 2 , Ashraf Soliman 3 , Ploutarchos Tzoulis 4 , Mehran Karimi 5 & Christos Kattamis 6
1Quisisana Hospital, Pediatrics, Italy; 2College of Medicine, Sultan Qaboos University, Pediatrics, Muscat, Oman; 3Hamad Medical Center, Pediatrics, Doha, Qatar; 4Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, United Kingdom; 5Hematology Research Center, Shiraz University of Medical Sciences, Hematology, Shiraz, Iran; 6National Kapodistrian University of Athens, Greece, First Department of Paediatrics, Athens, Greece
We assessed glycemia and insulin markers in 18 young children with beta thalassemia major (BTM). Insulin markers measured included: the Homeostatic Model Assessment index of insulin resistance (HOMA-IR), Matsuda index (MI), the insulinogenic index (IGI), and the oral disposition index (oDI). 9 had normal fasting glucose (FG) and 9 had impaired fasting glucose (IFG)
Results: HOMA-IR, a marker of IR was significantly higher in children with BTM compared to normal controls. Fasting insulin was significantly higher in children with BTM patients vs normal children. Despite higher fasting insulin compared to controls thalassaemic children (group A) had higher fasting glucose levels. Both findings support an insulin resistance state early in these patients. oDI was significantly lower in children with BTM (with and without IFG) compared to normal controls.
| Baseline variables | Children with β -TM and NGT (n: 9)Group A | Children with β -TM and isolated IFG (n:9) Group B | Controls (n.9) Group C | P-value A vs. B | P-value A vs. C | P-value B vs. C |
| Chronological age (yrs) | 5.41±0.72 | 5.59±1.73 | 5.14±0.4 | NS | NS | NS |
| Gender (Males/Females) | 4/5 | 6/3 | 5/4 | - | - | - |
| BMI (kg/m2) | 17.5±2.9 | 18.1±2.7 | 18.1±3.1 | NS | NS | NS |
| Serum ferritin (ng/ml) | 1,867±654.9 | 1,848±307.0 | - | NS | - | - |
| ALT (U/l) | 117.3±92.9 | 74.11±46.67 | - | NS | - | - |
| Fasting plasma glucose (mg/dl) | 84.7±7.3 | 108.4±5.0 | 76.3±7.4 | < 0.001 | NS | < 0.001 |
| Plasma glucose 2-h after OGTT (mg/dl) | 105.6±13.6 | 107.1±18.6 | 86.0±12.0 | NS | < 0.05 | < 0.05 |
| Fasting insulin (μ U/ml) | 8.88±1.96 | 10.5±2.7 | 3.7±2.7 | NS | < 0.001 | < 0.001 |
| MATSUDA INDEX (MI 0-120) | 6.70±2.24 | 6.38±2.28 | 17.11±6.7 | NS | < 0.001 | < 0.001 |
| HOMA-IR | 1.92±0.53 | 2.85±0.77 | 0.72±0.52 | < 0.05 | < 0.001 | < 0.001 |
| Insulinogenic Index (IGI) | 0.53±0.29 | 0.74±0.68 | 0.75±0.16 | NS | NS | NS |
| Oral disposition Index (oDI) | 3.45±2.11 | 4.01±3.82 | 12.92±5.11 | NS | < 0.001 | < 0.001 |
Conclusion: These findings supported the presence of significant insulin resistance in children with BTM on repeated blood transfusion and iron chelation
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