Endocrine Abstracts

Introduction: We evaluated glycemia and the iron status in patients with NT-SCD and 6 patients with TD- SCD by measuring serum ferritin level (SF), liver iron content (LIC), alanine transferase (ALT) and fasting blood glucose (FBG) over 5 years of follow up.

Results: At the initial assessment, 16 adults with (age: 33±14 years), and six of TD-SCD (n=6, age =25±10 years) were studied. 6/16 of NT-SCD had SF > 500 μg/l, and 5/16 had high LIC (> 36 μmol Fe/kg dry weight). 6/16 had elevated ALT concentrations. 2/16 had impaired fasting glucose (IFG), but none had IGT or diabetes (DM). In the TD-SCD who were receiving top-up RBC transfusion to keep Hb > 10 g/dl, and oral iron chelation (Exjade), all had high LIC and 14/16 had high. ALT was high in 2/6. 1/6 had IFG.Five years later, 3/16 of NTSCD had DM and 2 had IFG. Those who developed DM had had LIC =13, 75, and 22 mmol/kg 5 years before the development of DM. The 2/16 who developed IFG had had LIC =27 and 39 mmol/kg DW. In TDSCD, 2/6 developed DM and 1/6 had IFG. Those who developed DM had had LIC =127 and 20 mmol/kg and normal FBG 5 years before the development of DM. The one with IFG had previously LIC =22 mmol/kg and normal FBG 5 years back. Echocardiography revealed abnormalities of the left ventricle, dilated left atrium and dyskinesis in 5/22.FBG was correlated significantly with the age of patients (r=0.68, P0.01) but did not correlate with ferritin, LIC or BMI. LIC was correlated significantly with SF (r=0.89, P 0.001)

Conclusions: A significant number of our patients with ND-SCD and TDSCD develop dysglycemia (IFG, and DM) that is correlated with age but not correlated with BMI. Glycemic data and iron status in patients with NTD-SCD vs TD SCD at the beginning of the study (A) and after 5 years of follow-up (B) (mean +/- SD)