TY - JOUR
TI - A study of isolated hyperglycemia (Blood glucose ≥155 mg/dl) at 1-hour of oral glucose tolerance test (OGTT) in patients with β-transfusion dependent thalassemia (β-TDT) followed for 12 years
AU - de Sanctis, V.
AU - Soliman, A.
AU - Tzoulis, P.
AU - Daar, S.
AU - Pozzobon, G.C.
AU - Kattamis, C.
JO - Acta Biomedica
PY - 2021
VL - 92
TODO - 4
SP - null
PB - Mattioli 1885 Publishing Company
SN - null
TODO - 10.23750/abm.v92i4.11105
TODO - ascorbic acid;  biological marker;  deferasirox;  deferiprone;  deferoxamine;  glucose oxidase;  virus RNA, adolescent;  adrenal insufficiency;  adult;  alanine aminotransferase blood level;  Article;  beta transfusion dependent thalassemia;  blood sampling;  blood transfusion;  body mass;  body weight;  chelation therapy;  chronic liver disease;  clinical article;  diabetes mellitus;  disease surveillance;  dysglycemia;  erythrocyte concentrate;  female;  ferritin blood level;  follow up;  function test;  glucose blood level;  glucose homeostasis;  glucose tolerance;  Hepatitis C virus;  homeostasis model assessment;  human;  hyperglycemia;  hypersplenism;  hypertransaminasemia;  hypogonadotropic hypogonadism;  immunoassay;  insulin release;  insulin secretion sensitivity index 2;  insulin sensitivity;  iron chelation;  iron overload;  leukopenia;  male;  matsuda index insulin resistance;  medical parameters;  oral glucose tolerance test;  polymerase chain reaction;  quantitative insulin sensitive check;  Quantitative Insulin Sensitivity Check Index;  questionnaire;  retrospective study;  secondary amenorrhea;  short stature;  splenectomy;  splenomegaly;  thrombocytopenia;  transfusion dependent thalassemia;  beta thalassemia;  complication;  glucose blood level;  glucose tolerance test;  insulin resistance;  non insulin dependent diabetes mellitus, beta-Thalassemia;  Blood Glucose;  Diabetes Mellitus, Type 2;  Glucose Tolerance Test;  Humans;  Hyperglycemia;  Insulin Resistance;  Retrospective Studies
TODO - Objective: Subjects with normal glucose tolerance (NGT) but 1-hour post-load plasma glucose (1-h OGTT) ≥ 155 mg/dl (8.6 mmol/L; H-NGT) have an increased risk for developing Type 2 diabetes mellitus (T2DM), determining a new risk factor category with deeper metabolic impairment. The aim of this study was to evaluate the H-NGT as a diagnostic predictor of future dysglycemia in β-transfusion dependent thalassemia (β-TDT). Indices of insulin secretion and insulin sensitivity derived at baseline from OGTTs, were also reviewed. Study design and methods: OGTT and indices of insulin secretion and insulin sensitivity, derived at baseline during OGTT, in 17 β-TDT with H-NGT and 29 β-TDT with normal OGTT (NGT) and without H-NGT followed for 12 years were studied. Results: H-NGT was associated with decreased insulin sensitivity and progressive deterioration of glucose tolerance. At baseline, serum ferritin and serum alanine aminotransferase (ALT) levels were higher in patients with H-NGT compared to patients with NGT. A strong correlation was observed between ALT and 1-hour plasma glucose value during OGTT in the total group of 36 patients . Compliance to iron chelation therapy was poor in β-TDT patients with H-NGT. An inverse correlation was found between 1-hour plasma glucose value during OGTT and insulin secretion-sen-sitivity index-2 (ISSI-2) (r:-0.3298; p: 0.025), between ISSI-2 and ALT (r:-0.3262; p: 0.027), and between 1-hour plasma glucose value and ISSI-2 (r:-0.537; p: 0.005) in the whole group of β-TDT patients enrolled in our study. Conclusions: It is of paramount importance to screen early β-TDT patients at increased risk for glucose dysregulation. This retrospective study displayed that finding an isolated high 1-hour post-load glucose level (≥155 mg/dL; H-NGT) during the OGTT may serve as a simple biomarker to detect high-risk patients, with chronic liver disease and/or iron overload, who need periodic glycemic surveillance. Measuring the ISSI 2 represented another valuable predictive marker in the assessment of glycemia in these patients. © Mattioli 1885.
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