Insulin resistance, impaired glucose tolerance and alpha-thalassemia carrier state

Journal of Diabetes & Metabolic Disorders

Zahra Kashi¹  Mohsen Aarabi¹  Roya Shirzad³  Ghasem Janbabai²  Ramin Shekarriz²  Adele Bahar¹ 

[1] Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran;Cancer center, Mazandaran University of Medical Sciences, Sari, Iran;Department of internal medicine, Imam Khomeini hospital, Razi street, Sari, Iran

关键词: Pre-diabetes;    Impaired glucose tolerance;    Insulin resistance;    Alpha thalassemia;   

Others  :  1133301
DOI  :  10.1186/s40200-015-0129-2

 received in 2014-09-06, accepted in 2015-01-25,  发布年份 2015

【 摘 要 】

Background

This study was designed to determine relationship between the glucose metabolism disorder (the insulin resistance and the impaired glucose tolerance) and α-thalassemia.

Methods

In this historical cohort study, 80Alpha-thalassemia carriers and 80 healthy people were enrolled. The participants had no diabetes familial history and the waist circumference and blood pressure were in normal range (waist circumference of less than 102 cm in men, 88 cm in women and blood pressure <120/80 mmHg). The serum insulin level, fasting blood glucose (after 12 hours fasting) and two-hour plasma glucose during an oral glucose tolerance test (2-h OGTT) were measured. Insulin resistance was estimated according to homeostasis model assessment method (HOMA). Chi-square test, independent sample t-test and the relative risk were used for data analysis.

Results

According to FBS and OGTT results, the percentage of diabetes mellitus and pre-diabetes were 1.3% and 33.8% in Alpha-thalassemia carriers, respectively. The control group showed 2.5% diabetic and 13.8% pre-diabetic cases as well. The relative risk for the glucose tolerance impairment (diabetes and pre-diabetes) was 2.78 (95% CI: 1.31-5.88, P = 0.07).Six and a half percent of the Alpha-thalassemia group and 2.5% in the control group had 2.25 ≤ HOMAIR ≤ 3.59 (an intermediate state of Insulin sensitivity) p = 0.443. In the study, there was no subject with insulin resistance (HOMAIR >3.59).

Conclusions

The possibility of risk enhancement of the impaired glucose tolerance (pre-diabetes and diabetes mellitus) in patients with α-thalassemia is almost three times greater than the normal population without relationship with insulin resistance. Diabetic and pre-diabetic Alpha-thalassemia carrier state is younger than the general population suffering of these disorders.

【 授权许可】

   
2015 Bahar et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Suvarna J, Ingle H, Deshmukh CT: Insulin resistance and beta cell function in chronically transfused patients of thalassemia major. Indian Pediatr 2006, 43(5):393-400.
• [2]Khalifa AS, Salem M, Mounir E, El-Tawil MM, El-Sawy M, Abd Al-Aziz MM: Abnormal glucose tolerance in Egyptian beta-thalassemic patients: possible association with genotyping. Pediatr Diabetes 2004, 5(3):126-32.
• [3]Maddux BA, See W, Lawrence JC Jr, Goldfine AL, Goldfine ID, Evans JL: Protection against oxidative stress-induced insulin resistance in rat L6 muscle cells by mircomolar concentrations of alpha-lipoic acid. Diabetes 2001, 50(2):404-10.
• [4]Tangvarasittichai S, Pimanprom A, Choowet A, Tangvarasittichai O: Association of iron overload and oxidative stress with insulin resistance in transfusion-dependent beta-thalassemia major and beta-thalassemia/HbE patients. Clin Lab 2013, 59(7–8):861-8.
• [5]Flynn DM, Fairney A, Jackson D, Clayton BE: Hormonal changes in thalassaemia major. Arch Dis Child 1976, 51(11):828-36.
• [6]De Sanctis V, Soliman A, Yassin M: Iron overload and glucose metabolism in subjects with beta-thalassaemia major: an overview. Curr Diabetes Rev 2013, 9(4):332-41.
• [7]Tong PC, Ng MC, Ho CS, So WY, Li JK, Lam CW, et al.: C-reactive protein and insulin resistance in subjects with thalassemia minor and a family history of diabetes. Diabetes Care 2002, 25(8):1480-1.
• [8]Multicentre study on prevalence of endocrine complications in thalassaemia major: Italian Working Group on Endocrine Complications in Non-endocrine Diseases ClinEndocrinol (Oxf) 1995, 42(6):581-6.
• [9]Bahar A, Kashi Z, Sohrab M, Kosaryan M, Janbabai G: Relationship between beta-globin gene carrier state and insulin resistance. J Diabetes Metab Disord 2012, 11(1):22. BioMed Central Full Text
• [10]El-Hazmi MA, Al-Swailem A, Al-Fawaz I, Warsey AS, Al-Swailem A: Diabetes mellitus in children suffering from beta-thalassaemia. J Trop Pediatr 1994, 40(5):261-6.
• [11]Lao TT, Pun TC: Anaemia in pregnancy–is the current definition meaningful? Eur J ObstetGynecolReprod Biol 1996, 68(1–2):53-8.
• [12]Lao TT, Ho LF: alpha-Thalassaemia trait and gestational diabetes mellitus in Hong Kong. Diabetologia 2001, 44(8):966-71.
• [13]ᅟ: Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) JAMA 2001, 285(19):2486-97.
• [14]Lim JS, Yang JH, Chun BY, Kam S, Jacobs DR Jr, Lee DH: Is serum gamma-glutamyltransferase inversely associated with serum antioxidants as a marker of oxidative stress? Free RadicBiol Med 2004, 37(7):1018-23.
• [15]Simcox JA, McClain DA: Iron and diabetes risk. Cell Metab 2013, 17(3):329-41.