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Prevalence of diabetes mellitus in Chinese children with thalassaemia major
Author(s) -
Liang Yuzhen,
Bajoria Rekha,
Jiang Yan,
Su Hongwei,
Pan Hongfei,
Xia Ning,
Chatterjee Ratna,
Lai Yongrong
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12876
Subject(s) - medicine , diabetes mellitus , insulin resistance , impaired fasting glucose , gastroenterology , incidence (geometry) , quantitative insulin sensitivity check index , ferritin , insulin , endocrinology , impaired glucose tolerance , insulin sensitivity , physics , optics
Objective Diabetes mellitus is a common endocrinopathy in patients with β ‐thalassaemia major ( β ‐ TM ), which is high prevalent in southern China. This study aimed to determine the cause and prevalence of glycaemic disorders in Chinese children with β ‐ TM . Methods In this prospective study, fasting glucose and insulin ( FINS ) levels were assessed in 267 β ‐ TM and 80 non‐ TM control children. Homeostatic model assessment ( HOMA ) and the quantitative insulin sensitivity check index ( QUICKI ) were evaluated. Iron overload was assessed by serum ferritin ( SF ), total units of blood transfused and cardiac T2*. Results β ‐TM had higher FPG ( P < 0.001), FINS ( P < 0.001) and HOMA ‐ IR ( P < 0.05), but lower QUICKI ( P < 0.01) than those of controls. The impaired fasting glucose ( IFG ) was present in 30% of children, whereas 2% had diabetes. The prevalence of IFG in β ‐ TM group was higher in children aged >10 years (OR 6.5; 95% CI 3.7–11.4; P < 0.001), SF of >2500 μg/l ( OR 4.8; 95% CI 2.1–11.1; P < 0.01), serum ALT levels of >50 IU/l ( OR 2.1; 95% CI 1.2–3.7; P < 0.05) and cardiac T2* of <20 ms ( OR 3.3; 95% CI 1.7–6.6; P < 0. 01). The children on deferiprone ( DFP ) had a reduced incidence of glycaemic aberrations than those on other chelating agents ( OR 0.4; 95% CI 0.23–0.8; P < 0.05). Conclusions Our data suggest that IFG occurred in 30% of β TM children, perhaps due to insulin resistance secondary to iron overload. Deferiprone‐containing chelating agent may have a protective effect.