ESPE Abstracts

Background: Abnormalities in glucose homeostasis are fairly common complications in thalassemia major (TM) patients. Previous studies had shown associations between some endocrinopathies and iron overload of the myocardium, liver as assessed by MRI techniques. This study aimed at determining the relationship among cardiac T2*, liver T2* and abnormal glucose in TM patients.

Objective and hypotheses: A total of 34 (27 male) transfusion-dependent TM patients were included.

Method: The fast blood glucose (FBG) and insulin level, serum ferritin (SF), cardiac T2*, liver T2* were evaluated in all subjects. Insulin resistance index (IRI) and β cell function index were also estimated.

Results: The mean age was 11.17±4.27 years. The mean SF level was 3795.93±2764.81 ng/ml. The mean cardiac T2* was 21.51±12.46 ms. There were 41.17% of patients with cardiac T2* <20 ms. The median liver T2* was 1.62 (0.53–18.52) ms. Only 2.94% of patients with liver T2* > 6.3 ms. 14.7% of patients had insulin resistance (IR); 23.53% had impaired fast glucose; 5.9% had got diabetes mellitus. The incidence of abnormal glucose patients were lower with cardiac T2* >20 ms than those whose cardiac T2* were less than 20 ms (P=0.006). There were no statistical differences between liver T2* and the incidence of abnormal glucose. The liver T2* was well correlated with FBG, insulin and IRI. The result of logistic regression analysis indicated that the cardiac T2* was a significant predictor for the incidence of abnormal glucose in TM patients (P=0.035; odds ratio=1.182%; 95% CI=1.048–1.332).

Conclusion: The iron overload was much severer in TM patients of our centre, especially the liver iron overload. Liver T2* may have a relationship with insulin resistance and cardiac T2* was the independent risk factor of the incidence of abnormal glucose in patients with TM.