Objective: The functional status and influencing factors of pancreatic beta cells in patients with β-thalassemia major (β-TM) were investigated.
Methods: A cross-sectional study was conducted in 88 patients with β-TM, with an average age of 11.3±5.6 years. Thirty-two healthy subjects were selected as the control group. FBG, FINS, HOMA-IRI, HMOA-ISIand HOMA-β FI were calculated between the two groups. HBA1c, fructosamine and glycosylated albumin were detected in patients with β-TM, and oral glucose tolerance test, insulin release test, SF, cardiac and liver magnetic resonance T2* were detected.
Results: 1. FBG, FINS and HOMA-IRI increased significantly in the β-TM patients, whereas the HOMA-ISI and HOMA- FI decreased, but the differences of HOMA- FI were not statistically significant.
2. Among the 88 patients with β-TM, 13 (14.77%) patients had been diagnosed with diabetes, 27 (30.68%) patients had abnormal glucose metabolism, including 26 (29.55%) with impaired fasting glucose and 7 (7.95%) with impaired glucose tolerance. The youngest age of diabetes and impaired fasting glucose was 6 years old.
3. Patients with β-TM were divided into diabetes group, abnormal glucose metabolism group and normal glucose group, and the fructosamine (49 cases), glycosylated hemoglobin (54 cases) and glycosylated albumin (37 cases) were conducted. All the three indicators were increased with the aggravation of abnormal glucose metabolism.
4. Patients with β-TM were divided into the abnormal blood glucose group and the normal blood glucose group. The FBG and 2h BG blood glucose of the abnormal blood glucose group was significantly higher than the normal group. The insulin secretion was increased, and the difference was statistically significant at 1h.The abnormal blood glucose in the non-secretion peak group accounted for 57.15%, and the abnormal blood glucose in the 2h secretion peak delay group accounted for 63.64%. In the abnormal blood glucose group, HOMA-IRI increased, HOMA-ISI and HOMA-β FI decreased with statistical difference.
5. SF and cardiac T2* had statistically significant differences
Conclusion: 1.The morbidity of diabetes was 14.77%, the morbidity of abnormal glucose metabolism was 30.68% in β-TM patients..
2. HbA1c can be used as an indicator to evaluate the average blood glucose level
3.Patients with β-TM showed impaired glucose tolerance, abnormal insulin secretion, impaired insulin secretion ..
4. When patients with cardiac iron deposition or SF > 4000ng/ml are more prone to abnormal glucose metabolism, and glucose metabolism indicators should be actively and closely monitored and iron removal therapy should be strengthened
19 - 21 Sep 2019
European Society for Paediatric Endocrinology