ESPE2024 Poster Category 2 Multisystem Endocrine Disorders (13 abstracts)
Impact of Iron Chelation Therapy Adherence on Prediabetes Development in Young Adult β-Thalassemia Major Patients: A Comparative Analysis
Vincenzo De Sanctis 1 , Ashraf Soliman 2 , Shahina Daar 3 , Saveria Campisi 4 & Ploutarchos Tzoulis 4
1Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy. 2Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar. 3Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman. 4Department of Diabetes and Endocrinology, Whittington Hospital, University College London, london, United Kingdom
Introduction: In β-Thalassemia major (β-TDT) the influence of consistent iron chelation therapy on prediabetes development remains uncertain.
Objectives: To identify factors associated with prediabetes among β-TDT patients adhering to iron chelation therapy by comparing those who developed prediabetes versus those with normal glucose tolerance.
Methods: This retrospective study evaluated 30 β-TDT patients with 8 years of good iron chelation adherence, divided into Group A (prediabetes, n = 15) and Group B (normal glucose tolerance, n = 15). We examined serum ferritin levels, family diabetes history, transfusion and splenectomy history, HCV infection, chelation therapy types, and endocrine complications. (table 1)
Results: Analysis showed no significant differences in demographics, BMI, family history, or chelation therapy types between the groups. Similar adherence and endocrine complication rates suggest traditional risk factors may not predict prediabetes in this cohort. (table)
| Variables | Group A: Prediabetes | Group B: Normal OGTT | P value |
| Number of β-TDT patients | 15 | 15 | NS |
| Age (yr) | 32.7 ± 4.6 | 32.7 ± 5.4 | 1 |
| Body Mass Index (Kg/m^2) | 22.0 ± 2.5 | 22.8 ± 2.2 | 0.36 |
| Positive family history of diabetes | 1/15 (6.6%) | 5/15 (33.3%) | 0.072 |
| Mean pre-transfusional Hb level (g/dL) | 8.65 ± 0.30 | 8.73 ± 0.35 | 0.61 |
| Iron chelation therapy at last observation | |||
| - Desferrioxamine (DFO) monotherapy | 10/15 (66.6%) | 10/15 (66.6%) | NS |
| - Deferiprone (DFP) monotherapy | 3/15 (20%) | 5/15 (33.3%) | 0.41 |
| - Deferasirox (DFX) monotherapy | 2/15 (13.3%) | 0/15 (0%) | 0.15 |
| Patients without endocrine complications | 6/15 (40%) | 5/15 (33.3%) | 0.70 |
| SF (ng/mL) at last observation | 507.1 ± 189.5 | 515.2 ± 223.8 | 0.91 |
Conclusion: The study suggests that in β-TDT patients with consistent iron chelation therapy adherence, conventional risk factors like body mass index and family history don't significantly impact prediabetes development. This indicates a need for further exploration into β-TDT’s unique pathophysiology and the effects of long-term treatment to refine diabetes prevention strategies in this high-risk group.
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