Association of serum ferritin trends with liver enzyme patterns in ß-thalassemia major: A longitudinal correlational study.

Background: ß-Thalassemia major patients require lifelong blood transfusions, leading to iron overload and liver injury. This study examines the longitudinal association between serum ferritin and liver function over 5 years in pediatric patients. Methods: This retrospective study included 582 transfusion-dependent thalassemia patients aged 1-18 years. Serum ferritin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin were measured annually. Correlation and linear regression analyses assessed associations between ferritin trajectories and liver enzymes. Results: Mean ferritin rose from 1820 ± 960 ng/mL at baseline to 4500 ± 1900 ng/mL at year 5, indicating worsening iron overload. AST and ALT levels also steadily climbed over follow-up, whereas albumin declined slightly. Ferritin correlated positively with AST (r = 0.675, P < 0.01) and ALT (r = 0.607, P < 0.01), but not with albumin (r = -0.143, P = 0.153) annually. The regression interaction term showed within-patient ferritin increases over time were independently associated with escalating AST and ALT (P < 0.05), after adjusting for confounders. Conclusion: Rising ferritin levels predict progressive liver injury in regularly transfused pediatric thalassemia patients. Tighter control of iron overload may help preserve hepatic function.

Unravelling the obesity maze in diabetic patients: A comparative analysis of classification methods.

Background: Obesity is a significant health concern among individuals with type 2 diabetes mellitus (T2DM). Emerging evidence suggests that alternative measures, such as abdominal girth (AG) and body fat percentage (BF%), can provide a more accurate reflection of obesity-related metabolic risks in diabetic populations. This study aimed to compare the accuracy of different obesity classification methods, including BMI, AG, and BF%, among individuals with T2DM. Methodology: This was an observational cross-sectional study conducted among T2DM patients who came to the non-communicable diseases clinic of GG Govt Hospital, Jamnagar, Gujarat during the period of March-April 2023. Demographic and anthropometric information was collected. Body fat analysis was done using a validated Omron fat analyzer. Results: The study found the sensitivity of BMI in males and females as 41.6% and 45% against BF%, respectively. It also showed that the sensitivity of BMI in males and females was 38% and 40.7%, respectively, against AG. The present study also found a moderate positive correlation (r = 0.575) between AG and BF% in individuals with T2DM. Conclusion: The findings indicate that BF% and AG provide valuable insights into adiposity, surpassing the limitations of BMI as a measure of body composition. BF% is an indicator of body fat content, whereas AG serves as a proxy for central adiposity. The correlations between BF% and AG suggest that excess abdominal fat accumulation signifies increased body fat. By incorporating measures such as BF% and AG alongside BMI, clinicians can obtain a more comprehensive understanding of body composition and its relationship with metabolic abnormalities.

The Hidden Battle Within: Shedding Light on the Co-existence of Sarcopenia and Sarcopenic Obesity among Participants with Type 2 Diabetes in a Tertiary Care Hospital, Gujarat.

Introduction: Type 2 diabetes (T2DM) is characterised by chronic hyperglycaemia due to abnormal insulin secretion and/or utilisation. Currently, sarcopenia has emerged as a new complication of T2DM, which increases the risk of physical disability, and even death. The study aims to estimate the prevalence of sarcopenia and sarcopenic obesity (SO) as well as their association with various other factors related to T2DM. Methods: The study was an observational hospital-based cross-sectional study conducted among diabetic patients who came to the non-communicable diseases (NCD) clinic of a tertiary care hospital in Gujarat, India, from April 2023 to June 2023. Adult patients with T2DM attending follow-ups were included, with a diagnosis of T2DM for at least 1 year from the date of their electronic medical records, regardless of their mode of therapeutic treatment. They were on regular medical reviews with two or more visits to the study site in the past 1 year. Then a self-structured standard questionnaire was used to collect the data, containing socio-demographic characteristics, clinical profiles, anthropometric assessment (comprising weight, height and body mass index [BMI]), bio-impedance indices like body fat%, skeletal muscle% and handgrip by hand dynamometer. Results: In the study, a total of 404 participants participated. Their mean age was 55 ± 13.5 years and their mean body fat (BF) % was 30 ± 7.4%. BF%-defined obesity was found in 260 (64.4%) participants. A total of 362 (89.6%) had possible sarcopenia, 183 (45.3%) had sarcopenia and 124 (30.7%) had SO. Age (OR: 2.6, CI: 1.7-3.9), duration of diabetes for more than 7 years (OR: 7.5, CI: 3.65-15.4) and BF%-defined obesity (OR: 2.2, CI: 3.6-15) were statistically associated with Sarcopenia, in similar pattern age (OR: 2.4, CI: 1.5-3.7), and duration of diabetes more than 7 years (OR: 18.9, CI: 5.7-62) were associated with SO (P < 0.05). Conclusion: Older age, longer diabetes duration and BF%-defined obesity are associated with an increased likelihood of developing sarcopenia and sarcopenic obesity. Healthcare providers should prioritise regular screening for sarcopenia and SO in elderly individuals with diabetes to facilitate early detection and intervention.