Acute Effects of Blood Transfusion on Insulin Sensitivity and Pancreatic ß-Cell Function in Children with ß-Thalassemia/Hemoglobin E Disease.
J Clin Res Pediatr Endocrinol
; 10(1): 1-7, 2018 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-28739553
ABSTRACT
OBJECTIVE:
To assess the acute effects of blood transfusion on insulin sensitivity and pancreatic ß-cell function in thalassemia patients.METHODS:
Fifty children and adolescents with ß-thalassemia/HbE disease were enrolled in a prospective cohort study. Hemoglobin, serum ferritin and oral glucose tolerance test (OGTT) were performed prior to, and one week after blood transfusion. Insulin sensitivity indices [homeostatic model assessment (HOMA) of insulin resistance (HOMA-IR), whole body insulin sensitivity index (WBISI)] and ß-cell function indices [HOMA of ß-cell function (HOMA-ß), insulinogenic index (IGI), and disposition index (DI)] were calculated from glucose and insulin levels obtained during the OGTT.RESULTS:
Following blood transfusion, hemoglobin and serum ferritin increased significantly; 8.5 to 10.1 g/dL (p<0.001) and 1764 to 2160 ng/mL (p<0.001), respectively. ß-Cell function indices also increased significantly [median HOMA-ß 74.3 vs. 82.7 (p=0.033); median IGI 59.6 vs. 79.3 (p=0.003); median DI 658 vs. 794 (p=0.01)]. However, the insulin sensitivity index (WBISI) tended to decrease and the insulin resistance index (HOMA-IR) tended to increase although this did not reach significance. Multivariate analysis showed that pre-transfusion serum ferritin was the major factor negatively associated with WBISI and positively associated with HOMA-IR, but pre-transfusion hemoglobin had no significant association with insulin sensitivity indices post-transfusion.CONCLUSION:
This study demonstrated that acute increases in serum ferritin and hemoglobin following blood transfusion in patients with thalassemia might contribute to an increase in insulin secretion and to a trend towards increased insulin resistance.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemoglobina E
/
Hemoglobinas
/
Resistência à Insulina
/
Talassemia beta
/
Células Secretoras de Insulina
/
Ferritinas
/
Reação Transfusional
/
Insulina
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Res Pediatr Endocrinol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Tailândia