Abnormal Glucose Tolerance in Transfusion-Dependent β-Thalassemic Patients
- Jimmy P.S. Chern, MD1,
- Kai-Hsin Lin, MD2,
- Meng-Yao Lu, MD2,
- Dong-Tsam Lin, MD2,
- Kuo-Sin Lin, MD, PHD2,
- Jong-Dar Chen, MD1 and
- Cheng-Chung Fu, MD1
- 1Department of Family Medicine, Tao-Yuan Hospital, Department of Health, Tao-Yuan
- 2Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
Abstract
OBJECTIVE—To study the prevalence of and risk factors for abnormal glucose tolerance in transfusion-dependent β-thalassemic patients.
RESEARCH DESIGN AND METHODS—A total of 89 transfusion-dependent β-thalassemic patients were interviewed. Diabetes was previously diagnosed in 14 of them. In the remaining 75 patients, 68 participated in an oral glucose tolerance test. Potential risk factors were identified using the independent t test, χ2 test, and Fisher’s exact test. Logistic regression analysis was used to select the independent risk factors that best predicted abnormal glucose tolerance. A two-tailed P value of <0.05 was considered to be statistically significant.
RESULTS—The prevalence of impaired glucose tolerance was 8.5% (7 of 82) and that of diabetes was 19.5% (16 of 82). Presentation with diabetic ketoacidosis was 31.1% (5 of 16). The risk factors for abnormal glucose tolerance found in transfusion-dependent β-thalassemic patients were serum ferritin concentration and hepatitis C infection.
CONCLUSIONS—The interaction of iron overload and hepatitis C infection worsened the prognosis of thalassemic patients. Aggressive iron-chelation therapy as well as prevention and treatment of hepatitis C infection should be mandatory in managing glucose homeostasis in transfusion-dependent β-thalassemic patients in Taiwan.
- ADA, American Diabetes Association
- IGT, impaired glucose tolerance
- OGTT, oral glucose tolerance test
- OR, odds ratio
Footnotes
-
Address correspondence and reprint requests to Kai-Hsin Lin, MD, National Taiwan University Hospital, No. 7, Chungshan S. Rd., Taipei, Taiwan, 10016, R.O.C. E-mail: link{at}ha.mc.ntu.edu.tw.
Received for publication 3 July 2000 and accepted in revised form 18 January 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
