Evolution of OGTT in patients with beta-thalassaemia major in relation to chelation therapy.
Evolution of OGTT in patients with beta-thalassaemia major in relation to chelation therapy.
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DOI：
10.1016/j.diabres.2006.07.010
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发表时间：
2007-04
影响因子：
5.1
通讯作者：
A. Christoforidis;V. Perifanis;I. Tsatra;E. Vlachaki;M. Athanassiou-metaxa
中科院分区：
文献类型：
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作者：
A. Christoforidis;V. Perifanis;I. Tsatra;E. Vlachaki;M. Athanassiou-metaxa
在接受常规治疗（包括定期输血和充分螯合治疗）的重型β地中海贫血患者中，经常报告葡萄糖代谢紊乱。本研究的目的是评估地中海贫血患者口服葡萄糖耐量试验（OGTT）的演变与螯合治疗的关系。回顾性研究了间隔2年的两次OGTT的数据。被认为有资格参加本研究的患者是那些在过去2年内维持不变螯合治疗且未接受任何抗糖尿病药物的患者。31例患者（16例男性和15例女性）入组，研究结束时平均年龄为23.73±4.23岁。根据螯合治疗将患者分为三组。第一组给予去铁胺（DFO）皮下滴注，每次8小时，每周5 ~ 6次;第二组给予去铁酮（DFP）螯合剂，每日75 mg/kg，口服;在第一次OGTT时，发现26例患者（84%）OGTT正常;其中3例在第二次试验中显示葡萄糖耐量受损（1例与DFP螯合，2例接受联合治疗）。在第一次试验中，5名糖代谢受损的患者中没有一人成为糖尿病患者。相反，一名接受联合治疗的患者设法使其第二次OGTT正常化。与整个患者系列中葡萄糖耐量恶化的总体趋势相反，接受联合治疗的组设法增加了β细胞功能指数和降低了胰岛素抵抗指数，尽管与其他组相比没有统计学显著性。需要进一步的研究来支持这些初步结果。
Glucose metabolism disturbances are frequently reported among patients with β-thalassaemia major on conventional treatment consisted of regular blood transfusions and adequate chelation treatment. Aim of this study was to evaluate the evolution of oral glucose tolerance test (OGTT) in thalassaemic patients in relation to their chelation treatment. Data from two OGTTs performed with an interval of 2 years were studied retrospectively. Patients considered eligible for this study were those who maintained unchanged chelation treatment and did not receive any anti-diabetic agent during the last 2 years. Thirty-one patients (16 M and 15 F) were enrolled with a mean age of 23.73±4.23 years at the end of the study. Patients were divided into three groups concerning chelation treatment. First group was receiving deferoxamine (DFO) by an 8-hourly subcutaneous infusion five–six times a week, second group was chelated with deferiprone (DFP) at a daily dose of 75mg/kg orally and the third group was receiving combined therapy with DFO (3 days/week) and DFP (daily). At the time of the first OGTT, 26 patients (84%) were found to have normal OGTT; three of them showed an impaired glucose tolerance during second test (one was chelated with DFP and two were receiving combined therapy). None of the five patients with impaired glucose metabolism during the first test became diabetic. On contrary, one patient receiving combined therapy managed to normalize his second OGTT. In contrast with the overall trend of a deteriorating glucose tolerance in the whole patient series, the group receiving combined therapy managed to increased β-cell function index and decreased insulin resistance index, although not statistically significant when compared to other groups. Further studies are needed to support these preliminary results.