Konya'daki talasemi majörlü hastalarda bozulmuş glukoz toleransı ve diyabet prevalansı
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Dosyalar
Tarih
2007
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Konya'daki Talasemi Majörlü Hastalarda Bozulmuş Glukoz Toleransı ve Diyabet Prevalansı Amaç: Beta-Talasemi majörlü hastalarda yaşam süresi hipertransfüzyon protollerinin uygulanmasından sonra belirgin olarak uzamıştır. Bununla birlikte, bu bozulmuş glukoz toleransı ve diyabet gibi endokrin komplikasyonların artmasına yol açmıştır. Diyabetin pankreatik beta hücrelerinde aşırı demir birikiminin yol açtığı hasara bağlı olduğuna inanılmaktadır. Bununla birlikte, çeşitli ek kolaylaştırı faktörler görünmektedir. Bu çalışmanın amacı Konya, Selçuk Üniversitesi Meram Tıp Fakültesi Pediatrik Hematoloji Bölümü'nde izlenen beta-talasemi majörlü hastalardaki, diyabet ve bozulmuş glukoz tolerans sıklığını değerlendirmek ve beta-talasemi majöre eşlik eden şelasyon tedavisine uyum, diyabet için aile hikayesi ve hastaların demografik özelliklerinin diyabet patogenezindeki olası rolünü araştırmaktı. Materyal ve Metot: Talasemi majör tanısı ile izlenen yaş ortalaması 9.56 ± 5.59 (yıl) olan 51 hasta değerlendirmeye alındı. Hastalara oral glukoz tolerans testi uygulandı. 0., 30., 60., 90. ve 120. dakikalarda alınan kan örneklerinin sonuçları Dünya Sağlık Örgütü tanı kriterlerine göre yorumlandı. Bulgular: Talasemi majörlü hastalar arasında bozulmuş glukoz toleransı sıklığı %10 (51 hastanın 5'i), diyabet sıklığı ise %10 (51 hastanın 5'i) olarak bulundu. Ferritin düzeyi anormal glukoz toleranslı talasemili hastalarda normal glukoz toleranslı hastalara göre daha yüksekti ancak istatistiksel olarak anlamlı değildi. Anormal glukoz toleranslı hastaların hiçbirinde diyabet için aile hikayesi yoktu. Anormal glukoz toleranslı talasemik hastaların birinde HCV-RNA pozitif bulundu. Sonuç: Bu çalışma merkezimizdeki talasemi majörlü hastalarda bozulmuş glukoz toleransı ve diyabet prevalansının literatürdeki daha önce bildirilen sonuçlara benzer 69 olduğunu göstermektedir. Talasemik hastalar anormal glukoz toleransı için yakından takip edilmelidir. Talasemi majörlü hastaların tamamı sadece açlık glukozuyla doğrudan tanı almadığı için talasemik hastalarda anormal glukoz toleransının teşhisi için OGTT yapılmasını öneriyoruz. Yüksek serum ferritin konsantrasyonunun talasemi majörlü hastalarda anormal glukoz toleransı için bir risk faktörüdür. Yoğun demir şelasyon tedavisi ve hepatit C infeksiyonunun önlenmesi ve düzenli taramalarla tespit edilmesi talasemik hastalarda glukoz homeostazının kontrol altına alınmasında önemlidir.
Objective: The life period in patients with beta-thalassemia major has extended considerably after the introduction of hypertransfusion protocols. However, this resulted in an increase of endocrine complications such as glucose intolerance and diabetes. Diabetes is believed to be due to the damage inflicted by iron overload of pancreatic beta cells. However, various causes seem to be additional predisposing factors. The aim of the study was to evaluate the prevalence of diabetes and impaired glucose tolerance in beta-thalassemia major patients who had been observed in the Pediatric Hematology Unit, Department of Pediatrics, Selcuk University, Meram Faculty of Medicine, Konya and to study the possible role of demographic characteristics of patients, family history of diabetes and compliance with iron- chelation therapy in the pathogenesis of diabetes associated with beta-thalassemia major. Material and Methods: 51 patients with thalassemia major were chosen for this evaluation. Mean age was 9.56 ± 5.59 years. Oral glucose tolerance test was applied for the study group. Blood samples were taken at 0, 30, 60, 90, and 120 minutes and the results were interpreted according to the criteria published by World Health Organisation. Results: The prevalence of impaired glucose tolerance was 10% (5 of 51) and that of diabetes was 10% (5 of 51) among patients with thalassemia major. The ferritin level was high in thalassemic patients with abnormal glucose tolerance compared to those with normal glucose tolerance (p=0.098); the level was not statistically significant. None patients with abnormal glucose tolerance had a positive family history of diabetes. HCV-RNA was found positive in one of thalassemic patients with abnormal glucose tolerance. 71 Conclusion: This study shows that the prevalence of diabetes and impaired glucose tolerance in the patients with thalassemia major in our center were similar to results of previous reports in the literature. Thalassemic patients should be followed up closely for abnormal glucose tolerance. Because not all of the patients with thalassemia major could be correctly diagnosed by fasting glucose alone, we suggest that use OGTT for the diagnosed of abnormal glucose tolerance in thalassemic patients. High serum ferritin concentration is a risk factor of abnormal glucose tolerance in patients with thalassemia major. Aggressive iron- chelation therapy, prevention of hepatitis C infection and establishing of that by regular screenings are important in managing glucose homeostasis in thalassemic patients.
Objective: The life period in patients with beta-thalassemia major has extended considerably after the introduction of hypertransfusion protocols. However, this resulted in an increase of endocrine complications such as glucose intolerance and diabetes. Diabetes is believed to be due to the damage inflicted by iron overload of pancreatic beta cells. However, various causes seem to be additional predisposing factors. The aim of the study was to evaluate the prevalence of diabetes and impaired glucose tolerance in beta-thalassemia major patients who had been observed in the Pediatric Hematology Unit, Department of Pediatrics, Selcuk University, Meram Faculty of Medicine, Konya and to study the possible role of demographic characteristics of patients, family history of diabetes and compliance with iron- chelation therapy in the pathogenesis of diabetes associated with beta-thalassemia major. Material and Methods: 51 patients with thalassemia major were chosen for this evaluation. Mean age was 9.56 ± 5.59 years. Oral glucose tolerance test was applied for the study group. Blood samples were taken at 0, 30, 60, 90, and 120 minutes and the results were interpreted according to the criteria published by World Health Organisation. Results: The prevalence of impaired glucose tolerance was 10% (5 of 51) and that of diabetes was 10% (5 of 51) among patients with thalassemia major. The ferritin level was high in thalassemic patients with abnormal glucose tolerance compared to those with normal glucose tolerance (p=0.098); the level was not statistically significant. None patients with abnormal glucose tolerance had a positive family history of diabetes. HCV-RNA was found positive in one of thalassemic patients with abnormal glucose tolerance. 71 Conclusion: This study shows that the prevalence of diabetes and impaired glucose tolerance in the patients with thalassemia major in our center were similar to results of previous reports in the literature. Thalassemic patients should be followed up closely for abnormal glucose tolerance. Because not all of the patients with thalassemia major could be correctly diagnosed by fasting glucose alone, we suggest that use OGTT for the diagnosed of abnormal glucose tolerance in thalassemic patients. High serum ferritin concentration is a risk factor of abnormal glucose tolerance in patients with thalassemia major. Aggressive iron- chelation therapy, prevention of hepatitis C infection and establishing of that by regular screenings are important in managing glucose homeostasis in thalassemic patients.
Açıklama
Anahtar Kelimeler
Glukoz toleransı, Glucose tolerance, Talasemi majör, Beta-thalassemia major, Diyabet prevalansı, Diabetes prevalence
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Sert, A. (2007). Konya'daki talasemi majörlü hastalarda bozulmuş glukoz toleransı ve diyabet prevalansı. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
