Konya’daki talasemi majörlü hastalarda bozulmuş glukoz toleransı ve diyabet prevalansı
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Tarih
2009
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info:eu-repo/semantics/openAccess
Özet
Amaç: 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. Yöntem: 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 olduğunu göstermektedir. 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.
Objective: 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. 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 Organization. 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; 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. 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. 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.
Objective: 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. 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 Organization. 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; 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. 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. 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.
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Genel ve Dahili Tıp
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19
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1