History of myocardial iron loading is a strong risk factor for diabetes mellitus and hypogonadism in adults with β thalassemia major

2014 ◽  
Vol 92 (3) ◽  
pp. 229-236 ◽  
Author(s):  
Ai Leen Ang ◽  
Ploutarchos Tzoulis ◽  
Emma Prescott ◽  
Bernard A. Davis ◽  
Maria Barnard ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Thalassemia Major ◽  
Iron Loading ◽  
Myocardial Iron ◽  
Strong Risk Factor ◽  
History Of

scholarly journals The prevalence of insulin resistance in patients with β -thalassemia major at Cipto Mangunkusumo Hospital

2016 ◽  
Vol 43 (4) ◽  
pp. 117
Author(s):  
Caroline Mulawi ◽  
Bambang Tridjaja ◽  
Maria Abdulsalam ◽  
Zakiudin Munasir
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Family History ◽  
Glucose Metabolism ◽  
Thalassemia Major ◽  
Oral Glucose ◽  
Model Assessment ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
History Of

Background Diabetes mellitus is a common complication in pa-tients with thalassemia major. Iron overload plays an important roleby damaging the pancreatic β-cell and the liver cell, with the con-sequences of insulin deficiency and insulin resistance. Family his-tory of diabetes mellitus is one of the critical factors for the devel-opment of glucose metabolism derangement. However, the patho-genesis of glucose metabolism derangement remains unclear.Objective To evaluate the prevalence of impaired glucose toler-ance, diabetes mellitus, and insulin resistance in patients with β-thalassemia major treated in the Thalassemia Outpatient Clinic,Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a descriptive cross sectional study conductedin May 2002. Forty-eight subjects aged 10 to 18 years, grouped bytotal volume of transfusions and family history of diabetes mellitus,underwent an oral glucose tolerance test (OGTT), serum transfer-rin saturation, and insulin level examinations. Insulin resistancewas calculated from fasting plasma glucose and insulin concen-trations using the homeostasis model assessment (HOMA).Results One of 48 patients (2%) had impaired glucose toleranceat the age of 17 years. Diabetes mellitus occurred in three of 48patients (6%) at the age of 15.5 years in one patient and 18 yearsin two patients. Family history of diabetes mellitus was found in 2patients with diabetes mellitus and in the only one with impairedglucose tolerance. Insulin resistance was not detected in this study.Conclusion The prevalence of glucose metabolism derangementin patients with thalassemia major was low. No insulin resistancewas found in this study

Native T1 Values and Cardiac Involvement in Patients with Thalassemia Major

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 24-25
Author(s):  
Alessia Pepe ◽  
Nicola Martini ◽  
Antonio De Luca ◽  
Vincenzo Positano ◽  
Laura Pistoia ◽  
...  
Keyword(s):  
Iron Overload ◽  
T1 Mapping ◽  
Thalassemia Major ◽  
Clinical Impact ◽  
Cardiac Complications ◽  
Myocardial Iron ◽  
Native T1 ◽  
Molli Sequence ◽  
History Of ◽  
Myocardial T1

Background.The T2* cardiovascular magnetic resonance (CMR) is the gold standard for the non invasive detection of myocardial iron overload (MIO). The native myocardial T1 mapping has been proposed as a complementary tool, thanks to its higher sensitivity in presence of small amounts of iron, but no data are available in literature about its clinical impact. Objective:To explore the clinical impact of T1 mapping for detecting cardiac complications in thalassemia major (TM). Methods.We considered 146 TM patients (87 females, 38.7±11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. Three parallel short-axis slices of the left ventricle (LV) were acquired with the Modified Look-Locker Inversion recovery (MOLLI) sequence. The native T1 values in all 16 myocardial segments were obtained and the global value was the mean. Results.Twenty-one patients had an history of cardiac complications: 11 heart failure, 8 arrhythmias (7 supraventricular and 1 ventricular), and 2 pulmonary hyperthension. Patients with cardiac complications had significantly lower global heart T1 values (879.3±121.9 ms vs 963.2±98.5 ms; P<0.0001) (Figure) but comparable T2* values (33.32±11.66 ms vs 37.17±9.15 ms; P=0.116). Cardiac complications were more frequent in the group of patients with reduced global heart T1 value (<928 ms for males and <989 ms for females) compared to the group with normal global heart T1 value (71.4% vs 39.5%; P=0.009). Odds ratio (OR) for cardiac complications was 3.8 (95%CI=1.3-10.9) for patients with reduced global heart T1 value versus patients with normal global heart T1 value. Conclusion:We found out a significant association between decreased native global heart T1 values and a history of cardiac complications, suggesting that an early detection of myocardial iron burden by native T1 can support the clinicians in modifing chelation therapy earlier. Figure Disclosures Pepe: ApoPharma Inc.:Other: no profit support;Bayer:Other: no profit support;Chiesi Farmaceutici S.p.A.:Other: no profit support and speakers' honoraria.Pistoia:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.Meloni:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.

Benign Cardiac Effects of Hemoglobin H Disease

2016 ◽  
Vol 135 (4) ◽  
pp. 200-207
Author(s):  
Claire Sheeran ◽  
Donald K. Bowden ◽  
Sant-Rayn Pasricha ◽  
Ken Cheng ◽  
Giovanni Romanelli ◽  
...  
Keyword(s):  
Ferritin Level ◽  
Left Ventricular ◽  
Iron Loading ◽  
Myocardial Iron ◽  
Normal Range ◽  
Liver Iron ◽  
Imaging Results ◽  
History Of ◽  
Hbh Disease ◽  
Left Atrial Dilatation

Background/Aims: Hemoglobin H (HbH) disease is associated with iron overload, but whether this results in serious cardiac or vascular sequelae is unresolved. Methods: We identified 39 adult subjects (age 42 ± 12 years, 13 men) with HbH disease who had undergone echocardiography, 27 of whom had also undergone cardiac and liver magnetic resonance assessment of iron loading using T2*-weighted imaging. Results: None of the subjects had a history of heart failure or arrhythmias. There were 13/39 subjects with a ferritin level within the sex-based normal range and only 4/39 had ferritin >1,000 ng/ml. Left ventricular (LV) and left atrial dilatation was common, but LV ejection fraction was normal (≥55%) in all subjects. Age was positively correlated with log ferritin in the 27 nontransfused subjects (r = 0.43) and was inversely correlated with the transmitral E wave and E/A ratio (r = -0.69 and r = -0.79, respectively), but no relation of log ferritin with E or E/A was evident. The peak tricuspid regurgitation velocity was normal in 24/29 subjects for whom this was obtained, and it was no more than mildly elevated in the other 5. None of the tested subjects had an abnormal cardiac T2* reading, but half had evidence of liver iron loading. Conclusion: No myocardial iron loading or serious cardiac or vascular sequelae were identified in this cohort with HbH disease.

scholarly journals A Randomized, Placebo-Controlled, Double-Blind Trial of the Effect of Combined Therapy With Deferoxamine and Deferiprone on Myocardial Iron in Thalassemia Major Using Cardiovascular Magnetic Resonance

Circulation ◽  
2007 ◽  
Vol 115 (14) ◽  
pp. 1876-1884 ◽  
Author(s):  
M.A. Tanner ◽  
R. Galanello ◽  
C. Dessi ◽  
G.C. Smith ◽  
M.A. Westwood ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Endothelial Function ◽  
Thalassemia Major ◽  
Iron Chelator ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Iron Loading ◽  
Myocardial Iron

Background— Cardiac complications secondary to iron overload are the leading cause of death in β-thalassemia major. Approximately two thirds of patients maintained on the parenteral iron chelator deferoxamine have myocardial iron loading. The oral iron chelator deferiprone has been demonstrated to remove myocardial iron, and it has been proposed that in combination with deferoxamine it may have additional effect. Methods and Results— Myocardial iron loading was assessed with the use of myocardial T2* cardiovascular magnetic resonance in 167 patients with thalassemia major receiving standard maintenance chelation monotherapy with subcutaneous deferoxamine. Of these patients, 65 with mild to moderate myocardial iron loading (T2* 8 to 20 ms) entered the trial with continuation of subcutaneous deferoxamine and were randomized to receive additional oral placebo (deferoxamine group) or oral deferiprone 75 mg/kg per day (combined group). The primary end point was the change in myocardial T2* over 12 months. Secondary end points of endothelial function (flow-mediated dilatation of the brachial artery) and cardiac function were also measured with cardiovascular magnetic resonance. There were significant improvements in the combined treatment group compared with the deferoxamine group in myocardial T2* (ratio of change in geometric means 1.50 versus 1.24; P =0.02), absolute left ventricular ejection fraction (2.6% versus 0.6%; P =0.05), and absolute endothelial function (8.8% versus 3.3%; P =0.02). There was also a significantly greater improvement in serum ferritin in the combined group (−976 versus −233 μg/L; P <0.001). Conclusions— In comparison to the standard chelation monotherapy of deferoxamine, combination treatment with additional deferiprone reduced myocardial iron and improved the ejection fraction and endothelial function in thalassemia major patients with mild to moderate cardiac iron loading.

scholarly journals Misanian Men, are or aren't a Prostatic Adenocarcinoma?

2021 ◽  
Vol 14 ◽  
pp. 1-4
Author(s):  
Haider Qasim Alhelfi
Keyword(s):  
Prostate Cancer ◽  
Diabetes Mellitus ◽  
Risk Factor ◽  
Family History ◽  
Prostatic Carcinoma ◽  
Screening Program ◽  
High Grade ◽  
History Of ◽  
Male Patients ◽  
Oncology Center

It is an observational study in Al-Shafaa Oncology Center in Misan province about male patients with prostatic carcinoma to make an idea about the prevalence of this malignancy. This study was carried out during the period from July 2018 to March 2019 in Al-Shafaa Oncology Center in Al-Sadder teaching hospital in Misan province in which 53 male patients were involved. In our study we found that that the disease reaching a peak among patients between (70-80) years, (66.03%) of patients are a smoker (13.2%), had a family history of different type of cancer, (100%) of the patients had adenocarcinoma, (56.6%) that had high-grade cancer (Gleason score ˃8), (77.35%) of the patient had PSA level >100 ng/ml. The prostate cancer in Misan appears to be more likely to occur in the presence of particular risk factor like age, hypertension, family history, and less likely in the presence of diabetes mellitus. It is more likely to be presented with high grade and metastatic disease, and this may be primarily explained by the absence of the screening program.

scholarly journals Prevalence of Gestational Diabetes Mellitus and Maternal and Fetal Outcomes at the Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria

2020 ◽  
pp. 1-16
Author(s):  
D. H. John ◽  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Exposed Group ◽  
Fetal Outcomes ◽  
Previous Pregnancy ◽  
Increased Risk ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is a common cause of hyperglycaemia in pregnancy accounting for about 90% of all diabetic pregnancies. Women with GDM are at increased risk of maternal and fetal morbidity and mortality which are preventable through early diagnosis and treatment. Objective: The aim was to determine the prevalence of GDM, compare the maternal and neonatal complications among GDM and non-GDM pregnant women, and the risk factors associated with GDM. Methodology: A prospective cohort study was carried out among 105 pregnant women attending the antenatal clinic of RSUTH between February and August 2017. They were interviewed using a pre-structured questionnaire that covered variables related to socio-demographic factors and family, medical, and social history. Fasting blood sugar (FBS) was done after an overnight fast. Women who had FBS less than 7 mmol/L had 75 g Oral Glucose Tolerant Test (OGTT) done. Those diagnosed with gestational diabetes mellitus were the exposed group while those negative for GDM were the non-exposed group. Both groups were followed up to delivery, and maternal and fetal outcomes were noted. Statistical analysis was carried out using SPSS version 20 and significance set at p < 0.05. Results: The prevalence of GDM was 10.5%. Positive history of GDM in previous pregnancy was the only independent risk factor (p=0.04, Adj OR: 26.89, 95% CI 2.86 to 252.61). GDM mothers had a significantly higher risk of developing pre-eclampsia (RR=7.48; 95% CI =3.36 to 16.63). Neonates of GDM mothers were at increased risk of fetal macrosomia (RR =9.00; 95% CI=1.36 to 59.4) and neonatal admissions (RR=8.00; C.I =1.19 to 53.67). Conclusion: The study revealed that the prevalence of GDM was high and that those with GDM were at increased risk of developing fetal and maternal complications. A history of GDM in previous pregnancy was an essential risk factor for subsequent GDM.

scholarly journals Polymorphism E23K KCNJ11 Gen as a Risk Factor of Diabetes Mellitus in Serawai Tribe Of Bengkulu

2020 ◽  
Vol 4 (1) ◽  
pp. 11-18
Author(s):  
Raden Sunita ◽  
Sahidan Sahidan ◽  
Rachmat Hidayat ◽  
Resva Meinisasti
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Case Group ◽  
Kcnj11 Gene ◽  
Pcr Rflp ◽  
History Of ◽  
Genetic And Environmental Factors ◽  
E23k Polymorphism

ABSTRACT   Background: Type 2 diabetes mellitus (T2DM) is a multifactorial disease involving genetic and environmental factors. The E23K KCNJ11 gene polymorphism causes KATP canal overactivity, decreases cell membrane depolarization potential, and decreases insulin secretion. E23K polymorphism of the KCNJ11 gene as a risk factor for T2DM. Research Objective: This study aimed to analyze the E23K polymorphism of the KCNJ11 gene as a risk factor for T2DM in the Bengkulu Serawai. Method: This study is a case-control study. The subjects of the study were 100 people with T2DM patients as a case group (50 people) and Non-DM subjects with families who did not have a history of T2DM as a control group (50 people). Fasting blood glucose (GDP) was analyzed by spectrophotometry and E23K KCNJ11 gene by polymerase chain reaction fragment length polymorphism (PCR-RFLP). Data were analyzed by statistics. Results: The frequency of AA genotypes in cases was higher than the controls (12% and 8%) (p = 0.001). The frequency of A allele in the case was higher than the control (32% and 18%) (p = 0.017). The risk of T2DM on AA / GA genotypes was 4.75 times higher in cases than controls (p = 0,000, OR 4.75 95% CI 2.01-11.24). The risk of T2DM in A allele was 2.14 times higher in cases than in controls (p = 0.017, OR 2.14, 95% CI 1.11-4.15). Conclusion: E23K polymorphism of the KCNJ11 gene as a risk factor for T2DM in Bengkulu Serawai Tribe.   Keywords: E23K gene KCNJ11, DMT2, Non-DMT2.  

scholarly journals Screening of Hemoglobin A1c in Gestational Diabetes among women attending metabolic clinic at a tertiary care hospital in Uttar Pradesh

2019 ◽  
Vol 10 (2) ◽  
pp. 26-30
Author(s):  
Vivek Sinha ◽  
Poonam Kachhawa
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
P Value ◽  
Close Monitoring ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancies..Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims and Objectives: The purpose of this study was to evaluate the diagnostic screening value of the HbA1c, prevalence of GDM and associated risk factors. Materials and Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.

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