Insulin-Like Growth Factor -1 (IGF-1) and Glucose Dysregulation in Young Adult Patients with β-Thalassemia Major: Causality or Potential Link? :  IGF-1 and glucose dysregulation in thalassemia

Vincenzo De Sanctis; Ashraf Soliman; Shahina Daar; Ploutarchos Tzoulis; Mohamed A.  Yassin; Salvatore Di Maio; Christos Kattamis

doi:10.23750/abm.v93i6.13288

Insulin-Like Growth Factor -1 (IGF-1) and Glucose Dysregulation in Young Adult Patients with β-Thalassemia Major: Causality or Potential Link?

IGF-1 and glucose dysregulation in thalassemia

Authors

Vincenzo De Sanctis Quisisana Hospital, Ferrara
Ashraf Soliman Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar and Department of Pediatrics, Division of Endocrinology, Alexandria University Children’s Hospital, Alexandria, Egypt https://orcid.org/0000-0002-7145-6561
Shahina Daar 3 Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman, Oman https://orcid.org/0000-0001-9166-0052
Ploutarchos Tzoulis Department of Metabolism and Experimental Therapeutics, Division of Medicine, University College London, London, UK https://orcid.org/0000-0003-4228-071X
Mohamed A. Yassin Hematology-Oncology Department, National Centre for Cancer Care and Research, Doha, Qatar https://orcid.org/0000-0002-1144-8076
Salvatore Di Maio Emeritus Director in Pediatrics, Children’s Hospital “Santobono-Pausilipon”, Naples, Italy
Christos Kattamis First Department of Pediatrics, National Kapodistrian University of Athens, Greece

Keywords:

β-thalassemia major, Insulin-like growth factor-1, glucose homeostasis, oral glucose tolerance test

Abstract

Background: Insulin-like growth factor-1 (IGF-1) has been shown to lower blood glucose through stimulating glucose transport to fat and muscle and inhibiting hepatic glucose output. Although previous cross-sectional reports reported an association between low circulating concentrations of IGF-1 and glucose dysregulation (GD), its role is still debated. Aims of study: The present retrospective study was designed to assess the circulating IGF-1 levels in β-thalassemia major (β -TM) patients with normal oral glucose tolerance test (NGT-OGTT) and (GD) referred for an endocrine evaluation to explore the potential link between low IGF-1 and GD. Study design and methods: Our study included 34 young adult patients with β-TM; 12 patients with NGT after OGTT, 7 with impaired glucose tolerance (IGT), 9 with impaired fasting glucose (IFG) plus IGT, and 6 patients with β-TM-related diabetes mellitus (β-TM- DM). Results: Twenty-two β-TM patients with GD or β-TM- DM and 1 patient with NGT had IGF-1 levels below the 2.5^thpercentile. Correlation of IGF-1 with fasting plasma glucose, HOMA-IR (homeostatic model assessment for insulin resistance) and OGIS (oral glucose insulin sensitivity) was found. Moreover, a negative correlation was documented between ALT and the Insulinogenic Index (IGI) and a positive correlation between serum ferritin and PG 2-h after OGTT. Conclusion: This study reports for the first time an association between low levels of IGF-1 and GD in β-TM patients. Despite some limitations, our study can serve to generate proposals for more convenient and efficient methods to identify and treat early GD in patients with β-TM, and to conduct more extensive studies. www.actabiomedica.it)

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