Dysregulation of Glucose Homeostasis in Transfusion-Dependent Thalassaemia Patients With Iron Overload as Risk Factor of Endocrinopathies; A Comparative Study

Abstract

Objective: To provide insights into potential endocrine complications associated with elevated SF levels in patients with BTM.

Methodology: This cross-sectional study, conducted at the Thalassaemia Centre of Pakistan Institute of Medical Sciences (PIMS), Islamabad, investigated the association between plasma glucose and serum ferritin (SF) levels in BTM patients. Demographic variables, number of annual blood transfusions, and age at transfusion-dependent thalassaemia (TDT) diagnosis were recorded. Ferritin levels were categorized using a cutoff of 2,500 ng/mL, and glucometabolic status was assessed via an oral glucose tolerance test (OGTT). Statistical analysis was performed using IBM SPSS Statistics, Version 27.

Results: The study included 118 participants divided into two groups based on serum ferritin (SF) levels (>2500 ng/mL and <2500 ng/mL). Patients with SF levels >2500 ng/mL showed a higher percentage of impaired glucose tolerance (75.0%) compared to those with SF levels <2500 ng/mL (54.8%), with a small percentage having diabetes mellitus (7.1%). Linear regression revealed a significant predictive relationship between SF levels and blood glucose levels (F (1,116) = 21.4, p < 0.05, R² = .156). Additionally, a chi-square test showed significant results for SF levels and 2-hour OGTT (x² (2, N=118) = 13.097, p = 0.001).

Conclusion: Our study confirms the link between high serum ferritin levels and elevated risk of impaired glucose tolerance and diabetes mellitus. Specifically, serum ferritin levels above 2500 ng/mL indicate a heightened risk of endocrinopathies, particularly impaired glucose tolerance. These findings stress the importance of regular serum ferritin monitoring in thalassaemia patients undergoing blood transfusions to detect and manage glucose metabolism disorders promptly.