Serum Ferritin Levels and Other Associated Parameters with Diabetes Mellitus in Adult Patients Suffering from Beta Thalassemia Major

Abstract

Background

Although beta thalassemia major (BTM) patients are properly treated with blood transfusions in accompany with iron chelation therapy, they suffer from complications, such as diabetes mellitus (DM).

Purpose

The purpose was to detect the critical serum ferritin level and other parameters correlated with DM among adult BTM patients. Also, it was to study whether each of these parameters is associated with a certain period of age.

Patients and Methods

This study included 200 adult BTM patients. A cross-sectional study was carried out. Patients clinical and laboratory variables, such as ferritin levels, and fasting blood glucose (FBS) were extracted from medical records at Zagazig University Hospital, Egypt. Liver and cardiac iron contents were assessed using MRI T2* methods. Statistical analysis was performed using IBM SPSS V26.0 software package.

Results

The overall frequency of DM over the total sample equals 6.5%. There were no impaired fasting glucose (IFG) in the medical records. Statistical significance between serum ferritin and DM was (P = 0.014). The serum ferritin 2500 ng/mL with age group (27–<32) years-old were risk factors. The distributions of DM according to BMI were (3.5%) of class overweight. Significant association between DM and BMI was (r = 0.357, P < 0.001). Liver MRI T2* has significant correlation with serum ferritin, but cardiac MRI T2* was poorly correlated. Association between liver and cardiac MRI T2* was not found.

Conclusion

Age group (27–<32) years-old and ferritin >2500 ng/mL should be properly treated immediately. The serum ferritin and BMI of class “overweight” were risk factors for DM. Factors such as diet should be followed. Serum ferritin can be used for estimating liver iron content for economic factors. But cardiac MRI T2* must be performed for evaluating cardiac iron accurately.

Keywords:

• hemoglobin
• iron chelation
• blood glucose
• endocrinopathy

Abbreviations

S.Phosph, serum phosphorous; Hb, hemoglobin; ALT, aminotransferase alanine; AST, aminotransferase aspartate; Cr, creatinine; n, number; Std, standard; BTM, beta thalassemia major; BMI, body mass index; Sig, significance; Ferr, ferritin; MRI, magnetic resonance image.

Data Sharing Statement

No data sharing os this manuscript and the data were not published elsewhere.

Ethical Approval

This work complies with the Declaration of Helsinki. The study protocol was approved by the Institutional Review Board (IRB) Faculty of Medicine, Zagazig University, Egypt (Approval IRB #: 5895- 8-3-2020). The data are accessed confidentially by the authors. The information was not specific to certain patients and the work was cross-sectional study. The patient informed consent was waived for this research.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. 

Disclosure

The authors report no conflicts of interest in this work.