演題詳細

一般口演 / Oral Session

一般口演 1 (Oral Session 1) :鉄代謝 (Iron Metabolism)

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日程
2013年10月11日(金)
時間
09:30 - 10:30
会場
第3会場 / Room No.3 (さっぽろ芸文館 3F 蓬莱)
座長・司会
川端 浩 (Hiroshi Kawabata):1
1:京都大学 血液・腫瘍内科学
 
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Elevated serum ferritin levels >3,000 µg/L are highly associated with endocrinopathies in Thalassemia patients

演題番号 : OS-1-1

Sasinee Hantrakool:1、Adisak Tantiworawit:1、Ekarat Rattarittamrong:1、Chatree Chai-adisaksopha:1、Mattabhorn Phornphutkul:2、Somdet Srichairattanakool:3、Weerasak Nawarawong:1、Lalita Norasetthada:1

1:Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand、2:Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand、3:Department of Biology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

 

Background: Endocrinopathies are major complications in thalassemic patients. Serum ferritin levels reflect severity of iron overload and are associated with adverse clinical outcomes. We evaluate the prevalence and the risk factors of endocrinopathies (diabetes, hypothyroidism and hypogonadism) in these patients.Method: All thalassemic patients, age>18 years old were enrolled between August 2011 - December 2012. Medical records were reviewed. Fasting blood sugar, thyroid and gonadal functions were evaluated. Serum ferritin, non–transferrin binding iron (NTBI) and labile plasma iron (LPI) were measured at the same time. Result: Among 118 patients (60%females), median age 28 (18-71). There were 49.2% β-thalassemia/hemoglobin E, 28.8% homozygous β-thalassemia, 20.3% hemoglobin H disease. Most patients (58.5%) underwent splenectomy while only one third (37.3%) were non-transfusion dependent thalassemia (NTDT). The mean values and maximum ferritin levels were 2,379 μg/L(279-9,817) and 4,914 μg/L(279-37,656), respectively.The prevalence of diabetes mellitus, hypothyroidism and hypogonadism were 11.9%, 30.5% and 34.8%, respectively. Mean NTBI and LPI were 7.2 μM (0.05-30.3) and 4.3 μM (0.01-15.8). NTBI were correlated well with LPI. The maximum ferritin >3,000 μg/L was independently associated with diabetes [OR 9.94 (95%CI 1.34-79.27), p=0.004], hypothyroidism [OR 3.73 (95%CI 1.51-9.20), p=0.003] and hypogonadism [OR 3.54 (95%CI 1.63-7.69), p=0.001].Conclusion: High prevalence of endocrinopathies was found among thalassemic patients. The maximum ferritin level of >3,000 μg/L was a major risk factor of the development of diabetes, hypothyroidism and hypogonadism. These findings warrant the value of iron chelating therapy to prevent the development of endocrinopathies in patients with thalassemia.

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