FASTING PLASMA GLUCOSE LEVELS WITHIN THE HIGH NORMAL RANGE ARE ASSOCIATED WITH A SIGNIFICANTLY INCREASED RISK OF FUTURE DYSGLYCEMIA IN TRANSFUSION-DEPENDENT Β THALASSEMIA: A DECADE-LONG MULTICENTER RETROSPECTIVE ANALYSIS Article Swipe
Vincenzo De Sanctis
,
Forough Saki
,
Mehran Karimi
,
Mohammad Faranoush
,
Ihab El-Hakim
,
Ashraf Soliman
,
Shahina Daar
,
Ploutarchos Tzoulis
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.4084/mjhid.2025.072
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.4084/mjhid.2025.072
Objective: To evaluate the risk of developing glucose dysregulation and diabetes mellitus over a 10-year period among transfusion-dependent β-thalassemia (β-TDT) patients with varying levels of fasting plasma glucose (FPG) within the normoglycemic range. Setting: The study included β-TDT patients followed from January 2014 to January 2025 in three thalassemia canters; Tehran and Shiraz in Iran, and Ferrara in Italy. Participants: A total of 238 β-TDT patients (age range: 10–41.9 years; 96 males and 142 females) were included. Results: At baseline, the mean fasting plasma glucose (FPG) level was 88.0 ± 8.3 mg/dL (median: 90 mg/dL), and the mean serum ferritin (SF) level was 2,080 ± 2,072 µg/L (median: 1,368 µg/L). The mean alanine aminotransferase (ALT) level, available in 201/238 patients, was 29.0 ± 25.8 IU/L. β-TDT patients were categorized into three subgroups according to the conversion of FPG during the 10 year follow up [Group A: 93/238 β-TDT patients with persistent normal FPG according to ADA criteria; Group B: 67/238 patients developed persistent impaired fasting glucose (IFG), and Group C: 78/238 patients developed thalassemia-related diabetes mellitus (Th-RDM)]. Notably, 64.1% and 76.9 of patients with FPG at baseline ≥ 90 mg/dl and < 100 mg/dL developed impaired fasting glucose (Group B) and Th-RDM (Group C), respectively. To determine the optimal cutoff for the risk of progressing to impaired fasting glucose (IFG) and Th-RDM at 10-year follow-up, ROC curve analyses and respective areas under the curve were analyzed. The FPG cutoff value for optimal specificity and sensitivity was established at 87.5 mg/dL. Contributing factors associated with the progression to prediabetes and Th-RDM included: older age, gender (females), positive family history of type 1 or type 2 diabetes, lower pre-transfusion hemoglobin levels, severity of iron overload, and elevated liver enzyme levels. Conclusions: Higher FPG levels within the normoglycemic range in β-TDT patients are associated with a greater risk for future glucose dysregulation and diabetes. Close monitoring and timely intervention in these high-risk individuals should be considered in order to reduce the burden of hyperglycemia in this population.
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Metadata
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- en
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- https://doi.org/10.4084/mjhid.2025.072
- OA Status
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All OpenAlex metadata
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https://openalex.org/W4415754671Canonical identifier for this work in OpenAlex
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https://doi.org/10.4084/mjhid.2025.072Digital Object Identifier
- Title
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FASTING PLASMA GLUCOSE LEVELS WITHIN THE HIGH NORMAL RANGE ARE ASSOCIATED WITH A SIGNIFICANTLY INCREASED RISK OF FUTURE DYSGLYCEMIA IN TRANSFUSION-DEPENDENT Β THALASSEMIA: A DECADE-LONG MULTICENTER RETROSPECTIVE ANALYSISWork title
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articleOpenAlex work type
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enPrimary language
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2025Year of publication
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2025-10-31Full publication date if available
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Vincenzo De Sanctis, Forough Saki, Mehran Karimi, Mohammad Faranoush, Ihab El-Hakim, Ashraf Soliman, Shahina Daar, Ploutarchos TzoulisList of authors in order
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https://doi.org/10.4084/mjhid.2025.072Publisher landing page
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://doi.org/10.4084/mjhid.2025.072Direct OA link when available
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0Total citation count in OpenAlex
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| abstract_inverted_index.was | 88, 103, 121, 246 |
| abstract_inverted_index.≥ | 188 |
| abstract_inverted_index.< | 192 |
| abstract_inverted_index.(SF) | 101 |
| abstract_inverted_index.(age | 67 |
| abstract_inverted_index.2014 | 43 |
| abstract_inverted_index.2025 | 46 |
| abstract_inverted_index.25.8 | 124 |
| abstract_inverted_index.29.0 | 122 |
| abstract_inverted_index.76.9 | 181 |
| abstract_inverted_index.87.5 | 249 |
| abstract_inverted_index.88.0 | 89 |
| abstract_inverted_index.age, | 263 |
| abstract_inverted_index.from | 41 |
| abstract_inverted_index.into | 130 |
| abstract_inverted_index.iron | 282 |
| abstract_inverted_index.mean | 82, 98, 112 |
| abstract_inverted_index.over | 13 |
| abstract_inverted_index.risk | 5, 213, 305 |
| abstract_inverted_index.this | 333 |
| abstract_inverted_index.type | 270, 273 |
| abstract_inverted_index.were | 76, 128, 235 |
| abstract_inverted_index.with | 22, 150, 184, 254, 302 |
| abstract_inverted_index.year | 142 |
| abstract_inverted_index.(ALT) | 115 |
| abstract_inverted_index.(FPG) | 29, 86 |
| abstract_inverted_index.(IFG) | 220 |
| abstract_inverted_index.1,368 | 109 |
| abstract_inverted_index.2,072 | 106 |
| abstract_inverted_index.2,080 | 104 |
| abstract_inverted_index.64.1% | 179 |
| abstract_inverted_index.Close | 312 |
| abstract_inverted_index.Group | 158, 169 |
| abstract_inverted_index.IU/L. | 125 |
| abstract_inverted_index.Iran, | 55 |
| abstract_inverted_index.among | 17 |
| abstract_inverted_index.areas | 231 |
| abstract_inverted_index.curve | 227, 234 |
| abstract_inverted_index.level | 87, 102 |
| abstract_inverted_index.liver | 286 |
| abstract_inverted_index.lower | 276 |
| abstract_inverted_index.males | 72 |
| abstract_inverted_index.mg/dL | 92, 194 |
| abstract_inverted_index.mg/dl | 190 |
| abstract_inverted_index.older | 262 |
| abstract_inverted_index.order | 325 |
| abstract_inverted_index.range | 296 |
| abstract_inverted_index.serum | 99 |
| abstract_inverted_index.study | 36 |
| abstract_inverted_index.these | 318 |
| abstract_inverted_index.three | 48, 131 |
| abstract_inverted_index.total | 62 |
| abstract_inverted_index.under | 232 |
| abstract_inverted_index.value | 240 |
| abstract_inverted_index.µg/L | 107 |
| abstract_inverted_index.(Group | 199, 203 |
| abstract_inverted_index.(IFG), | 167 |
| abstract_inverted_index.67/238 | 160 |
| abstract_inverted_index.78/238 | 171 |
| abstract_inverted_index.93/238 | 147 |
| abstract_inverted_index.Higher | 290 |
| abstract_inverted_index.Italy. | 59 |
| abstract_inverted_index.Shiraz | 53 |
| abstract_inverted_index.Tehran | 51 |
| abstract_inverted_index.Th-RDM | 202, 222, 260 |
| abstract_inverted_index.[Group | 145 |
| abstract_inverted_index.burden | 329 |
| abstract_inverted_index.cutoff | 210, 239 |
| abstract_inverted_index.during | 139 |
| abstract_inverted_index.enzyme | 287 |
| abstract_inverted_index.family | 267 |
| abstract_inverted_index.follow | 143 |
| abstract_inverted_index.future | 307 |
| abstract_inverted_index.gender | 264 |
| abstract_inverted_index.level, | 116 |
| abstract_inverted_index.levels | 24, 292 |
| abstract_inverted_index.mg/dL. | 250 |
| abstract_inverted_index.normal | 152 |
| abstract_inverted_index.period | 16 |
| abstract_inverted_index.plasma | 27, 84 |
| abstract_inverted_index.range. | 33 |
| abstract_inverted_index.range: | 68 |
| abstract_inverted_index.reduce | 327 |
| abstract_inverted_index.should | 321 |
| abstract_inverted_index.timely | 315 |
| abstract_inverted_index.within | 30, 293 |
| abstract_inverted_index.years; | 70 |
| abstract_inverted_index.β-TDT | 38, 65, 126, 148, 298 |
| abstract_inverted_index.10-year | 15, 224 |
| abstract_inverted_index.201/238 | 119 |
| abstract_inverted_index.Ferrara | 57 |
| abstract_inverted_index.January | 42, 45 |
| abstract_inverted_index.alanine | 113 |
| abstract_inverted_index.factors | 252 |
| abstract_inverted_index.fasting | 26, 83, 165, 197, 218 |
| abstract_inverted_index.glucose | 8, 28, 85, 166, 198, 219, 308 |
| abstract_inverted_index.greater | 304 |
| abstract_inverted_index.history | 268 |
| abstract_inverted_index.levels, | 279 |
| abstract_inverted_index.levels. | 288 |
| abstract_inverted_index.mg/dL), | 95 |
| abstract_inverted_index.optimal | 209, 242 |
| abstract_inverted_index.varying | 23 |
| abstract_inverted_index.µg/L). | 110 |
| abstract_inverted_index.(median: | 93, 108 |
| abstract_inverted_index.(β-TDT) | 20 |
| abstract_inverted_index.Notably, | 178 |
| abstract_inverted_index.Results: | 78 |
| abstract_inverted_index.Setting: | 34 |
| abstract_inverted_index.analyses | 228 |
| abstract_inverted_index.baseline | 187 |
| abstract_inverted_index.canters; | 50 |
| abstract_inverted_index.diabetes | 11, 175 |
| abstract_inverted_index.elevated | 285 |
| abstract_inverted_index.evaluate | 3 |
| abstract_inverted_index.females) | 75 |
| abstract_inverted_index.ferritin | 100 |
| abstract_inverted_index.followed | 40 |
| abstract_inverted_index.impaired | 164, 196, 217 |
| abstract_inverted_index.included | 37 |
| abstract_inverted_index.mellitus | 12, 176 |
| abstract_inverted_index.patients | 21, 39, 66, 127, 149, 161, 172, 183, 299 |
| abstract_inverted_index.positive | 266 |
| abstract_inverted_index.severity | 280 |
| abstract_inverted_index.10–41.9 | 69 |
| abstract_inverted_index.Abstract. | 0 |
| abstract_inverted_index.according | 133, 154 |
| abstract_inverted_index.analyzed. | 236 |
| abstract_inverted_index.available | 117 |
| abstract_inverted_index.baseline, | 80 |
| abstract_inverted_index.criteria; | 157 |
| abstract_inverted_index.determine | 207 |
| abstract_inverted_index.developed | 162, 173, 195 |
| abstract_inverted_index.diabetes, | 275 |
| abstract_inverted_index.diabetes. | 311 |
| abstract_inverted_index.high-risk | 319 |
| abstract_inverted_index.included. | 77 |
| abstract_inverted_index.included: | 261 |
| abstract_inverted_index.overload, | 283 |
| abstract_inverted_index.patients, | 120 |
| abstract_inverted_index.subgroups | 132 |
| abstract_inverted_index.(Th-RDM)]. | 177 |
| abstract_inverted_index.(females), | 265 |
| abstract_inverted_index.Objective: | 1 |
| abstract_inverted_index.associated | 253, 301 |
| abstract_inverted_index.considered | 323 |
| abstract_inverted_index.conversion | 136 |
| abstract_inverted_index.developing | 7 |
| abstract_inverted_index.follow-up, | 225 |
| abstract_inverted_index.hemoglobin | 278 |
| abstract_inverted_index.monitoring | 313 |
| abstract_inverted_index.persistent | 151, 163 |
| abstract_inverted_index.respective | 230 |
| abstract_inverted_index.categorized | 129 |
| abstract_inverted_index.established | 247 |
| abstract_inverted_index.individuals | 320 |
| abstract_inverted_index.population. | 334 |
| abstract_inverted_index.prediabetes | 258 |
| abstract_inverted_index.progressing | 215 |
| abstract_inverted_index.progression | 256 |
| abstract_inverted_index.sensitivity | 245 |
| abstract_inverted_index.specificity | 243 |
| abstract_inverted_index.thalassemia | 49 |
| abstract_inverted_index.Conclusions: | 289 |
| abstract_inverted_index.Contributing | 251 |
| abstract_inverted_index.intervention | 316 |
| abstract_inverted_index.Participants: | 60 |
| abstract_inverted_index.dysregulation | 9, 309 |
| abstract_inverted_index.hyperglycemia | 331 |
| abstract_inverted_index.normoglycemic | 32, 295 |
| abstract_inverted_index.respectively. | 205 |
| abstract_inverted_index.β-thalassemia | 19 |
| abstract_inverted_index.pre-transfusion | 277 |
| abstract_inverted_index.aminotransferase | 114 |
| abstract_inverted_index.thalassemia-related | 174 |
| abstract_inverted_index.transfusion-dependent | 18 |
| cited_by_percentile_year | |
| countries_distinct_count | 7 |
| institutions_distinct_count | 8 |
| citation_normalized_percentile |