Relationship between pancreatic iron overload, glucose metabolism and cardiac complications in sickle cell disease: An Italian multicentre study.

Abstract

OBJECTIVES:

Evidence about the cross-talk between iron, glucose metabolism, and cardiac disease is increasing. We aimed to explore the link of pancreatic iron by Magnetic Resonance Imaging (MRI) with glucose metabolism and cardiac complications (CC) in sickle cell disease (SCD) patients.

METHODS:

We considered 70 SCD patients consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. Iron overload was quantified by R2* technique and biventricular function by cine images. Macroscopic myocardial fibrosis was evaluated by late gadolinium enhancement technique. Glucose metabolism was assessed by the oral glucose tolerance test.

RESULTS:

Patients with an altered glucose metabolism showed a significantly higher pancreas R2* than patients with normal glucose metabolism. Pancreatic siderosis emerged as a risk factor for the development of metabolic alterations (OddsRatio 8.25, 95%confidence intervals 1.51-45.1; p = .015). Global pancreas R2* values were directly correlated with mean serum ferritin levels and liver iron concentration. Global pancreas R2* was not significantly associated with global heart R2* and macroscopic myocardial fibrosis. Patients with history of CC showed a significantly higher global pancreas R2* than patients with no CC.

CONCLUSIONS:

Our findings support the evaluation of pancreatic R2* by MRI in SCD patients to prevent the development of metabolic and cardiac disorders.

• Authors: Laura Pistoia, Antonella Meloni, Massimo Allò, Anna Spasiano, Giuseppe Messina, Francesco Sorrentino, Maria Rita Gamberini, Angela Ermini, Stefania Renne, Priscilla Fina, Giuseppe Peritore, Vincenzo Positano, Alessia Pepe, Filippo Cademartiri
• Journal: European journal of haematology (Eur J Haematol) Vol. 109 Issue 3 Pg. 289-297 (Sep 2022) ISSN: 1600-0609 [Electronic] England
• PMID: 35690882 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Contrast Media
• Gadolinium
• Iron
• Glucose

Topics

• Anemia, Sickle Cell (complications, metabolism)
• Cardiomyopathies (metabolism)
• Contrast Media (metabolism)
• Fibrosis
• Gadolinium (metabolism)
• Glucose (metabolism)
• Humans
• Iron (metabolism)
• Iron Overload (complications, diagnosis)
• Liver (metabolism)
• Magnetic Resonance Imaging (methods)
• Myocardium (metabolism)
• Pancreas (diagnostic imaging, metabolism, pathology)
• beta-Thalassemia (complications)