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Pediatr Blood Cancer. 2008 Aug;51(2):256-60. doi: 10.1002/pbc.21589.

Abnormalities in glucose tolerance are common in children with fanconi anemia and associated with impaired insulin secretion.

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1
Division of Endocrinology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, MLC 7012, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. deborah.elder@cchmc.org

Abstract

BACKGROUND:

To determine prevalence of abnormal glucose metabolism in Fanconi Anemia (FA).

PROCEDURE:

Thirty-nine children with FA underwent 2-hr oral glucose tolerance test (OGTT). Reference lean adolescents (REF) were older than FA patients (mean +/- SD: FA 8.6 +/- 3.9 years, REF 19.8 +/- 0.3 years, P < 0.001), but comparable in BMI Z-scores (FA 1.25 +/- 0.58, REF -0.02 +/- 0.24; P = 0.24). Patients had normal glucose tolerance (NGT) or abnormal glucose metabolism (AGM) by American Diabetes Association Criteria. Insulinogenic index estimated beta-cell function. Insulin resistance estimation used homeostatic model assessment (HOMA-IR). Insulin secretion estimation relative to insulin sensitivity used disposition index (DI).

RESULTS:

Among FA patients, 46% had AGM. Compared to REF, there were significant differences in glycemic responses (area under curve: FA-NGT 344 +/- 42, FA-AGM 596 +/- 35, REF 208 +/- 25 mM, P < 0.0001) and insulinogenic index (FA-NGT 105 +/- 29, FA-AGM 44 +/- 8, and REF 173 +/- 41 pM/mM, P < 0.05). Insulin sensitivity did not differ among NGT, AGM, and REF (HOMA-IR: FA-NGT 1.9 +/- 0.4, FA-AGM 2.2 +/- 0.5, REF 1.3 +/- 0.2, P = NS). However, DI was significantly lower in both FA groups than REF [NGT 63.6 +/- 16.5 vs. AGM 26.4 +/- 3.5 (P < 0.048); REF 132.6 +/- 24.5 (NGT and AGM vs. REF, both P < 0.0002)].

CONCLUSION:

Abnormalities in glucose metabolism are frequent in young FA patients without prior diagnosis of diabetes, and are associated with marked defects in insulin secretion.

PMID:
18454466
DOI:
10.1002/pbc.21589
[Indexed for MEDLINE]
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