Study of Insulin Resistance in Patients with β Thalassemia Major and Validity of Triglyceride Glucose (TYG) Index

Arif M. Ansari, Kamalakshi G. Bhat, Smitha S. Dsa, Soundarya Mahalingam, Nitin Joseph

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Complications like impaired glucose tolerance and diabetes mellitus due to iron overload need early identification in thalassemia. We studied the proportion of insulin resistance in thalassemia major patients on chronic transfusion, identified insulin resistance using homeostasis model assessment of insulin resistance (HOMA-IR) and triglyceride glucose (TYG) index, compared them and validated TYG index. In total, 73 thalassemia patients on regular transfusion for 3 years with serum ferritin >1500 ng/mL were studied. Serum ferritin, fasting blood glucose, triglycerides, and insulin levels were measured, HOMA-IR, and TYG index calculated and analyzed. Mean fasting glucose, triglyceride, and serum insulin values were 104 mg/dL, 164.18 mg/dL, and 19.6 m IU/mL, respectively. Mean serum ferritin was 5156 ng/mL. Insulin resistance was prevalent in one third of thalassemia patients and showed increase with age and serum ferritin. Insulin resistance by HOMA-IR was 32% as against 16% by TYG index with a cut-off value of 4.3. Using receiver operating charecteristic curve analysis, it was found that, by lowering the value of TYG index to 4.0215, sensitivity improved to 78.3% (from 39.13%) with specificity of 70%. Hence, we recommend a newer lower cut-off value of 4.0215 for TYG index for better sensitivity and specificity in identifying insulin resistance.

Original languageEnglish
Pages (from-to)128-131
Number of pages4
JournalJournal of Pediatric Hematology/Oncology
Volume40
Issue number2
DOIs
Publication statusPublished - 01-01-2018

Fingerprint

beta-Thalassemia
Insulin Resistance
Triglycerides
Glucose
Ferritins
Thalassemia
Serum
Homeostasis
Fasting
Insulin
Iron Overload
Glucose Intolerance
Blood Glucose
Diabetes Mellitus
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

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title = "Study of Insulin Resistance in Patients with β Thalassemia Major and Validity of Triglyceride Glucose (TYG) Index",
abstract = "Complications like impaired glucose tolerance and diabetes mellitus due to iron overload need early identification in thalassemia. We studied the proportion of insulin resistance in thalassemia major patients on chronic transfusion, identified insulin resistance using homeostasis model assessment of insulin resistance (HOMA-IR) and triglyceride glucose (TYG) index, compared them and validated TYG index. In total, 73 thalassemia patients on regular transfusion for 3 years with serum ferritin >1500 ng/mL were studied. Serum ferritin, fasting blood glucose, triglycerides, and insulin levels were measured, HOMA-IR, and TYG index calculated and analyzed. Mean fasting glucose, triglyceride, and serum insulin values were 104 mg/dL, 164.18 mg/dL, and 19.6 m IU/mL, respectively. Mean serum ferritin was 5156 ng/mL. Insulin resistance was prevalent in one third of thalassemia patients and showed increase with age and serum ferritin. Insulin resistance by HOMA-IR was 32{\%} as against 16{\%} by TYG index with a cut-off value of 4.3. Using receiver operating charecteristic curve analysis, it was found that, by lowering the value of TYG index to 4.0215, sensitivity improved to 78.3{\%} (from 39.13{\%}) with specificity of 70{\%}. Hence, we recommend a newer lower cut-off value of 4.0215 for TYG index for better sensitivity and specificity in identifying insulin resistance.",
author = "Ansari, {Arif M.} and Bhat, {Kamalakshi G.} and Dsa, {Smitha S.} and Soundarya Mahalingam and Nitin Joseph",
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AU - Bhat, Kamalakshi G.

AU - Dsa, Smitha S.

AU - Mahalingam, Soundarya

AU - Joseph, Nitin

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