Relationship between pancreatic iron overload, glucose metabolism and cardiac complications in sickle cell disease: An Italian multicentre study
Laura Pistoia
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Search for more papers by this authorAntonella Meloni
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
U.O.C. Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Search for more papers by this authorMassimo Allò
Ematologia Microcitemia, Ospedale San Giovanni di Dio – ASP Crotone, Crotone, Italy
Search for more papers by this authorAnna Spasiano
U.O.S.D. Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale “A. Cardarelli”, Naples, Italy
Search for more papers by this authorGiuseppe Messina
Centro Microcitemie, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
Search for more papers by this authorFrancesco Sorrentino
U.O.S. Day Hospital Talassemici, Ospedale "Sant'Eugenio"- ASL Roma2, Rome, Italy
Search for more papers by this authorMaria Rita Gamberini
U. O. di Day Hospital della Talassemia e delle Emoglobinopatie. Dipartimento della Riproduzione e dell'Accrescimento, Azienda Ospedaliero-Universitaria “S. Anna”, Ferrara, Italy
Search for more papers by this authorAngela Ermini
S.O.S. Immunoematologia e Medicina Trasfusionale Ospedale S. Maria Annunziata, Florence, Italy
Search for more papers by this authorStefania Renne
Struttura Complessa di Cardioradiologia-UTIC, Presidio Ospedaliero “Giovanni Paolo II”, Lamezia Terme, Italy
Search for more papers by this authorPriscilla Fina
Unità Operativa Complessa Diagnostica per Immagini, Ospedale "Sandro Pertini", Rome, Italy
Search for more papers by this authorGiuseppe Peritore
Unità Operativa Complessa di Radiologia, "ARNAS" Civico, Di Cristina Benfratelli, Palermo, Italy
Search for more papers by this authorVincenzo Positano
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
U.O.C. Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Search for more papers by this authorAlessia Pepe
Department of Medicine, Institute of Radiology, University of Padua, Padua, Italy
Search for more papers by this authorCorresponding Author
Filippo Cademartiri
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Correspondence
Filippo Cademartiri, Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1 - 56124 Pisa, Italy.
Email: [email protected]
Search for more papers by this authorLaura Pistoia
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Search for more papers by this authorAntonella Meloni
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
U.O.C. Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Search for more papers by this authorMassimo Allò
Ematologia Microcitemia, Ospedale San Giovanni di Dio – ASP Crotone, Crotone, Italy
Search for more papers by this authorAnna Spasiano
U.O.S.D. Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale “A. Cardarelli”, Naples, Italy
Search for more papers by this authorGiuseppe Messina
Centro Microcitemie, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
Search for more papers by this authorFrancesco Sorrentino
U.O.S. Day Hospital Talassemici, Ospedale "Sant'Eugenio"- ASL Roma2, Rome, Italy
Search for more papers by this authorMaria Rita Gamberini
U. O. di Day Hospital della Talassemia e delle Emoglobinopatie. Dipartimento della Riproduzione e dell'Accrescimento, Azienda Ospedaliero-Universitaria “S. Anna”, Ferrara, Italy
Search for more papers by this authorAngela Ermini
S.O.S. Immunoematologia e Medicina Trasfusionale Ospedale S. Maria Annunziata, Florence, Italy
Search for more papers by this authorStefania Renne
Struttura Complessa di Cardioradiologia-UTIC, Presidio Ospedaliero “Giovanni Paolo II”, Lamezia Terme, Italy
Search for more papers by this authorPriscilla Fina
Unità Operativa Complessa Diagnostica per Immagini, Ospedale "Sandro Pertini", Rome, Italy
Search for more papers by this authorGiuseppe Peritore
Unità Operativa Complessa di Radiologia, "ARNAS" Civico, Di Cristina Benfratelli, Palermo, Italy
Search for more papers by this authorVincenzo Positano
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
U.O.C. Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Search for more papers by this authorAlessia Pepe
Department of Medicine, Institute of Radiology, University of Padua, Padua, Italy
Search for more papers by this authorCorresponding Author
Filippo Cademartiri
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Correspondence
Filippo Cademartiri, Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1 - 56124 Pisa, Italy.
Email: [email protected]
Search for more papers by this authorFunding information: E-MIOT project receives ‘no-profit financial support’ from industrial sponsorships (Chiesi Farmaceutici S.p.A., Bayer S.p.A.). The funders had no role in study design, data collection and analysis, or the decision to publish or in preparation of the manuscript.
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.
CONFLICT OF INTEREST
No potential conflicts of interest relevant to this article were reported.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from https://emiot.ftgm.it/, but restrictions apply to the availability of these data, which were used under license for the current study and therefore are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of F.C.
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