Effect of deferoxamine therapy on insulin resistance in end-stage renal disease patients with iron overload.

Abstract

Cardiovascular diseases are a common cause of morbidity and mortality in subjects on regular hemodialysis. Insulin resistance is associated with increased cardiovascular diseases. Elevated serum ferritin is linked to insulin resistance. The aim of this work is to study the effect of desferoxamine therapy on some of the cardiovascular risk factors such as fasting insulin, B-cell function, insulin resistance, glucose, HbA1c%, lipid profile, blood pressure and carotid intima media thickness (CAIMT). Our study included ten subjects on regular hemodialysis with elevated serum ferritin. We measured the fasting serum glucose, HbA1c%, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), fasting lipid profile, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and complete blood count (CBC). Statistically significant decreases in fasting serum insulin, B-cell function, glucose, HbA1c% and HOMA-IR were noted after deferoxamine therapy. No statistically significant difference was seen with regard to lipid profile, blood pressure and CAIMT. Iron overload increases insulin resistance and cardiovascular risk in hemodialysis subjects. Correction of anemia by iron therapy should keep target ferritin as per guidelines. Further studies are needed to determine the safest ferritin level among hemodialysis subjects.

• Authors: Alsayed Ahmed Alnahal, Magdy Tahan, Aymen Fathy, Tamer Fathy
• Journal: Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia (Saudi J Kidney Dis Transpl) Vol. 25 Issue 4 Pg. 808-13 (Jul 2014) ISSN: 1319-2442 [Print] Saudi Arabia
• PMID: 24969192 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Blood Glucose
• Glycated Hemoglobin A
• Insulin
• Iron Chelating Agents
• hemoglobin A1c protein, human
• Ferritins
• Deferoxamine

Topics

• Adult
• Biomarkers (blood)
• Blood Glucose (drug effects, metabolism)
• Blood Pressure (drug effects)
• Cardiovascular Diseases (blood, diagnosis, etiology, physiopathology, prevention & control)
• Carotid Intima-Media Thickness
• Deferoxamine (therapeutic use)
• Female
• Ferritins (blood)
• Glycated Hemoglobin (metabolism)
• Humans
• Insulin (blood)
• Insulin Resistance
• Insulin-Secreting Cells (drug effects, metabolism)
• Iron Chelating Agents (therapeutic use)
• Iron Overload (blood, diagnosis, drug therapy, etiology, physiopathology)
• Kidney Failure, Chronic (blood, complications, diagnosis, physiopathology, therapy)
• Male
• Middle Aged
• Renal Dialysis (adverse effects)
• Risk Factors
• Time Factors
• Treatment Outcome