Insulin resistance and glucose homeostasis in Egyptian children with sickle cell anemia

Abstract

Background A single gene mutation produces sickle cell anemia (SCA), an autosomal recessive illness. The body can keep the glycemic state in normal range via various mechanisms depending mainly on pancreatic hormones. Aim Evaluation of glucose homeostasis and insulin resistance in a group of Egyptian sickle cell children. Patients and methods This cross-sectional comparative study was carried out on 80 participants aged from 5 to 16 years old of both sexes, 40 patients with sickle cell hemoglobinopathies and in a steady state (case group), and 40 healthy individuals as control (control group). Fasting blood glucose, fasting serum insulin, glycosylated hemoglobin were measured in all participants, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was calculated. Serum fructosamine (SF) was measured in the cases group. Results Glucose homeostasis was kept normal in most patients with only 10% of them showed abnormal glycemia. HOMA–IR was significantly different between the two groups with 15% of patients had pathological HOMA-IR. The study found a strong positive correlation (r=0.479, <0.001) between the HOMA-IR and the frequency of vaso-occlusive crisis per year before participants were recruited and between SF and fasting blood glucose (r=0.772, <0.001). On comparing glycosylated hemoglobin between both groups there was no statistically significant difference between both groups (P value = 0.874) Conclusions and recommendations Normal glucose homeostasis was proved in the majority of patients. Insulin resistance was detected in a limited number of sickle cell anemia patients. Follow-up of glucose homeostasis is indicated in sickle cell cases.