{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:06:04Z","timestamp":1789790764103,"version":"4.0.1"},"reference-count":60,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T00:00:00Z","timestamp":1637884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019189","name":"Bayer","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100019189","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007560","name":"Chiesi (Italy)","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100007560","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In thalassemia major, pancreatic iron was demonstrated as a powerful predictor not only for the alterations of glucose metabolism but also for cardiac iron, fibrosis, and complications, supporting a profound link between pancreatic iron and heart disease. We determined for the first time the prevalence of pancreatic iron overload (IO) in thalassemia intermedia (TI) and systematically explored the link between pancreas T2* values and glucose metabolism and cardiac outcomes. We considered 221 beta-TI patients (53.2% females, 42.95 \u00b1 13.74 years) consecutively enrolled in the Extension\u2013Myocardial Iron Overload in Thalassemia project. Magnetic Resonance Imaging was used to quantify IO (T2* technique) and biventricular function and to detect replacement myocardial fibrosis. The glucose metabolism was assessed by the oral glucose tolerance test (OGTT). Pancreatic IO was more frequent in regularly transfused (N = 145) than in nontransfused patients (67.6% vs. 31.6%; p &lt; 0.0001). In the regular transfused group, splenectomy and hepatitis C virus infection were both associated with high pancreatic siderosis. Patients with normal glucose metabolism showed significantly higher global pancreas T2* values than patients with altered OGTT. A pancreas T2* &lt; 17.9 ms predicted an abnormal OGTT. A normal pancreas T2* value showed a 100% negative predictive value for cardiac iron. Pancreas T2* values were not associated to biventricular function, replacement myocardial fibrosis, or cardiac complications. Our findings suggest that in the presence of pancreatic IO, it would be prudent to initiate or intensify iron chelation therapy to prospectively prevent both disturbances of glucose metabolism and cardiac iron accumulation.<\/jats:p>","DOI":"10.3390\/jcm10235561","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T01:43:22Z","timestamp":1638323002000},"page":"5561","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The Link of Pancreatic Iron with Glucose Metabolism and Cardiac Iron in Thalassemia Intermedia: A Large, Multicenter Observational Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2284-8585","authenticated-orcid":false,"given":"Antonella","family":"Meloni","sequence":"first","affiliation":[{"name":"Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"},{"name":"Unit\u00e0 Operativa Complessa di Bioingeneria, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5319-2769","authenticated-orcid":false,"given":"Laura","family":"Pistoia","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gamberini","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa di Day Hospital della Talassemia e delle Emoglobinopatie, Dipartimento della Riproduzione e dell\u2019Accrescimento, Azienda Ospedaliero-Universitaria \u201cS. Anna\u201d, 44124 Cona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7361-3308","authenticated-orcid":false,"given":"Paolo","family":"Ricchi","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Semplice Dipartimentale Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Cecinati","sequence":"additional","affiliation":[{"name":"Struttura Semplice di Microcitemia, Ospedale \u201cSS. Annunziata\u201d Azienda Sanitaria Locale Taranto, 74123 Taranto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sorrentino","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Semplice Dipartimentale Day Hospital Talassemici, Ospedale \u201cSant\u2019Eugenio\u201d, 00143 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana","family":"Cuccia","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa Ematologia con Talassemia, Azienda di Rilievo Nazionale ad Alta Specializzazione Civico \u201cBenfratelli-Di Cristina\u201d, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"All\u00f2","sequence":"additional","affiliation":[{"name":"Ematologia Microcitemia, Ospedale San Giovanni di Dio\u2014Azienda Sanitaria Provinciale di Crotone, 88900 Crotone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Righi","sequence":"additional","affiliation":[{"name":"Diagnostica per Immagini e Radiologia Interventistica, Ospedale del Delta, 44023 Lagosanto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla","family":"Fina","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa Diagnostica per Immagini, Ospedale \u201cSandro Pertini\u201d, 00157 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada","family":"Riva","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Radiologia, Ospedale \u201cSS. Annunziata\u201d Azienda Sanitaria Locale Taranto, 74100 Taranto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Renne","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Cardioradiologia-Unit\u00e0 di Terapia Intensiva Cardiologica, Presidio Ospedaliero \u201cGiovanni Paolo II\u201d, 88046 Lamezia Terme, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Peritore","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Radiologia, Azienda di Rilievo Nazionale ad Alta Specializzazione Civico \u201cBenfratelli-Di Cristina\u201d, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2010-9164","authenticated-orcid":false,"given":"Stefano","family":"Dalmiani","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa Infotelematica Translational BioInformatics and eHealth, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6955-9572","authenticated-orcid":false,"given":"Vincenzo","family":"Positano","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"},{"name":"Unit\u00e0 Operativa Complessa di Bioingeneria, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2020-9365","authenticated-orcid":false,"given":"Emilio","family":"Quaia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Radiology, University of Padua, 35100 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0579-3279","authenticated-orcid":false,"given":"Filippo","family":"Cademartiri","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Pepe","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy"},{"name":"Department of Medicine, Institute of Radiology, University of Padua, 35100 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1056\/NEJMra050436","article-title":"Beta-thalassemia","volume":"353","author":"Rund","year":"2005","journal-title":"N. 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