345 GLUCOSE INTOLERANCE IN APLASTIC ANEMIA TREATED WITH 0XYMETHOLONE

Abstract

The onset of glucose intolerance in three patients receiving oxymetholone for aplastic anemia (AA), an association not previously reported, led to this investigation. Eight patients aged 9 to 20 years with acquired AA or Fanconi's anemia were evaluated. Seven had received oxymetholone at dosages of 1 to 5 mg/kg/d for 11 to 139 months and one patient did not require oxymetholone. All had oral glucose tolerance tests (OGTT) with glucose and total immunoreactive insulin (TIRI) determined at 0, 1/2, 1, 2, 3, and 4 hours. Seven patients had HLA analyses. The mean glucose of the seven patients receiving oxymetholone was elevated during OGTT (p<0.001 for each sampling time). TIRI was elevated in five of these patients (p<0.05-0.001). In these five patients basal TIRI correlated with dose (r=0.89, p<0.01) and duration (r=0.98, p<0.001) of oxymetholone therapy. TIRI response areas also correlated with dose and duration of treatment (r=0.83, p<0.05 and r=0.90, p<0.01, respectively). The two remaining patients were overtly diabetic siblings with low TIRI. The patient not receiving oxymetholone had normal OGTT and TIRI levels. In one patient OGTT was normal prior to therapy but abnormal after treatment for 11 months at 2 mg/kg/d. HLA analyses revealed the siblings had a B locus antigen associated with juvenile diabetes mellitus but no other relationships were found. These data suggest glucose intolerance is related to oxymetholone and that the mechanism may be insulin resistance.