Blood glucose trends in glycogen storage disease type Ia: A cross‐sectional study

作者：Tokiko Fukuda, Tetsuya Ito, Takashi Hamazaki, Ayano Inui, Mika Ishige, Reiko Kagawa, Norio Sakai, Yoriko Watanabe, Hironori Kobayashi, Yosuke Wasaki, Junki Taura, Yuki Imamura, Tsutomu Tsukiuda, Kimitoshi Nakamura · 发表于：Journal of Inherited Metabolic Disease · 年份：2023 · DOI：10.1002/jimd.12610 · 被引用次数：9 · 研究领域：Glycogen Storage Diseases and Myoclonus、Lysosomal Storage Disorders Research、Sympathectomy and Hyperhidrosis Treatments

BACKGROUND: Glycogen storage disease type Ia (GSDIa) is caused by biallelic pathogenic variants in the glucose-6-phosphatase gene (G6PC) and mainly characterized by hypoglycemia, hepatomegaly, and renal insufficiency. Although its symptoms are reportedly mild in patients carrying the G6PC c.648G>T variant, the predominant variant in Japanese patients, details remain unclear. Therefore, we examined continuous glucose monitoring (CGM) data and daily nutritional intake to clarify their associations in Japanese patients with GSDIa with G6PC c.648G>T. METHODS: This cross-sectional study enrolled 32 patients across 10 hospitals. CGM was performed for 14 days, and nutritional intake was recorded using electronic diaries. Patients were divided according to genotype (homozygous/compound heterozygous) and age. The durations of biochemical hypoglycemia and corresponding nutritional intake were analyzed. Multiple regression analysis was performed to identify factors associated with the duration of biochemical hypoglycemia. RESULTS: Data were analyzed for 30 patients. The mean daily duration of hypoglycemia (<4.0 mmol/L) in the homozygous group increased with age (2-11 years [N = 8]: 79.8 min; 12-18 years [5]: 84.8 min; ≥19 years [10]: 131.5 min). No severe hypoglycemic symptoms were recorded in the patients' diaries. The mean frequency of snack intake was approximately three times greater in patients aged 2-11 years (7.1 times/day) than in those aged 12-18 years (1.9 times/day) or ≥19 ye...