4.5 Article

Body composition in patients with hepatic glycogen storage diseases

Journal

NUTRITION
Volume 104, Issue -, Pages -

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.nut.2022.111763

Keywords

Inborn errors of metabolism; Hepatic glycogen storage disease; Body composition; absorptiometry; Dual x-ray; Uncooked cornstarch; treatment

Funding

  1. Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [31/2013]
  2. Fundacao de Amparo a Pesquisa do Estado do Rio Grande do Sul [PPSUS/2013]
  3. Hospital de Clinicas de Porto Alegre Research Fund

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This study evaluated the body composition of patients with hepatic glycogen storage disorders (GSDs) and found a high frequency of increased fat mass. The study also suggested that treatment with uncooked cornstarch (UCCS) is associated with excess weight and may impair protein intake, leading to a decrease in lean mass.
Objectives: The present study aimed to evaluate the body composition of hepatic glycogen storage disorders (GSDs) through dual energy x-ray absorptiometry. Methods: This was an exploratory, observational, cross-sectional study. Twenty-four patients with GSD (type Ia: n = 13, Ib: n = 5, III: n = 2, and IX-alpha/beta/gamma: n = 4; female sex: n = 13; age < 8 y: n = 3, 8-19 y: n = 14, and > 19 y: n = 7) were included. Three-day dietary records were collected in the week preceding dual energy x-ray absorptiometry. Body composition findings were correlated with clinical parameters, uncooked cornstarch (UCCS) regimen, dietary intake, and markers of treatment adherence. Results: An elevated fat mass (FM) index was found in 16 of 21 patients (age 8-19 y: n = 10 and > 19-y: n = 6; GSD type Ia: n = 12, Ib: n = 2, III: n = 1, and IX-gamma: n = 1). A lean mass (LM) index evaluation showed no LM deficits in relation to corresponding reference populations. Relative skeletal muscle index values were decreased in 2 of 7 adult patients (type Ib: n = 1 and IX-alpha: n = 1). UCCS (g/d) correlated positively with the FM index (rs = 0.7; P < 0.01). In contrast, relative UCCS intake (g/kg body weight) was negatively associated with LM/ kg (rs =-0.8;P <= 0.01). Conclusions: These findings suggest a high frequency of elevated FM in patients with hepatic GSDs. We also suggest that treatment with UCCS is associated with excess weight in these patients. Additionally, the treatment strategy can impair protein intake, and lead to a decrease in LM. (c) 2022 Elsevier Inc. All rights reserved.

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