生酮饮食对GLUT1缺乏综合征的营养干预。

Young-Sun Kim, Woojeong Kim, Ji-Hoon Na, Young-Mock Lee
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摘要

葡萄糖转运蛋白1型(GLUT1)缺乏综合征(DS)是一种由SLC2A1基因突变导致的缺乏引起的代谢性脑疾病,其特征是脑代谢异常和相关的代谢性脑病。大脑葡萄糖供应减少会导致脑损伤,导致婴儿期神经发育迟缓,并出现眼睛异常、小头畸形、共济失调和僵硬等症状。GLUT1 DS的治疗选择包括生酮饮食(KD)、药物治疗和康复治疗。其中,KD是一种必要且最重要的治疗方法,因为它通过产生酮体产生能量来促进脑神经发育。该病例是对2022年5月至2023年1月在江南Severance医院诊断为GLUT1 DS的婴儿进行强化KD营养干预的重点研究。在最初住院期间,通过使用浓缩配方奶粉进行营养干预以解决摄入不良的问题,并尝试引入补充喂养。在第二次住院并诊断为GLUT1 DS后,通过实施KD营养干预和调整抗惊厥药物的类型和剂量,在婴儿的生长发育、营养状况和癫痫控制方面取得了积极的效果,副作用最小。总之,对于GLUT1 DS患者,重要的是实施适当比例的生酮和非生酮成分的KD以提供足够的能量。此外,个性化和集约化的营养管理是改善生长发育和营养状况的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Nutritional Intervention Through Ketogenic Diet in GLUT1 Deficiency Syndrome.

Glucose transporter type 1 (GLUT1) deficiency syndrome (DS) is a metabolic brain disorder caused by a deficiency resulting from SLC2A1 gene mutation and is characterized by abnormal brain metabolism and associated metabolic encephalopathy. Reduced glucose supply to the brain leads to brain damage, resulting in delayed neurodevelopment in infancy and symptoms such as eye abnormalities, microcephaly, ataxia, and rigidity. Treatment options for GLUT1 DS include ketogenic diet (KD), pharmacotherapy, and rehabilitation therapy. Of these, KD is an essential and the most important treatment method as it promotes brain neurodevelopment by generating ketone bodies to produce energy. This case is a focused study on intensive KD nutritional intervention for an infant diagnosed with GLUT1 DS at Gangnam Severance Hospital from May 2022 to January 2023. During the initial hospitalization, nutritional intervention was performed to address poor intake via the use of concentrated formula and an attempt was made to introduce complementary feeding. After the second hospitalization and diagnosis of GLUT1 DS, positive effects on the infant's growth and development, nutritional status, and seizure control were achieved with minimal side effects by implementing KD nutritional intervention and adjusting the type and dosage of anticonvulsant medications. In conclusion, for patients with GLUT1 DS, it is important to implement a KD with an appropriate ratio of ketogenic to nonketogenic components to supply adequate energy. Furthermore, individualized and intensive nutritional management is necessary to improve growth, development, and nutritional status.

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