肝糖原贮积症的内分泌并发症:长期展望

Ja Hye Kim, Yena Lee, Soojin Hwang, Dohyung Kim, Beom Hee Lee, Gu-Hwan Kim, Han-Wook Yoo, Jin-Ho Choi
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摘要

目的:肝型糖原贮积症(GSDs)患者可表现出低血糖、血脂异常或骨质疏松症等内分泌特征。本研究旨在探讨肝型糖原贮积症患者的长期内分泌后果:本研究纳入了 52 个家族的 64 名肝 GSD 患者,包括 GSD Ia 型(37 个家族中的 41 名患者)、Ib 型(3 个无亲属关系)、III 型(6 个家族中的 8 名患者)、IV 型(1 名患者)和 IX 型(5 个家族中的 11 名患者)。所有患者均经基因证实。对临床和内分泌检查结果进行了回顾性分析:诊断时的中位年龄和目前年龄分别为 2.4 岁(0.1-42.4 岁)和 17.6 岁(1.0-47.8 岁)。确诊时的平均身高 SDS 为 -3.5 ± 1.4,35.6% 的患者身材矮小。3.4 岁以后确诊的患者出现身材矮小的风险较高(OR = 36.1;P 值 < 0.001)。在 33 名达到最终身高的患者中,有 23 人(69.7%)出现青春期延迟。在随访期间,46 名患者(71.9%)出现高甘油三酯血症,25 名患者(39%)出现低密度脂蛋白胆固醇水平升高。在接受双能 X 射线吸收测量的 24 名患者中,22 名患者的左侧脊柱骨矿密度 Z 值为-3.0 ± 1.3:本研究描述了肝脏GSD患者的长期内分泌后果。结论:本研究描述了肝脏 GSD 患者的长期内分泌后果,儿科内分泌专家应了解 GSD 的表现特征和长期内分泌后遗症,以提供适当的治疗,减少其发病率。
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Endocrine Complications in Hepatic Glycogen Storage Diseases: A Long-term Perspective.

Patients with a hepatic type of glycogen storage diseases (GSDs) can manifest endocrine features such as hypoglycemia, dyslipidemia, or osteoporosis. This study aimed to investigate the long-term endocrine consequences in patients with hepatic GSDs.This study included 64 patients from 52 families with hepatic GSDs including GSD type Ia (41 patients from 37 families), Ib (3 unrelated), III (8 from 6 families), IV (1 patient), and IX (11 from 5 families). All patients were genetically confirmed. Clinical and endocrine findings were retrospectively analyzed.The median age at diagnosis and current age were 2.4 years (range, 0.1-42.4 years) and 17.6 years (range, 1.0-47.8 years), respectively. The mean height SDS at diagnosis was -3.5±1.4, and short stature was observed in 35.6% of patients. Patients diagnosed after the age of 3.4 years exhibited a high risk of short stature (OR=36.1; P-value<0.001). Among 33 patients who reached the final height, 23 (69.7%) showed delayed puberty. Hypertriglyceridemia was observed in 46 patients (71.9%), whereas 25 patients (39%) had elevated low-density lipoprotein cholesterol levels during the follow-up period. Among 24 patients who underwent dual-energy X-ray absorptiometry, 22 showed a low bone mineral density Z-score of -3.0±1.3 at the L-spine.This study described the long-term endocrine consequences in patients with hepatic GSDs. Pediatric endocrinologists should be aware of the presenting features and long-term endocrine sequelae of GSDs to provide proper management and decrease its morbidities.

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