■糖原贮积病Ia型(GSDIa)是由葡萄糖-6-磷酸酶催化亚基1(G6PC1)基因中的致病性变体引起的碳水化合物代谢的先天性错误,并与肝细胞腺瘤(HCA)形成有关。关于GSDIa中HCA发生的危险因素的数据很少。我们调查了HCA发展与性别的关系,G6PC1基因型,和血清甘油三酯浓度(TG)。
■对基因证实GSDIa≥12年的患者进行观察性研究。对患者进行性别分类;存在2、1或0个预测的严重G6PC1变异(PSV);以及儿童期的中位TG(<12岁;分层为高于/低于5.65mmol/L,即500mg/dl)。
■纳入53名患者(23名女性),其中26例患者的中位年龄(IQR)为21岁(17-25岁)。在25岁的时候,48%的女性和30%的男性患有HCA(log-rankp=0.045)。三分之二的GSDIa患者携带2PSV,20%携带1,13%不携带1。PSV的数量或任何特定的G6PC1变体都与HCA的发生无关。男性儿童TG为3.4(3.0-4.2)mmol/L女性为5.6(4.0-7.9)mmol/L(p=0.026)。儿童TG>5.65mmol/L与年轻时的HCA发育有关,与儿童TG<5.65mmol/L的患者相比(18vs.33年;对数秩p=0.001)。Cox回归分析包括TG,性别,TG-性别交互作用校正显示儿童TG>5.65mmol/L是HCA发展的独立危险因素(风险比[HR]6.0;95%CI1.2-29.8;p=0.028)。
■在GSDIa患者中,儿童高TG与HCA风险增加有关,和HCA发展的早期开始,与性相关的高甘油三酯血症无关,和G6PC1基因型。
■糖原贮积病Ia型(GSDIa)是一种罕见的,遗传性代谢疾病,可并发肝肿瘤(肝细胞腺瘤),这反过来又可能导致出血或进展为肝癌。与GSDIa患者肝细胞腺瘤形成相关的危险因素在很大程度上是未知的。在我们的研究中,我们发现儿童时期血清甘油三酯浓度高,但不是特定的遗传变异,与以后诊断肝细胞腺瘤的风险增加有关。
UNASSIGNED: Glycogen storage disease type Ia (GSDIa) is an inborn error of carbohydrate metabolism caused by pathogenic variants in the glucose-6-phosphatase catalytic subunit 1 (G6PC1) gene and is associated with hepatocellular adenoma (HCA) formation. Data on risk factors for HCA occurrence in GSDIa are scarce. We investigated HCA development in relation to sex, G6PC1 genotype, and serum triglyceride concentration (TG).
UNASSIGNED: An observational study of patients with genetically confirmed GSDIa ≥12 years was performed. Patients were categorised for sex; presence of 2, 1, or 0 predicted severe G6PC1 variant (PSV); and median TG during childhood (<12 years; stratified for above/below 5.65 mmol/L, i.e. 500 mg/dl).
UNASSIGNED: Fifty-three patients (23 females) were included, of which 26 patients developed HCA at a median (IQR) age of 21 (17-25) years. At the age of 25 years, 48% of females and 30% of males had developed HCA (log-rank p = 0.045). Two-thirds of patients with GSDIa carried 2 PSVs, 20% carried 1, and 13% carried none. Neither the number of PSVs nor any specific G6PC1 variants were associated with HCA occurrence. Childhood TG was 3.4 (3.0-4.2) mmol/L in males vs. 5.6 (4.0-7.9) mmol/L in females (p = 0.026). Childhood TG >5.65 mmol/L was associated with HCA development at younger age, compared with patients with childhood TG <5.65 mmol/L (18 vs. 33 years; log-rank p = 0.001). Cox regression analysis including TG, sex, and TG-sex interaction correction revealed childhood TG >5.65 mmol/L as an independent risk factor for HCA development (hazard ratio [HR] 6.0; 95% CI 1.2-29.8; p = 0.028).
UNASSIGNED: In patients with GSDIa, high childhood TG was associated with an increased risk of HCA, and earlier onset of HCA development, independent of sex-associated hypertriglyceridaemia, and G6PC1 genotype.
UNASSIGNED: Glycogen storage disease type Ia (GSDIa) is a rare, inherited metabolic disease that can be complicated by liver tumours (hepatocellular adenomas), which in turn may cause bleeding or progress to liver cancer. Risk factors associated with hepatocellular adenoma formation in patients with GSDIa are largely unknown. In our study, we found that high serum triglyceride concentrations during childhood, but not specific genetic variants, were associated with increased risk of hepatocellular adenoma diagnosis later in life.