Bhattacharya K, Orton R C, Qi X, Mundy H, Morley D W, Champion M P, Eaton S, Tester R F, Lee P J
Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK.
J Inherit Metab Dis. 2007 Jun;30(3):350-7. doi: 10.1007/s10545-007-0479-0. Epub 2007 May 19.
To determine whether a new starch offers better short-term metabolic control than uncooked cornstarch in patients with glycogen storage diseases (GSDs).
A short-term double-blind cross-over pilot study comparing uncooked physically modified cornstarch (WMHM20) with uncooked cornstarch in patients with GSD types Ia, Ib and III. Twenty-one patients (ages 3-47, 9 female) were given 2 g/kg cornstarch or WMHM20 mixed in water. Blood glucose, lactate and insulin, and breath hydrogen and (13)CO2 enrichment were measured, at baseline and after each load. The hourly biochemical evaluations terminated when blood glucose was < or = 3.0 mmol/L, when the study period had lasted 10 h or when the patient wished to end the test. The alternative starch was administered under similar trial conditions a median of 10 days later.
The median starch load duration was 9 h for WMHM20 versus 7 h for cornstarch. Glucose decreased more slowly (p = 0.05) and lactate was suppressed faster (p = 0.17) for WMHM20 compared with cornstarch. Peak hydrogen excretion was increased (p = 0.05) when cornstarch was taken.
These data indicate longer duration of euglycaemia and better short-term metabolic control in the majority of GSD patients with WMHM20 compared to cornstarch.
确定一种新型淀粉在糖原贮积病（GSD）患者中是否比生玉米淀粉能提供更好的短期代谢控制。
一项短期双盲交叉试验性研究，比较生的物理改性玉米淀粉（WMHM20）与生玉米淀粉在Ia型、Ib型和III型GSD患者中的效果。21名患者（年龄3 - 47岁，9名女性）服用2 g/kg混入水中的玉米淀粉或WMHM20。在基线期及每次负荷后测量血糖、乳酸和胰岛素，以及呼气氢气和（13）CO2富集情况。当血糖≤3.0 mmol/L、研究期持续10小时或患者希望结束试验时，终止每小时的生化评估。在类似试验条件下，10天后中位数时间给予另一种淀粉。
WMHM20的淀粉负荷持续时间中位数为9小时，而玉米淀粉为7小时。与玉米淀粉相比，WMHM20的葡萄糖下降更慢（p = 0.05），乳酸抑制更快（p = 0.17）。服用玉米淀粉时，氢气排泄峰值增加（p = 0.05）。
这些数据表明，与玉米淀粉相比，WMHM20在大多数GSD患者中能使血糖正常的持续时间更长，短期代谢控制更好。
