Ficicioglu Can, Thomas Nina, Yager Claire, Gallagher Paul R, Hussa Christie, Mattie Andrea, Day-Salvatore Debra L, Forbes Brian J
Department of Pediatrics, Section of Biochemical Genetics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 34th and Civic Boulevard 9S23, Philadelphia, PA 19104, USA.
Mol Genet Metab. 2008 Dec;95(4):206-12. doi: 10.1016/j.ymgme.2008.09.005. Epub 2008 Oct 30.
Newborn screening for galactosemia has shown a high prevalence of partial galactose uridyl transferase deficiencies such as Duarte (DG) galactosemia.
To determine whether (a) there is any clinical impact of DG galactosemia on development (b) there is a relationship between outcome and biochemical parameters in patients who receive no treatment.
Twenty-eight children with DG galactosemia. Group-I-17 children had a lactose restricted diet in the first year of life. Group-II-11 children had a regular diet since birth.
Developmental, physical, and ophthalmologic assessments were completed on both DG groups. RBC gal-1-p and urine galactitol were monitored during the follow-up visits in every child with DG galactosemia. Gal-1-p, urine galactitol, liver function tests, and FSH were tested at the time of study visit.
The groups had statistically significant differences on RBC gal-1-p and urine galactitol at the 2 week, 1 month, 6 month, and 1 year time points. There was no statistical difference of gal-1-p or urine galactitol in group-I and -II at the time of study. The groups had statistically significant differences on adaptive scores, but not on language or IQ. None of the DG subjects had abnormal liver function at the time of diagnosis or the study visit. The FSH levels were normal. There were no statistically significant relationships between the first year metabolic values and developmental outcomes.
The data presented here indicate that clinical and developmental outcomes in DG galactosemics are good regardless of any diet changes.
新生儿半乳糖血症筛查显示部分半乳糖尿苷转移酶缺乏症(如杜阿尔特(DG)半乳糖血症)的患病率很高。
确定(a)DG半乳糖血症对发育是否有任何临床影响(b)未接受治疗的患者其结局与生化参数之间是否存在关系。
28名患有DG半乳糖血症的儿童。第一组-17名儿童在生命的第一年采用限制乳糖饮食。第二组-11名儿童自出生以来一直采用常规饮食。
对两组DG患儿均完成发育、身体和眼科评估。对每例DG半乳糖血症患儿在随访期间监测红细胞半乳糖-1-磷酸(RBC gal-1-p)和尿半乳糖醇。在研究访视时检测半乳糖-1-磷酸、尿半乳糖醇、肝功能测试和促卵泡激素(FSH)。
两组在2周、1个月、6个月和1年时间点的红细胞半乳糖-1-磷酸和尿半乳糖醇存在统计学显著差异。在研究时,第一组和第二组的半乳糖-1-磷酸或尿半乳糖醇无统计学差异。两组在适应性评分上存在统计学显著差异,但在语言或智商方面无差异。在诊断或研究访视时,所有DG受试者的肝功能均无异常。促卵泡激素水平正常。第一年的代谢值与发育结局之间无统计学显著关系。
此处呈现的数据表明,无论饮食是否改变,DG半乳糖血症患者的临床和发育结局都良好。