Bodamer OA, Feillet F, Lane RE, Lee PJ, Dixon MA, Halliday D, Leonard JV. Utilization of cornstarch in glycogen storage disease type Ia.
Eur J Gastroenterol Hepatol 2002;
14:1251-6. [PMID:
12439121 DOI:
10.1097/00042737-200211000-00014]
[Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE
Uncooked cornstarch (UCCS) is used widely for the treatment of patients with glycogen storage disease type I (GSD-I). Previous studies suggested that glucose absorption may be impaired in GSD-I. In order to measure utilization of UCCS in young adults with GSD-Ia and healthy controls, we used a C-breath test based on the natural enrichment of C in UCCS.
DESIGN
Open, not randomized, prospective interventional study.
METHODS
Following 1 g/kg UCCS, we studied eight subjects with GSD-Ia (7 males, 1 female; mean age 28.3 years, range 16-42 years) and 15 healthy controls (10 males, 5 females; mean age 23.5 years, range 19-36 years). Breath samples for analysis of CO enrichment were collected at baseline and at 30-min intervals for 6 h or until hypoglycaemia occurred. Indirect calorimetry was used to measure respiratory gas exchange. Intermediate metabolites, lipids and glucose were measured in plasma. Breath H concentrations were measured as an indicator of malabsorption.
RESULTS
Cumulative utilization over 6 h was significantly higher in controls (18.35 +/- 6.2% of total carbohydrate intake) than in subjects with GSD-Ia (11.5 +/- 4.7%) (P < 0.02). However, utilization of UCCS was virtually identical up to 2.5 h. Two subjects with GSD-Ia fulfilled the criteria for malabsorption.
CONCLUSIONS
Starch digestion and absorption are not impaired in GSD-Ia. However, overall utilization of UCCS appears to be lower in GSD-Ia, which is most likely secondary to perturbed intermediary metabolism. There are important implications for treatment of this disorder. Ways to improve the efficacy of UCCS in GSD-I are needed.
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