1
|
Pena MJ, Pinto A, de Almeida MF, de Sousa Barbosa C, Ramos PC, Rocha S, Guimas A, Ribeiro R, Martins E, Bandeira A, Dias CC, MacDonald A, Borges N, Rocha JC. Continuous use of glycomacropeptide in the nutritional management of patients with phenylketonuria: a clinical perspective. Orphanet J Rare Dis 2021; 16:84. [PMID: 33581730 PMCID: PMC7881530 DOI: 10.1186/s13023-021-01721-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background In phenylketonuria (PKU), modified casein glycomacropeptide supplements (CGMP-AA) are used as an alternative to the traditional phenylalanine (Phe)-free L-amino acid supplements (L-AA). However, studies focusing on the long-term nutritional status of CGMP-AA are lacking. This retrospective study evaluated the long-term impact of CGMP-AA over a mean of 29 months in 11 patients with a mean age at CGMP-AA onset of 28 years (range 15–43) [8 females; 2 hyperphenylalaninaemia (HPA), 3 mild PKU, 3 classical PKU and 3 late-diagnosed]. Outcome measures included metabolic control, anthropometry, body composition and biochemical parameters. Results CGMP-AA, providing 66% of protein equivalent intake from protein substitute, was associated with no significant change in blood Phe with CGMP-AA compared with baseline (562 ± 289 µmol/L vs 628 ± 317 µmol/L; p = 0.065). In contrast, blood tyrosine significantly increased on CGMP-AA (52.0 ± 19.2 μmol/L vs 61.4 ± 23.8 μmol/L; p = 0.027). Conclusions Biochemical nutritional markers remained unchanged which is an encouraging finding in adults with PKU, many of whom are unable to maintain full adherence with nutritionally fortified protein substitutes. Longitudinal, prospective studies with larger sample sizes are necessary to fully understand the metabolic impact of using CGMP-AA in PKU.
Collapse
Affiliation(s)
- Maria João Pena
- Departamento de Biomedicina, Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, 4200-319, Porto, Portugal
| | - Alex Pinto
- Department of Dietetics, Birmingham Children's Hospital, Birmingham, B4 6NH, UK.,Faculty of Health and Human Sciences, University of Plymouth, Plymouth, PL6 8BH, UK
| | - Manuela Ferreira de Almeida
- Centro de Genética Médica, Centro Hospitalar Universitário Do Porto (CHUP), 4099-028, Porto, Portugal.,Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal.,UMIB/ICBAS/UP), Unit for Multidisplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313, Porto, Portugal
| | - Catarina de Sousa Barbosa
- Centro de Genética Médica, Centro Hospitalar Universitário Do Porto (CHUP), 4099-028, Porto, Portugal.,Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal
| | - Paula Cristina Ramos
- Centro de Genética Médica, Centro Hospitalar Universitário Do Porto (CHUP), 4099-028, Porto, Portugal.,Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal
| | - Sara Rocha
- Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal
| | - Arlindo Guimas
- Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal
| | - Rosa Ribeiro
- Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal.,UMIB/ICBAS/UP), Unit for Multidisplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313, Porto, Portugal
| | - Esmeralda Martins
- Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal.,UMIB/ICBAS/UP), Unit for Multidisplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313, Porto, Portugal
| | - Anabela Bandeira
- Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal
| | - Cláudia Camila Dias
- Center for Health Technology and Services Research (CINTESIS), 4200-450, Porto, Portugal.,Department of Community Medicine, Information and Health Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450, Porto, Portugal
| | - Anita MacDonald
- Department of Dietetics, Birmingham Children's Hospital, Birmingham, B4 6NH, UK
| | - Nuno Borges
- Center for Health Technology and Services Research (CINTESIS), 4200-450, Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180, Porto, Portugal
| | - Júlio César Rocha
- Centro de Genética Médica, Centro Hospitalar Universitário Do Porto (CHUP), 4099-028, Porto, Portugal. .,Centro de Referência na área das Doenças Hereditárias do Metabolismo, CHUP, 4099-001, Porto, Portugal. .,Center for Health Technology and Services Research (CINTESIS), 4200-450, Porto, Portugal. .,Nutrition and Metabolism, Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056, Lisbon, Portugal.
| |
Collapse
|