SLC34A3 GENE MUTATION AS A RARE CAUSE OF HYPOPHOSPHATEMIA IN TWO SIBLINGS

Context

Hereditary hypophosphatemic rickets with hypercalciuria (HHRH) is a rare autosomal recessive disorder, which is characterized by renal phosphate wasting, hypercalciuria, increased 1,25-dihydroxyvitamin D, and decreased parathormone (PTH) levels.

Objective

Here we report different clinical features of two siblings with HHRH, confirmed with molecular diagnosis.

Subjects and methods

16.4 years old boy (P1), and 8.7 years old girl (P2) were referred to our outpatient clinic due to clinical suspicion of metabolic bone diseases.

Results

P1 had severe hypophosphatemia. Additionally, PTH concentration was near to the lower limit, 1,25-dihydroxyvitamin-D concentration was near to the upper limit. P2 had relatively milder clinical and laboratory findings. Bilateral renal calculi were detected on ultrasound in both of them. HHRH was suspected due to their described biochemistry and the presence of bilateral renal calculi. Molecular analysis of SLC34A3 gene revealed a homozygous variant c.756G>A (p.Gln252=) and a splice donor variant c.1335+2T>A. After oral phosphate treatment, clinical and biochemical improvements were observed. However treatment nonadherence of patients was a barrier to reach treatment goal.

Conclusion

The clinical phenotype due to the same mutation in the SLC34A3 gene may vary even among the members of the same family. An accurate diagnosis is important for the appropriate treatment.

Eating behaviors and related cultural attitudes of African American men and women

Cultural groups often participate in traditions and activities surrounding food and eating, which contribute to group differences in maladaptive eating-related patterns and outcomes. This study explored the relationships between cultural attitudes and eating behaviors of young adult African American men and women. Endorsing a strong orientation on various dimensions of African American culture were related to less dieting, bulimic, and anorexic behaviors and attitudes. This study extended our knowledge of the ways in which cultural attitudes were related to the physical and mental health of African Americans and recognized the significance of individual differences within this group.

Outcomes of a church-based diabetes prevention program delivered by peers: a feasibility study

PURPOSE

This purpose of this study was to investigate the feasibility and potential health impact of a church-based diabetes prevention program delivered by peers.

METHODS

Thirteen at-risk African American adults were recruited to a peer-led diabetes prevention program adapted from the National Diabetes Education Program's Power to Prevent curriculum. The program consisted of 6 core education sessions followed by 6 biweekly telephone support calls. Components of feasibility examined included recruitment, attendance, and retention. Baseline, 8-week, and 20-week assessments measured clinical outcomes (percentage body weight change, waist circumference, lipid panel, blood pressure) and lifestyle behaviors (eg, physical activity and diet).

RESULTS

Of the 13 participants enrolled at baseline, 11 completed the intervention. Mean attendance across 6 core sessions was 5.2 classes (87%). At 8 weeks, significant improvements were found for physical activity (P = .031), waist circumference (P = .049), serum cholesterol (P = .036), systolic blood pressure (P = .013), and fat intake (P = .006). At 20 weeks, not only did participants sustain the improvements made following the core intervention, but they also demonstrated additional improvements for HDL (P = .002) and diastolic blood pressure (P = .004).

CONCLUSION

Findings suggest that it is feasible to conduct a peer-led diabetes prevention program in a church-based setting that has a potentially positive impact on health-related outcomes.

Training peers to deliver a church-based diabetes prevention program

PURPOSE

The purpose of this study was to examine the feasibility and acceptability of training peers to function as lifestyle coaches and to deliver a church-based lifestyle modification program.

METHODS

We recruited 6 African-American adults to participate in an 8-hour peer lifestyle coach (PLC) training program followed by a subsequent 2-hour booster session. The PLC training program addressed several key areas, including: (1) developing empowerment-based facilitation, active listening, and behavior change skills; (2) learning self-management strategies (eg, reading food labels, counting calories); (3) practicing session delivery; and (4) interpreting clinical lab results. Training evaluation was conducted retrospectively (immediately following the delivery of the diabetes prevention intervention rather than after the 8-hour training session) and measured program satisfaction and efficacy from the perspective of participants.

RESULTS

Peer lifestyle coaches' confidence levels for performing core skills (eg, asking open-ended questions, 5-step behavioral goal-setting process) and advanced skills (eg, addressing resistance, discussing sensitive topics) were uniformly high. Similarly, PLCs were very satisfied with the length of training, balance between content and skills development, and preparation for leading group- and individual-based support activities.

CONCLUSIONS

Findings suggest that it is feasible to customize a PLC training program that is acceptable to participants and that equips participants with the knowledge and skills to facilitate a church-based diabetes prevention intervention.