کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6219748 | 1607435 | 2015 | 8 صفحه PDF | دانلود رایگان |
ObjectiveTo examine the impact of fasting and glucose tolerance on selected metabolic variables in children with spinal muscular atrophy (SMA) type II in a well state, secondary to reports of glucose regulation abnormalities in SMA.Study designIn this prospective pilot study, 6 children aged 7-11Â years with SMA type II participated in an oral glucose tolerance test and a supervised medical fast during 2 overnight visits at the University of Utah. At baseline, a dual-energy x-ray absorptiometry scan was performed to determine body composition. Laboratory test results were obtained at baseline and in response to the respective interventions. Data analysis was descriptive. Prefasting and postfasting data were evaluated using the Wilcoxon signed-rank test.ResultsBased on the dual-energy x-ray absorptiometry scan, all 6 children were variably obese at baseline. All 6 exhibited hyperinsulinemia, and 3 of 6 met formal American Diabetes Association criteria for impaired glucose tolerance. According to homeostatic insulin resistance calculations, 5 of the 6 participants were insulin-resistant. All 6 participants tolerated a monitored fast for 20Â hours without hypoglycemia (blood glucose <54Â mg/dL). Free fatty acid levels increased significantly from prefasting to postfasting, whereas levels of several plasma amino acids decreased significantly during fasting.ConclusionChildren with SMA type II defined as obese using objective variables are at increased risk for impaired glucose tolerance regardless of whether or not they visually appear obese. Further studies are needed to determine the prevalence of impaired glucose tolerance and tolerance for fasting within the broader heterogeneous SMA population and to develop appropriate guidelines for intervention.
Journal: The Journal of Pediatrics - Volume 167, Issue 6, December 2015, Pages 1362-1368.e1