PracticeUpdate Conference Series - SSIEM 2018

Cholesterol Ratios May Help Detect Risk of Insulin Resistance and Metabolic Syndrome in Patients With GSDI Chronic hyperlipidemia and adipose tissue dysfunction may play a role in insulin resistance andmetabolic syndrome in patients with glycogen storage disease type Ia (GSDI).

N on-HDL cholesterol, triglyceride/ HDL ratio, and non-HDL cholesterol/ HDL cholesterol ratio may be useful tools for early detection of the risk of insulin resistance and metabolic syndrome in patients with GSDIa, reports an assessment of lipid markers in patients with GSDI. Alessandro Rossi, MD, of the Università Federico II in Naples, Italy, and colleagues set out to assess lipid markers in patients with GSDI. “We performed this study to unveil the metabolic risk of patients with GSDI,” Dr. Rossi told Elsevier’s PracticeUpdate . They enrolled 12 patients with GSDIa, 6 with GSDIb, 26 age-matched controls, and 12 sex-matched controls. They measured waist circumference, serum glucose and plasma cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and leptin.

Non-HDL cholesterol, triglyceride/ HDL cholesterol ratio, and non-HDL cholesterol/HDL cholesterol ratio were also assessed as well as serum insulin and markers of insulin resistance (Homeostatic Model Assessment of Insulin Resistance [HOMA-IR], Quantitative Insulin Sensitivity Check Index [QUICKI], insulin sensitivity index [ISI]). Patients with GSDIa exhibited higher waist circumference, cholesterol, triglyceride, and insulin levels (P < .001), non-HDL cholesterol (P < .01), triglyceride/HDL cholesterol ratio (P < .01), non-HDL cholesterol/HDL cholesterol ratio (P < .05), and HOMA-IR (P < .001) than controls. QUICKI and ISI were lower than in controls (P < .001). Glucose, HDL cholesterol, LDL cholesterol, and leptin did not differ significantly.

Patients with GSDIb demonstrated lower cholesterol, LDL cholesterol, and HDL cholesterol (P < .001). Waist circumference, glucose, non-HDL cholesterol, leptin, insulin, triglyceride/HDL cholesterol, non-HDL cholesterol/HDL ratio, HOMA-IR, QUICKI, and ISI did not differ significantly. In patients with GSDIa, non-HDL cholesterol and triglyceride/HDL cholesterol ratio correlated directly with glucose levels (P < .05). HDL cholesterol correlated inversely with waist circumference (P < .05). Leptin levels correlated directly with insulin and HOMA-IR (P < .05) and correlated inversely with QUICKI and ISI (P < .05). Dr. Rossi explained that a higher risk of developing insulin resistance and metabolic syndrome has been shown in patients with GSDIa. Hyperlipidemia is a typical feature of GSDIa.

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PRACTICEUPDATE CONFERENCE SERIES • SSIEM 2018