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Bone mineral density and markers of bone turnover in patients with glycogen storage disease types I, III and IX. 2004

J Cabrera-Abreu, and N J Crabtree, and E Elias, and W Fraser, and R Cramb, and S Alger
Department of Clinical Chemistry, Birmingham Children's Hospital, Birmingham, UK.

Patients with glycogen storage disease (GSD) types I, III and IX show reduced bone mineral content, but there is scarce data on new serum and urine markers of bone turnover or their relationship to bone densitometry. Six GSD I, four GSD III and four GSD IX patients underwent bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry. Free pyridinoline (fPYD):creatinine and free deoxypyridinoline (fDPD):creatinine ratios were analysed on random urines. Procollagen type I C-terminal propeptide, procollagen type I N-terminal propeptide (PINP), carboxyterminal telopeptide of type I collagen and bone-specific alkaline phosphatase were analysed in serum. Some GSD I and GSD III patients had low or very low BMD. There was no difference in total body BMD z-score between the GSD types after adjusting for height (p=0.110). Bone marker analysis showed no consistent pattern. Urine fPYD:creatinine ratio was raised in four GSD I and two GSD III patients, while serum PINP was inappropriately low in some of these patients. There was no clear correlation between any markers of bone destruction and total body z-score, but the patient with the lowest total body z-score showed the highest concentrations of both urinary fPYD:creatinine and fDPD:creatinine ratios. We conclude that some GSD I and GSD III patients have very low bone mineral density. There is no correlation between mineral density and bone markers in GSD patients. The inappropriately low concentration of PINP in association with the raised urinary fPYD:creatinine and fDPD:creatinine ratios seen in two GSD I patients reflect uncoupling of bone turnover. All these findings taken together suggest that some GSD I and GSD III patients may be at an increased risk of osteoporosis.

UI MeSH Term Description Entries
D008297 Male Males
D005260 Female Females
D005953 Glycogen Storage Disease Type I An autosomal recessive disease in which gene expression of glucose-6-phosphatase is absent, resulting in hypoglycemia due to lack of glucose production. Accumulation of glycogen in liver and kidney leads to organomegaly, particularly massive hepatomegaly. Increased concentrations of lactic acid and hyperlipidemia appear in the plasma. Clinical gout often appears in early childhood. Glucose-6-Phosphatase Deficiency,Glucosephosphatase Deficiency,Glycogenosis 1,Hepatorenal Glycogen Storage Disease,von Gierke Disease,Deficiency, Glucosephosphatase,Gierke Disease,Gierke's Disease,Glycogen Storage Disease 1 (GSD I),von Gierke's Disease,Deficiencies, Glucose-6-Phosphatase,Deficiencies, Glucosephosphatase,Deficiency, Glucose-6-Phosphatase,Disease, Gierke,Disease, Gierke's,Disease, von Gierke,Disease, von Gierke's,Gierkes Disease,Glucose 6 Phosphatase Deficiency,Glucose-6-Phosphatase Deficiencies,Glucosephosphatase Deficiencies,von Gierkes Disease
D006008 Glycogen Storage Disease A group of inherited metabolic disorders involving the enzymes responsible for the synthesis and degradation of glycogen. In some patients, prominent liver involvement is presented. In others, more generalized storage of glycogen occurs, sometimes with prominent cardiac involvement. Glycogenosis,Disease, Glycogen Storage,Diseases, Glycogen Storage,Glycogen Storage Diseases,Glycogenoses,Storage Disease, Glycogen,Storage Diseases, Glycogen
D006010 Glycogen Storage Disease Type III An autosomal recessive metabolic disorder due to deficient expression of amylo-1,6-glucosidase (one part of the glycogen debranching enzyme system). The clinical course of the disease is similar to that of glycogen storage disease type I, but milder. Massive hepatomegaly, which is present in young children, diminishes and occasionally disappears with age. Levels of glycogen with short outer branches are elevated in muscle, liver, and erythrocytes. Six subgroups have been identified, with subgroups Type IIIa and Type IIIb being the most prevalent. Cori's Disease,Debrancher Deficiency,Forbes Disease,Glycogen Debranching Enzyme Deficiency,Glycogenosis 3,Limit Dextrinosis,Amylo-1,6-Glucosidase Deficiency,Cori Disease,Deficiency, Debrancher,Glycogen Debrancher Deficiency,Glycogen Storage Disease III,Glycogen Storage Disease Type 3,Amylo 1,6 Glucosidase Deficiency,Amylo-1,6-Glucosidase Deficiencies,Coris Disease,Debrancher Deficiencies,Debrancher Deficiencies, Glycogen,Debrancher Deficiency, Glycogen,Deficiencies, Amylo-1,6-Glucosidase,Deficiencies, Debrancher,Deficiencies, Glycogen Debrancher,Deficiency, Amylo-1,6-Glucosidase,Deficiency, Glycogen Debrancher,Dextrinoses, Limit,Dextrinosis, Limit,Disease, Cori,Disease, Cori's,Disease, Forbes,Glycogen Debrancher Deficiencies,Glycogenosis 3s,Limit Dextrinoses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D015415 Biomarkers Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, ENVIRONMENTAL EXPOSURE and its effects, disease diagnosis; METABOLIC PROCESSES; SUBSTANCE ABUSE; PREGNANCY; cell line development; EPIDEMIOLOGIC STUDIES; etc. Biochemical Markers,Biological Markers,Biomarker,Clinical Markers,Immunologic Markers,Laboratory Markers,Markers, Biochemical,Markers, Biological,Markers, Clinical,Markers, Immunologic,Markers, Laboratory,Markers, Serum,Markers, Surrogate,Markers, Viral,Serum Markers,Surrogate Markers,Viral Markers,Biochemical Marker,Biologic Marker,Biologic Markers,Clinical Marker,Immune Marker,Immune Markers,Immunologic Marker,Laboratory Marker,Marker, Biochemical,Marker, Biological,Marker, Clinical,Marker, Immunologic,Marker, Laboratory,Marker, Serum,Marker, Surrogate,Serum Marker,Surrogate End Point,Surrogate End Points,Surrogate Endpoint,Surrogate Endpoints,Surrogate Marker,Viral Marker,Biological Marker,End Point, Surrogate,End Points, Surrogate,Endpoint, Surrogate,Endpoints, Surrogate,Marker, Biologic,Marker, Immune,Marker, Viral,Markers, Biologic,Markers, Immune
D015502 Absorptiometry, Photon A noninvasive method for assessing BODY COMPOSITION. It is based on the differential absorption of X-RAYS (or GAMMA RAYS) by different tissues such as bone, fat and other soft tissues. The source of (X-ray or gamma-ray) photon beam is generated either from radioisotopes such as GADOLINIUM 153, IODINE 125, or Americanium 241 which emit GAMMA RAYS in the appropriate range; or from an X-ray tube which produces X-RAYS in the desired range. It is primarily used for quantitating BONE MINERAL CONTENT, especially for the diagnosis of OSTEOPOROSIS, and also in measuring BONE MINERALIZATION. Absorptiometry, X-Ray,Dual-Photon Absorptiometry,Photodensitometry, X-Ray,Photon Absorptiometry,Single-Photon Absorptiometry,X-Ray Absorptiometry,Absorptiometry, Dual X-Ray,Absorptiometry, Dual-Energy Radiographic,Absorptiometry, Dual-Energy X-Ray,DEXA Scan,DPX Absorptiometry,DXA Scan,Densitometry, X-Ray,Densitometry, Xray,Dual X-Ray Absorptiometry,Dual-Energy Radiographic Absorptiometry,Dual-Energy X-Ray Absorptiometry,Dual-Energy X-Ray Absorptiometry Scan,Radiographic Absorptiometry, Dual-Energy,X-Ray Absorptiometry, Dual-Energy,X-Ray Photodensitometry,Absorptiometries, DPX,Absorptiometry, DPX,Absorptiometry, Dual Energy Radiographic,Absorptiometry, Dual Energy X Ray,Absorptiometry, Dual X Ray,Absorptiometry, Dual-Photon,Absorptiometry, Single-Photon,Absorptiometry, X Ray,DEXA Scans,DXA Scans,Densitometry, X Ray,Dual Energy Radiographic Absorptiometry,Dual Energy X Ray Absorptiometry,Dual Energy X Ray Absorptiometry Scan,Dual Photon Absorptiometry,Dual X Ray Absorptiometry,Photodensitometry, X Ray,Radiographic Absorptiometry, Dual Energy,Scan, DEXA,Scan, DXA,Scans, DEXA,Scans, DXA,Single Photon Absorptiometry,X Ray Absorptiometry,X Ray Absorptiometry, Dual Energy,X Ray Photodensitometry,X-Ray Absorptiometry, Dual,X-Ray Densitometry,Xray Densitometry
D015519 Bone Density The amount of mineral per square centimeter of BONE. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by X-RAY ABSORPTIOMETRY or TOMOGRAPHY, X RAY COMPUTED. Bone density is an important predictor for OSTEOPOROSIS. Bone Mineral Content,Bone Mineral Density,Bone Densities,Bone Mineral Contents,Bone Mineral Densities,Density, Bone,Density, Bone Mineral

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