Evaluation of the risk factors for noncommunicable diseases in patients with inborn errors of amino acid metabolism receiving nutrition therapy

J Pediatr Endocrinol Metab. 2023 Oct 6;36(12):1146-1153. doi: 10.1515/jpem-2023-0325. Print 2023 Dec 15.

Abstract

Objectives: There is growing concern about the low-protein and high-energy diet therapies used in the treatment of inherited amino acid metabolism disorders. We aimed to identify the risk factors for noncommunicable diseases that may arise from nutritional therapies and suggests approaches that may prevent the development of the noncommunicable diseases.

Methods: The present study evaluates 112 patients, on long-term nutritional therapy for at least the last 2 years with a diagnosis of an inborn error of the amino acid metabolism, and their 28 healthy siblings. The participants are assessed for the development of overweight and metabolic syndrome based on an analysis of anthropometric parameters, body composition and the results of biochemical tests.

Results: Anthropometric measurements including BMI, weight Z-score, waist circumference and fat mass were not significantly different between patients and controls. Height Z-scores were similar in phenylketonuria patients compared to controls, but lower in urea cycle disorders, organic acidemia and maple syrup urine disease groups. No increased risk of development of overweight or metabolic syndrome was detected in the patient group, while there were findings suggesting malnutrition in patients diagnosed with urea cycle disorders. There was a correlation between patients' BMI and C3-carnitine levels in organic acidemia patients and leucine levels in maple syrup urine disease patients.

Conclusions: All forms of malnutrition can be prevented in patient groups receiving limited nutrients under a dietary management protocol, based on the findings of anthropometric and biochemical evaluations and analyses of body composition.

Keywords: inborn errors of amino acid metabolism; malnutrition; noncommunicable disease; nutrition therapy; obesity; overweight.

MeSH terms

  • Amino Acid Metabolism, Inborn Errors*
  • Amino Acids
  • Humans
  • Malnutrition*
  • Maple Syrup Urine Disease*
  • Metabolic Syndrome* / epidemiology
  • Metabolic Syndrome* / etiology
  • Noncommunicable Diseases*
  • Nutrition Therapy*
  • Overweight
  • Risk Factors
  • Urea Cycle Disorders, Inborn*

Substances

  • Amino Acids