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KMID : 0918520160160030135
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Journal of the Korean Society of Inherited Metabolic Disease
2016 Volume.16 No. 3 p.135 ~ p.140
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Clinical and Laboratory Characteristics of Galactokinase Hyperactivity
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Yang Seung-Do
Lee Jeong-Ho
Shin Young-Lim
Lee Dong-Hwan
Hong Young-Hee
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Abstract
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Purpose: Galactose is metabolized to galactose-1-phosphate by galactokinase (GALK), galactose-1-phosphate uridyltransferase (GALT) and UDP-galactose-4-epimerase (GALE), and galactosemia occurs when each enzyme is deficient. In Korea, unlike foreign countries, classic galactosemia is rare and transient galactosemia due to GALK hyperactivity is reported, but studies on frequency, clinical significance, and genetic variation are lacking. In this study, we analyzed the clinical characteristics of patients with galactosemia due to GALK hyperactivity.
Method: We investigated 85 patients who had an elevated galactose level in the neonatal screening test without deficiency of enzymes at Department of Pediatrics, Seoul & Bucheon Soonchunhyang University Hospital from January 2008 to June 2016. We investigated the level of galactose, galactose-1- phosphate, GALK and duration of galactose normalization, and analyzed the correlation between GALK elevation and galactose, galactose-1-phosphate and duration of galactose normalization. And the levels of galactose, galactose-1-phosphate, and duration of galactose normalization were compared between the galactose-free formula feeding group and non-feeding group.
Result: Mean age of visit was 26.7±16.1 days. Duration of galactose normalization was 35.3±20.5 days. Mean galactose level was 18.5±7.3 mg/dL in the neonatal screening and follow-up galactose level in serum was 2.3±5.4 mg/dL. The mean value of galactose-1-phosphate was 6.0±4.7 mg/dL and the mean GALK level was 3.84±1.28 μmol/Hr/gHb. There was no significant correlation between GALK levels and galactose levels in the neonatal screening test (P=0.351), and we analyzed the correlation between GALK levels and follow-up galactose levels in serum, there was no significant correlation (P= 0.101). There was a significant correlation between GALK levels and galactose-1-phosphate (P=0.015),
and the correlation between GALK levels and duration of galactose normalization was not statistically significant (P=0.176). 49% of the patients were fed galactose-free formula, and 45% were not. Galactose and galactose-1-phosphate levels in the neonatal screening test were statistically significantly higher (P=0.004, 0.034) in using galactose-free formula group. Duration of galactose normalization was not related to the use of galactose-free formula (P=0.266, 0.249).
Conclusion: Galactosemia due to GALK hyperactivity seems to be a temporary phenomenon and may not require galactose restriction. More research is needed on the role of the nuclear protein, racial traits and genetic variations in Korean patients.
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KEYWORD
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Galactosemia, Galactose, Galactokinase hyperactivity
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