1
|
Spaziani M, Semeraro A, Bucci E, Rossi F, Garibaldi M, Papassifachis MA, Pozza C, Anzuini A, Lenzi A, Antonini G, Radicioni AF. Hormonal and metabolic gender differences in a cohort of myotonic dystrophy type 1 subjects: a retrospective, case-control study. J Endocrinol Invest 2020; 43:663-675. [PMID: 31786795 DOI: 10.1007/s40618-019-01156-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/23/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE Myotonic dystrophy type 1 (DM1) is a genetic disorder caused by CTG expansion in the DMPK gene. The aim was to investigate the endocrine and metabolic aspects of DM1. PATIENTS AND METHODS Retrospective, case-control study. We compared pituitary, thyroid, adrenal, gonadal and liver function and glycolipid metabolism of 63 DM1 patients against 100 control subjects. Given age-related differences, 2 further subgroups were created to investigate the pituitary-gonadal axis: < 41 (1a) and ≥ 41 (1b) years old for male subjects and < 46 (2a) and ≥ 46 (2b) years old for female subjects. Testicular and thyroid ultrasounds were also performed in the DM1 group. RESULTS FT3 and FT4 were significantly lower in DM1 men than controls, while for both males and females, thyroglobulin, ACTH and cortisol were significantly higher in the DM1 group. Gonadotropin levels were significantly higher and inhibin B and DHEA-S levels significantly lower in DM1 patients than controls for both male subgroups. Testosterone and SHBG were significantly higher in controls than in patients for subgroup 1a. Prolactin was significantly higher in patients in subgroups 1b, while testosterone was lower in subgroup 2a than in age-matched female controls. A correlation between the number of CTG repeats and the percentage of male hypogonadal subjects was found. Finally, there was a worse glucose and lipid pattern and significantly higher transaminase and gamma-GT levels in both male and female patients. CONCLUSIONS The high frequency of endocrine and metabolic abnormalities in DM1 highlights the importance of endocrine monitoring to enable the prompt initiation of a suitable therapy.
Collapse
Affiliation(s)
- M Spaziani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy.
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy.
| | - A Semeraro
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - E Bucci
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - F Rossi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - M Garibaldi
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - M A Papassifachis
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - C Pozza
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - A Anzuini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
| | - G Antonini
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - A F Radicioni
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Level - 1, Room 33, Rome, Italy
- Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| |
Collapse
|
2
|
Symonds T, Randall JA, Campbell P. Review of patient-reported outcome measures for use in myotonic dystrophy type 1 patients. Muscle Nerve 2017; 56:86-92. [DOI: 10.1002/mus.25469] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Tara Symonds
- Clinical Outcomes Solutions; Folkestone Kent United Kingdom
| | | | | |
Collapse
|
3
|
Mateos-Aierdi AJ, Goicoechea M, Aiastui A, Fernández-Torrón R, Garcia-Puga M, Matheu A, López de Munain A. Muscle wasting in myotonic dystrophies: a model of premature aging. Front Aging Neurosci 2015. [PMID: 26217220 PMCID: PMC4496580 DOI: 10.3389/fnagi.2015.00125] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Myotonic dystrophy type 1 (DM1 or Steinert’s disease) and type 2 (DM2) are multisystem disorders of genetic origin. Progressive muscular weakness, atrophy and myotonia are the most prominent neuromuscular features of these diseases, while other clinical manifestations such as cardiomyopathy, insulin resistance and cataracts are also common. From a clinical perspective, most DM symptoms are interpreted as a result of an accelerated aging (cataracts, muscular weakness and atrophy, cognitive decline, metabolic dysfunction, etc.), including an increased risk of developing tumors. From this point of view, DM1 could be described as a progeroid syndrome since a notable age-dependent dysfunction of all systems occurs. The underlying molecular disorder in DM1 consists of the existence of a pathological (CTG) triplet expansion in the 3′ untranslated region (UTR) of the Dystrophia Myotonica Protein Kinase (DMPK) gene, whereas (CCTG)n repeats in the first intron of the Cellular Nucleic acid Binding Protein/Zinc Finger Protein 9(CNBP/ZNF9) gene cause DM2. The expansions are transcribed into (CUG)n and (CCUG)n-containing RNA, respectively, which form secondary structures and sequester RNA-binding proteins, such as the splicing factor muscleblind-like protein (MBNL), forming nuclear aggregates known as foci. Other splicing factors, such as CUGBP, are also disrupted, leading to a spliceopathy of a large number of downstream genes linked to the clinical features of these diseases. Skeletal muscle regeneration relies on muscle progenitor cells, known as satellite cells, which are activated after muscle damage, and which proliferate and differentiate to muscle cells, thus regenerating the damaged tissue. Satellite cell dysfunction seems to be a common feature of both age-dependent muscle degeneration (sarcopenia) and muscle wasting in DM and other muscle degenerative diseases. This review aims to describe the cellular, molecular and macrostructural processes involved in the muscular degeneration seen in DM patients, highlighting the similarities found with muscle aging.
Collapse
Affiliation(s)
- Alba Judith Mateos-Aierdi
- Neuroscience Area, Biodonostia Health Research Institute San Sebastián, Spain ; CIBERNED, Instituto Carlos III, Ministerio de Economía y Competitividad Madrid, Spain
| | - Maria Goicoechea
- Neuroscience Area, Biodonostia Health Research Institute San Sebastián, Spain ; CIBERNED, Instituto Carlos III, Ministerio de Economía y Competitividad Madrid, Spain
| | - Ana Aiastui
- CIBERNED, Instituto Carlos III, Ministerio de Economía y Competitividad Madrid, Spain ; Cell Culture Platform, Biodonostia Health Research Institute, San Sebastián Spain
| | - Roberto Fernández-Torrón
- Neuroscience Area, Biodonostia Health Research Institute San Sebastián, Spain ; CIBERNED, Instituto Carlos III, Ministerio de Economía y Competitividad Madrid, Spain ; Department of Neurology, Hospital Universitario Donostia, San Sebastián Spain
| | - Mikel Garcia-Puga
- Oncology Area, Biodonostia Health Research Institute San Sebastián, Spain
| | - Ander Matheu
- Oncology Area, Biodonostia Health Research Institute San Sebastián, Spain
| | - Adolfo López de Munain
- Neuroscience Area, Biodonostia Health Research Institute San Sebastián, Spain ; CIBERNED, Instituto Carlos III, Ministerio de Economía y Competitividad Madrid, Spain ; Department of Neurology, Hospital Universitario Donostia, San Sebastián Spain ; Department of Neuroscience, Universidad del País Vasco UPV-EHU San Sebastián, Spain
| |
Collapse
|
4
|
Seesing FM, van Vught LE, Rose MR, Drost G, van Engelen BGM, van der Wilt GJ. The individualized neuromuscular quality of life questionnaire: cultural translation and psychometric validation for the Dutch population. Muscle Nerve 2015; 51:496-500. [PMID: 25042897 DOI: 10.1002/mus.24337] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 07/03/2014] [Accepted: 07/08/2014] [Indexed: 02/05/2023]
Abstract
INTRODUCTION In this study we describe the translation and psychometric evaluation of the Dutch Individualized Neuromuscular Quality of Life (INQoL) questionnaire. METHODS Backward and forward translation of the questionnaire was executed, and psychometric properties were assessed on the basis of reliability and validity. RESULTS Two hundred six patients were included in the study. Reliability analyses resulted in Cronbach alpha values of >0.70 for all subdomains. Known-group validity showed a significant correlation between INQoL scores and severity as well as age for the majority of subdomains. Item-total correlation for overall quality of life was satisfactory. Concurrent validity with the SF-36 and EQ-5D was good (range of Spearman correlation coefficients -0.43 to -0.76). CONCLUSIONS This study resulted in a questionnaire that is appropiate for use in the Dutch-speaking population to measure quality of life among patients with a wide variety of muscle disorders. This confirms and extends data obtained in the UK, US, Italy, and Serbia.
Collapse
Affiliation(s)
- Femke M Seesing
- Department of Neurology, Radboud University Medical Centre, 935 Neurology, Reinier Postlaan 4, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | | | | | | | | | | |
Collapse
|
5
|
Barone-Rochette G, Jankowski A, Rodiere M. Apport de l’IRM et du scanner cardiaque en pratique clinique courante. Rev Med Interne 2014; 35:742-51. [DOI: 10.1016/j.revmed.2014.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 05/07/2014] [Accepted: 06/16/2014] [Indexed: 10/25/2022]
|
6
|
Jacquet C, Brembilla-Perrot B, Marc Sellal JM, Mohamed S, Terrier de la Chaise A, Kaminsky P. Troubles du rythme et intolérance musculaire à l’effort chez un adulte jeune révélant une laminopathie. Rev Med Interne 2014; 35:617-20. [DOI: 10.1016/j.revmed.2014.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 04/02/2014] [Accepted: 05/10/2014] [Indexed: 10/25/2022]
|
7
|
Poussel M, Kaminsky P, Renaud P, Laroppe J, Pruna L, Chenuel B. Supine changes in lung function correlate with chronic respiratory failure in myotonic dystrophy patients. Respir Physiol Neurobiol 2014; 193:43-51. [PMID: 24440340 DOI: 10.1016/j.resp.2014.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 01/07/2014] [Accepted: 01/08/2014] [Indexed: 10/25/2022]
Abstract
Quality of life and prognosis of patients with myotonic dystrophy type 1 (MD1) often depend on the degree of lung function impairment. This study was designed to assess the respective prevalence of ventilatory restriction, hypoxaemia and hypercapnia in MD1 patients and to determine whether postural changes in lung function could contribute to the early diagnosis of poor respiratory outcome. Fifty-eight patients (42.6±12.9 years) with MD1 were prospectively evaluated from April 2008 to June 2010 to determine their supine and upright lung function and arterial blood gases. The prevalence of ventilatory restriction was 36% and increased with the severity of muscular disability (from 7.7% to 70.6%). The prevalence of hypoxaemia and hypercapnia was 37.9% and 25.9%, respectively. Multiple regression analysis showed that the supine fall in FEV1 was the only variable associated with ventilatory restriction, hypoxaemia and hypercapnia. Our data indicate that supine evaluation of lung function could be helpful to predict poor respiratory outcome, which is closely correlated with hypoxaemia and/or hypercapnia.
Collapse
Affiliation(s)
- Mathias Poussel
- Department of Pulmonary Function Testing and Exercise Testing, CHU Nancy, Nancy F-54000, France; EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, F-54000, France.
| | - Pierre Kaminsky
- Department of Internal Medicine and Orphan Diseases, CHU Nancy, Nancy F-54000, France; Reference Centre in Inherited Metabolism Diseases, CHU Nancy, Nancy F-54000, France
| | - Pierre Renaud
- Department of Pulmonary Function Testing and Exercise Testing, CHU Nancy, Nancy F-54000, France; EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, F-54000, France
| | - Julien Laroppe
- Department of Pulmonary Function Testing and Exercise Testing, CHU Nancy, Nancy F-54000, France; EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, F-54000, France
| | - Lelia Pruna
- Department of Internal Medicine and Orphan Diseases, CHU Nancy, Nancy F-54000, France; Reference Centre in Inherited Metabolism Diseases, CHU Nancy, Nancy F-54000, France
| | - Bruno Chenuel
- Department of Pulmonary Function Testing and Exercise Testing, CHU Nancy, Nancy F-54000, France; EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, F-54000, France
| |
Collapse
|