Serum sex hormone-binding globulin levels are reduced and inversely associated with intrahepatic lipid content and saturated fatty acid fraction in adult patients with glycogen storage disease type 1a

PURPOSE

De novo lipogenesis has been inversely associated with serum sex hormone-binding globulin (SHBG) levels. However, the directionality of this association has remained uncertain. We, therefore, studied individuals with glycogen storage disease type 1a (GSD1a), who are characterized by a genetic defect in glucose-6-phosphatase resulting in increased rates of de novo lipogenesis, to assess the downstream effect on serum SHBG levels.

METHODS

A case-control study comparing serum SHBG levels in patients with GSD1a (n = 10) and controls matched for age, sex, and BMI (n = 10). Intrahepatic lipid content and saturated fatty acid fraction were quantified by proton magnetic resonance spectroscopy.

RESULTS

Serum SHBG levels were statistically significantly lower in patients with GSD1a compared to the controls (p = 0.041), while intrahepatic lipid content and intrahepatic saturated fatty acid fraction-a marker of de novo lipogenesis-were significantly higher in patients with GSD1a (p = 0.001 and p = 0.019, respectively). In addition, there was a statistically significant, inverse association of intrahepatic lipid content and saturated fatty acid fraction with serum SHBG levels in patients and controls combined (β: - 0.28, 95% CI: - 0.47;- 0.09 and β: - 0.02, 95% CI: - 0.04;- 0.01, respectively).

CONCLUSION

Patients with GSD1a, who are characterized by genetically determined higher rates of de novo lipogenesis, have lower serum SHBG levels than controls.

Number, nature & impact of incoming telephone calls on residents and their work during evening shifts

BACKGROUND

Internal medicine residents are frequently interrupted by phone calls, which may compromise workflow, work quality and job satisfaction.

AIM

This study investigates the number, nature and impact of calls on residents and their work during evening shifts in the emergency department and ward.

METHODS

This prospective observational study compares measurements from direct observations with subjective data from questionnaires.

RESULTS

Residents received 26 resp. 30 (median) calls per shift in the emergency department and ward, with duration of 50 resp. 80 seconds. Residents perceived high burden and impact on quality of work and job satisfaction.

DISCUSSION & CONCLUSION

Frequent interruptions by phone calls were observed, which resulted in high burden. Our study raises the urgency for finding solutions and provides insights necessary for possible interventions.