The adult galactosemic phenotype

S.E. Waisbren, N.L. Potter, C.M. Gordon, R.C. Green, P. Greenstein, C.S. Gubbels, M.E. Rubio-Gozalbo, D. Schomer, C. Welt, V. Anastasoaie, K. D'Anna, J. Gentile, C.Y. Guo, L. Hecht, R. Jackson, B.M. Jansma, Y. Li, V. Lip, D.T. Miller, M. MurrayL. Power, N. Quinn, F. Rohr, Y. Shen, A. Skinder-Meredith, I. Timmers, R. Tunick, A. Wessel, H. Levy, L. Elsas, G.T. Berry

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Abstract

BACKGROUND: Classic galactosemia is an autosomal recessive disorder due to galactose-1-phosphate uridyltransferase (GALT) deficiency. Newborn screening and early treatment do not completely prevent tremor, speech deficits, and diminished IQ in both sexes and premature ovarian insufficiency (POI) in women. Data on how individuals with galactosemia fare as adults will improve our ability to predict disease progression.
METHODS: Thirty-three adults (mean age = 32.6 ± 11.7 years; range = 18-59) with classic galactosemia, confirmed by genotype and undetectable GALT enzyme activity, were evaluated. Analyses assessed associations among age, genotype, clinical features and laboratory measures.
RESULTS: The sample included 17 men and 16 women. Subjects exhibited cataracts (21%), low bone density (24%), tremor (46%), ataxia (15%), dysarthria (24%), and apraxia of speech (9%). Subjects reported depression (39%) and anxiety (67%). Mean full scale IQ was 88 ± 20, (range = 55-122). All subjects followed a dairy-free diet and 75-80% reported low intake of calcium and vitamin D. Mean height, weight and body mass were within established norms. All female subjects had been diagnosed with POI. One woman and two men had had children. Logistic regression analyses revealed no associations between age, genotype or gender with IQ, tremor, ataxia, dysarthria, apraxia of speech or anxiety. Each 10- year increment of age was associated with a twofold increase in odds of depression.
CONCLUSIONS: Taken together, these data do not support the hypothesis that galactosemia is a progressive neurodegenerative disease. However, greater attention to depression, anxiety, and social relationships may relieve the impact of this disorder in adults.
Original languageEnglish
Pages (from-to)279-286
JournalJournal of Inherited Metabolic Disease
Volume32
Issue number2
DOIs
Publication statusPublished - 1 Mar 2012

Cite this

Waisbren, S. E., Potter, N. L., Gordon, C. M., Green, R. C., Greenstein, P., Gubbels, C. S., ... Berry, G. T. (2012). The adult galactosemic phenotype. Journal of Inherited Metabolic Disease, 32(2), 279-286. https://doi.org/10.1007/s10545-011-9372-y
Waisbren, S.E. ; Potter, N.L. ; Gordon, C.M. ; Green, R.C. ; Greenstein, P. ; Gubbels, C.S. ; Rubio-Gozalbo, M.E. ; Schomer, D. ; Welt, C. ; Anastasoaie, V. ; D'Anna, K. ; Gentile, J. ; Guo, C.Y. ; Hecht, L. ; Jackson, R. ; Jansma, B.M. ; Li, Y. ; Lip, V. ; Miller, D.T. ; Murray, M. ; Power, L. ; Quinn, N. ; Rohr, F. ; Shen, Y. ; Skinder-Meredith, A. ; Timmers, I. ; Tunick, R. ; Wessel, A. ; Levy, H. ; Elsas, L. ; Berry, G.T. / The adult galactosemic phenotype. In: Journal of Inherited Metabolic Disease. 2012 ; Vol. 32, No. 2. pp. 279-286.
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abstract = "BACKGROUND: Classic galactosemia is an autosomal recessive disorder due to galactose-1-phosphate uridyltransferase (GALT) deficiency. Newborn screening and early treatment do not completely prevent tremor, speech deficits, and diminished IQ in both sexes and premature ovarian insufficiency (POI) in women. Data on how individuals with galactosemia fare as adults will improve our ability to predict disease progression.METHODS: Thirty-three adults (mean age = 32.6 ± 11.7 years; range = 18-59) with classic galactosemia, confirmed by genotype and undetectable GALT enzyme activity, were evaluated. Analyses assessed associations among age, genotype, clinical features and laboratory measures.RESULTS: The sample included 17 men and 16 women. Subjects exhibited cataracts (21{\%}), low bone density (24{\%}), tremor (46{\%}), ataxia (15{\%}), dysarthria (24{\%}), and apraxia of speech (9{\%}). Subjects reported depression (39{\%}) and anxiety (67{\%}). Mean full scale IQ was 88 ± 20, (range = 55-122). All subjects followed a dairy-free diet and 75-80{\%} reported low intake of calcium and vitamin D. Mean height, weight and body mass were within established norms. All female subjects had been diagnosed with POI. One woman and two men had had children. Logistic regression analyses revealed no associations between age, genotype or gender with IQ, tremor, ataxia, dysarthria, apraxia of speech or anxiety. Each 10- year increment of age was associated with a twofold increase in odds of depression.CONCLUSIONS: Taken together, these data do not support the hypothesis that galactosemia is a progressive neurodegenerative disease. However, greater attention to depression, anxiety, and social relationships may relieve the impact of this disorder in adults.",
author = "S.E. Waisbren and N.L. Potter and C.M. Gordon and R.C. Green and P. Greenstein and C.S. Gubbels and M.E. Rubio-Gozalbo and D. Schomer and C. Welt and V. Anastasoaie and K. D'Anna and J. Gentile and C.Y. Guo and L. Hecht and R. Jackson and B.M. Jansma and Y. Li and V. Lip and D.T. Miller and M. Murray and L. Power and N. Quinn and F. Rohr and Y. Shen and A. Skinder-Meredith and I. Timmers and R. Tunick and A. Wessel and H. Levy and L. Elsas and G.T. Berry",
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Waisbren, SE, Potter, NL, Gordon, CM, Green, RC, Greenstein, P, Gubbels, CS, Rubio-Gozalbo, ME, Schomer, D, Welt, C, Anastasoaie, V, D'Anna, K, Gentile, J, Guo, CY, Hecht, L, Jackson, R, Jansma, BM, Li, Y, Lip, V, Miller, DT, Murray, M, Power, L, Quinn, N, Rohr, F, Shen, Y, Skinder-Meredith, A, Timmers, I, Tunick, R, Wessel, A, Levy, H, Elsas, L & Berry, GT 2012, 'The adult galactosemic phenotype', Journal of Inherited Metabolic Disease, vol. 32, no. 2, pp. 279-286. https://doi.org/10.1007/s10545-011-9372-y

The adult galactosemic phenotype. / Waisbren, S.E.; Potter, N.L.; Gordon, C.M.; Green, R.C.; Greenstein, P.; Gubbels, C.S.; Rubio-Gozalbo, M.E.; Schomer, D.; Welt, C.; Anastasoaie, V.; D'Anna, K.; Gentile, J.; Guo, C.Y.; Hecht, L.; Jackson, R.; Jansma, B.M.; Li, Y.; Lip, V.; Miller, D.T.; Murray, M.; Power, L.; Quinn, N.; Rohr, F.; Shen, Y.; Skinder-Meredith, A.; Timmers, I.; Tunick, R.; Wessel, A.; Levy, H.; Elsas, L.; Berry, G.T.

In: Journal of Inherited Metabolic Disease, Vol. 32, No. 2, 01.03.2012, p. 279-286.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The adult galactosemic phenotype

AU - Waisbren, S.E.

AU - Potter, N.L.

AU - Gordon, C.M.

AU - Green, R.C.

AU - Greenstein, P.

AU - Gubbels, C.S.

AU - Rubio-Gozalbo, M.E.

AU - Schomer, D.

AU - Welt, C.

AU - Anastasoaie, V.

AU - D'Anna, K.

AU - Gentile, J.

AU - Guo, C.Y.

AU - Hecht, L.

AU - Jackson, R.

AU - Jansma, B.M.

AU - Li, Y.

AU - Lip, V.

AU - Miller, D.T.

AU - Murray, M.

AU - Power, L.

AU - Quinn, N.

AU - Rohr, F.

AU - Shen, Y.

AU - Skinder-Meredith, A.

AU - Timmers, I.

AU - Tunick, R.

AU - Wessel, A.

AU - Levy, H.

AU - Elsas, L.

AU - Berry, G.T.

PY - 2012/3/1

Y1 - 2012/3/1

N2 - BACKGROUND: Classic galactosemia is an autosomal recessive disorder due to galactose-1-phosphate uridyltransferase (GALT) deficiency. Newborn screening and early treatment do not completely prevent tremor, speech deficits, and diminished IQ in both sexes and premature ovarian insufficiency (POI) in women. Data on how individuals with galactosemia fare as adults will improve our ability to predict disease progression.METHODS: Thirty-three adults (mean age = 32.6 ± 11.7 years; range = 18-59) with classic galactosemia, confirmed by genotype and undetectable GALT enzyme activity, were evaluated. Analyses assessed associations among age, genotype, clinical features and laboratory measures.RESULTS: The sample included 17 men and 16 women. Subjects exhibited cataracts (21%), low bone density (24%), tremor (46%), ataxia (15%), dysarthria (24%), and apraxia of speech (9%). Subjects reported depression (39%) and anxiety (67%). Mean full scale IQ was 88 ± 20, (range = 55-122). All subjects followed a dairy-free diet and 75-80% reported low intake of calcium and vitamin D. Mean height, weight and body mass were within established norms. All female subjects had been diagnosed with POI. One woman and two men had had children. Logistic regression analyses revealed no associations between age, genotype or gender with IQ, tremor, ataxia, dysarthria, apraxia of speech or anxiety. Each 10- year increment of age was associated with a twofold increase in odds of depression.CONCLUSIONS: Taken together, these data do not support the hypothesis that galactosemia is a progressive neurodegenerative disease. However, greater attention to depression, anxiety, and social relationships may relieve the impact of this disorder in adults.

AB - BACKGROUND: Classic galactosemia is an autosomal recessive disorder due to galactose-1-phosphate uridyltransferase (GALT) deficiency. Newborn screening and early treatment do not completely prevent tremor, speech deficits, and diminished IQ in both sexes and premature ovarian insufficiency (POI) in women. Data on how individuals with galactosemia fare as adults will improve our ability to predict disease progression.METHODS: Thirty-three adults (mean age = 32.6 ± 11.7 years; range = 18-59) with classic galactosemia, confirmed by genotype and undetectable GALT enzyme activity, were evaluated. Analyses assessed associations among age, genotype, clinical features and laboratory measures.RESULTS: The sample included 17 men and 16 women. Subjects exhibited cataracts (21%), low bone density (24%), tremor (46%), ataxia (15%), dysarthria (24%), and apraxia of speech (9%). Subjects reported depression (39%) and anxiety (67%). Mean full scale IQ was 88 ± 20, (range = 55-122). All subjects followed a dairy-free diet and 75-80% reported low intake of calcium and vitamin D. Mean height, weight and body mass were within established norms. All female subjects had been diagnosed with POI. One woman and two men had had children. Logistic regression analyses revealed no associations between age, genotype or gender with IQ, tremor, ataxia, dysarthria, apraxia of speech or anxiety. Each 10- year increment of age was associated with a twofold increase in odds of depression.CONCLUSIONS: Taken together, these data do not support the hypothesis that galactosemia is a progressive neurodegenerative disease. However, greater attention to depression, anxiety, and social relationships may relieve the impact of this disorder in adults.

U2 - 10.1007/s10545-011-9372-y

DO - 10.1007/s10545-011-9372-y

M3 - Article

VL - 32

SP - 279

EP - 286

JO - Journal of Inherited Metabolic Disease

JF - Journal of Inherited Metabolic Disease

SN - 0141-8955

IS - 2

ER -

Waisbren SE, Potter NL, Gordon CM, Green RC, Greenstein P, Gubbels CS et al. The adult galactosemic phenotype. Journal of Inherited Metabolic Disease. 2012 Mar 1;32(2):279-286. https://doi.org/10.1007/s10545-011-9372-y