Evaluation of glucose tolerance and effect of dietary management on increased visceral fat in a patient with Werner syndrome
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- Yamamoto Reina
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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- Akasaki Kyota
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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- Horita Masataka
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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- Yonezawa Makoto
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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- Asakura Hiroki
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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- Kanamori Takehiro
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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- Maezawa Yoshiro
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
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- Koshizaka Masaya
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
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- Yokote Koutaro
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
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- Kurita Seiichiro
- Department of Endocrinology and Metabolism, National Hospital Organization Kanazawa Medical Center, Ishikawa 920-8650, Japan
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Abstract
<p>Werner syndrome (WS), a type of progeria, is a hereditary condition caused by a mutation in the WRN gene. A 62-year-old Japanese woman was diagnosed with WS at the age of 32 and has been visiting the hospital for follow-up since the last 30 years. The patient developed diabetes at the age of 46, and at the age of 60, her body mass index increased from 20.1 to 22.7 kg/m2 owing to her unhealthy eating habits; her visceral fat area at the age of 61 was 233 cm2. With dietary control, her body weight, including the visceral fat and subcutaneous fat, decreased at the age of 62, and her insulin secretion, obesity, and fatty liver improved. We conducted the oral glucose challenge test four times, including at the prediabetic stage, to evaluate the insulin-secretion ability. The patient’s insulin resistance gradually increased for more than 14 years, and her insulin secretion ability began to decrease 14 years after her diabetes diagnosis. Despite a remarkable decrease in body weight and fat mass with dietary management, the psoas muscle index did not decrease significantly in proportion to the body weight or fat mass. However, muscle mass monitoring is important for preventing the progression of sarcopenia. Hence, gradual reduction of visceral fat and weight by dietary management may be useful in treating diabetes in patients with WS, particularly in those whose visceral fat is significantly increased.</p>
Journal
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- Endocrine Journal
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Endocrine Journal 67 (12), 1239-1246, 2020
The Japan Endocrine Society