Liver glycogen stores via 13C magnetic resonance spectroscopy in healthy children: randomized, controlled study

Horstman, Astrid MH.; Bawden, Stephen J.; Spicer, Abi; Darwish, Noura; Goyer, Amélie; Egli, Léonie; Rupp, Natacha; Minehira, Kaori; Gowland, Penny; Breuillé, Denis; Macdonald, Ian A.; Simpson, Elizabeth J.

Abstract

Background
Owing to its role in glucose homeostasis, liver glycogen concentration ([LGly]) can be a marker of altered metabolism seen in disorders which impact health of children. However, there is a paucity of normative data for this measure in children to allow comparison with patients, and time-course assessment of [LGly] in response to feeding has not been reported. 13C-magnetic resonance spectroscopy (13C-MRS) is used extensively in research to non-invasively assess liver metabolites in adult health and disease, but similar measurements in children are lacking.

Objective
The main objectives were to quantify the depletion of [LGly] after overnight fasting, and the subsequent response to feeding.

Design
In a randomized, open-label, incomplete block design study, healthy, normal-weight children (8-12y) attended 2 evening visits, each separated by ≥5 days and directly followed by a morning visit. An individually tailored, standardized meal was consumed 3-hours prior to evening assessments. Participants then remained fasted until the morning visit. [LGly] was assessed once in the fed (20:00hrs) and fasted state (08:00hrs) using 13C-MRS. After the 8:00hrs assessment, 200ml of a mixed-macronutrient drink containing 15.5g (402kJ) or 31g carbohydrate (804kJ), or water only, was consumed, with 13C-MRS measurements then performed hourly for 4h. Each child was randomized to 2 of 3 drink options across the 2 mornings. Data are expressed as mean (SD).

Results
Twenty-four children (13F:11M) completed the study (9.9(1.1)y, BMI percentile 45.7(25.9)). [LGly] decreased from 377.9(141.3) to 277.3(107.4) mmol·l-1 overnight; depletion rate 0.14(0.15) mmol·l-1·min-1. Incremental responses of [LGly] to test drinks differed (P<0.001), with incremental net AUC of [LGly] over 4h (i.netAUC240min) being higher for 15.5g (-67.1(205.8) mmol·l-1·240min; P<0.01) and 31g carbohydrate (101.6(180.9) mmol·l-1·240min; P<0.005) compared to water (-253.1(231.2) mmol·l-1·240min).

Conclusion
After overnight fasting, [LGly] decreased by 22.9(25.1)%, and [LGly] i.netAUC240min was higher after subsequent consumption of 15.5g and 31g carbohydrate, compared to water.

Clinical Trial Registry number: NCT04278209 (www.clinicaltrials.gov)

Citation

Horstman, A. M., Bawden, S. J., Spicer, A., Darwish, N., Goyer, A., Egli, L., …Simpson, E. J. (2023). Liver glycogen stores via 13C magnetic resonance spectroscopy in healthy children: randomized, controlled study. American Journal of Clinical Nutrition, https://doi.org/10.1016/j.ajcnut.2023.01.014

• Journal Article Type: Article
• Acceptance Date: Jan 13, 2023
• Publication Date: 2023-01
• Deposit Date: Jan 29, 2023
• Publicly Available Date: Feb 2, 2023
• Journal: The American Journal of Clinical Nutrition
• Print ISSN: 0002-9165
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.ajcnut.2023.01.014
• Keywords: Muscle glycogen concentration, fasting, feeding, carbohydrate metabolism, gastric emptying
• Public URL: https://nottingham-repository.worktribe.com/output/16507001
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0002916523005427?via%3Dihub