Targeted deletion of liver glucose-6 phosphatase mimics glycogen storage disease type 1a including development of multiple adenomas

Background and Aims Glycogen storage disease type 1a (GSD1a) is an inherited disease caused by a deficiency in the catalytic subunit of the glucose-6 phosphatase enzyme (G6Pase). GSD1a is characterized by hypoglycaemia, hyperlipidemia, and lactic acidosis with associated hepatic (including hepatocellular adenomas), renal, and intestinal disorders. A total G6pc (catalytic subunit of G6Pase) knock-out mouse model has been generated that mimics the human pathology. However, these mice rarely live longer than 3months and long-term liver pathogenesis cannot be evaluated. Herein, we report the long-term characterization of a liver-specific G6pc knock-out mouse model (L- G6pc −/− ). Methods We generated L- G6pc −/− mice using an inducible CRE-lox strategy and followed up the development of hepatic tumours using magnetic resonance imaging. Results L- G6pc −/− mice are viable and exhibit normoglycemia in the fed state. They develop hyperlipidemia, lactic acidosis, and uricemia during the first month after gene deletion. However, these plasmatic parameters improved after 6months. L- G6pc −/− mice develop hepatomegaly with glycogen accumulation and hepatic steatosis. Using an MRI approach, we could detect hepatic nodules with diameters of less than 1mm, 9months after induction of deficiency. Hepatic nodules (1mm) were detected in 30–40% of L- G6pc −/− mice at 12months. After 18months, all L- G6pc −/− mice developed multiple hepatocellular adenomas of 1–10mm diameter. Conclusions This is the first report of a viable animal model of the hepatic pathology of GSD1a, including the late development of hepatocellular adenomas.