Guanidinoacetic acid deficiency: a new entity in clinical medicine?

Int J Med Sci. 2020 Sep 12;17(16):2544-2550. doi: 10.7150/ijms.47757. eCollection 2020.

Abstract

Guanidinoacetic acid (GAA, also known as glycocyamine or betacyamine) is a naturally-occurring derivative of glycine and a direct metabolic precursor of creatine, a key player in high-phosphate cellular bioenergetics. GAA is found in human serum and urine, with circulating GAA likely reflects an equilibrium between its endogenous production and utilization/excretion. GAA deficiency (as indicated by low serum GAA) has been reported in various conditions yet this intriguing clinical entity appears to be poorly characterized as yet, either as a primary deficit or a sequel of secondary disease. This minireview article summarizes the inherited and acquired disorders with apparent GAA deficiency and discusses a possible relevance of GAA shortfall in clinical medicine.

Keywords: AGAT deficiency; epilepsy; guanidinoacetic acid; renal failure; traumatic injury.

Publication types

  • Review

MeSH terms

  • Creatine / metabolism
  • Energy Metabolism
  • Glycine / analogs & derivatives*
  • Glycine / blood
  • Glycine / deficiency
  • Glycine / metabolism
  • Glycine / urine
  • Humans
  • Metabolic Diseases / blood
  • Metabolic Diseases / etiology*
  • Metabolic Diseases / metabolism
  • Metabolic Diseases / urine

Substances

  • glycocyamine
  • Creatine
  • Glycine