Sialylated sarcolemmal glycoproteins include α-dystroglycan, neural cell adhesion molecule (NCAM), neprilysin, insulin-like growth factor 1 (IGFR1), tumor necrosis factor receptor 1 (TNFR1), and β1-integrin, which play roles in skeletal muscle cell signaling pathways, cytoskeleton and extracellular matrix interactions, muscle regeneration, and response to stress and mechanical load; several of these have been shown to be hyposialylated in GNE myopathy [8–12, 35]. Here, IGF1 is linked to Distal myopathy, Nonaka type.