Recently, another case of moderate erythrocyte AK1 deficiency associated with chronic non-spherocytic hemolytic anemia in China was reported, suggesting that decreased AK1 protein enzyme activity may cause AMP-activated protein kinase (AMPK) dysregulation, which in turn leads to glycogen synthase kinase-3 beta activation and neurodegeneration [29]. Here, AK1 is linked to hyperinsulinemic hypoglycemia, familial, 4.