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Tarantino RM, Abreu GDM, Fonseca ACPD, Kupfer R, Pereira MDFC, Campos Júnior M, Zajdenverg L, Rodacki M. MODY probability calculator for GCK and HNF1A screening in a multiethnic background population. Arch Endocrinol Metab 2020; 64:17-23. [PMID: 31576961 PMCID: PMC10522291 DOI: 10.20945/2359-3997000000173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/19/2019] [Indexed: 11/23/2022]
Abstract
Objective We aimed to identify the frequency of monogenic diabetes, which is poorly studied in multiethnic populations, due to GCK or HNF1A mutations in patients with suggestive clinical characteristics from the Brazilian population, as well as investigate if the MODY probability calculator (MPC) could help patients with their selection. Subjects and methods Inclusion criteria were patients with DM diagnosed before 35 years; body mass index < 30 kg/m2; negative autoantibodies; and family history of DM in two or more generations. We sequenced HNF1A in 27 patients and GCK in seven subjects with asymptomatic mild fasting hyperglycemia. In addition, we calculated MODY probability with MPC. Results We identified 11 mutations in 34 patients (32.3%). We found three novel mutations. In the GCK group, six cases had mutations (85.7%), and their MODY probability on MPC was higher than 50%. In the HNF1A group, five of 27 individuals had mutations (18.5%). The MPC was higher than 75% in 11 subjects (including all five cases with HNF1A mutations). Conclusion Approximately one third of the studied patients have GCK or HNF1A mutations. Inclusion criteria included efficiency in detecting patients with GCK mutations but not for HNF1A mutations (< 20%). MPC was helpful in narrowing the number of candidates for HNF1A screening.
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Affiliation(s)
| | | | | | - Rosane Kupfer
- Instituto Estadual de Diabetes e Endocrinologia do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Mario Campos Júnior
- Laboratório de Genética Humana, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Lenita Zajdenverg
- Departamento de Medicina Interna, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Melanie Rodacki
- Departamento de Medicina Interna, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Nowak N, Szopa M, Thanabalasingham G, McDonald TJ, Colclough K, Skupien J, James TJ, Kiec-Wilk B, Kozek E, Mlynarski W, Hattersley AT, Owen KR, Malecki MT. Cystatin C is not a good candidate biomarker for HNF1A-MODY. Acta Diabetol 2013; 50:815-20. [PMID: 22350134 PMCID: PMC3898131 DOI: 10.1007/s00592-012-0378-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 01/30/2012] [Indexed: 11/25/2022]
Abstract
Cystatin C is a marker of glomerular filtration rate (GFR). Its level is influenced, among the others, by CRP whose concentration is decreased in HNF1A-MODY. We hypothesized that cystatin C level might be altered in HNF1A-MODY. We aimed to evaluate cystatin C in HNF1A-MODY both as a diagnostic marker and as a method of assessing GFR. We initially examined 51 HNF1A-MODY patients, 56 subjects with type 1 diabetes (T1DM), 39 with type 2 diabetes (T2DM) and 43 non-diabetic individuals (ND) from Poland. Subjects from two UK centres were used as replication panels: including 215 HNF1A-MODY, 203 T2DM, 39 HNF4A-MODY, 170 GCK-MODY, 17 HNF1B-MODY and 58 T1DM patients. The data were analysed with additive models, adjusting for gender, age, BMI and estimated GFR (creatinine). In the Polish subjects, adjusted cystatin C level in HNF1A-MODY was lower compared with T1DM, T2DM and ND (p < 0.05). Additionally, cystatin C-based GFR was higher than that calculated from creatinine level (p < 0.0001) in HNF1A-MODY, while the two GFR estimates were similar or cystatin C-based lower in the other groups. In the UK subjects, there were no differences in cystatin C between HNF1A-MODY and the other diabetic subgroups, except HNF1B-MODY. In UK HNF1A-MODY, cystatin C-based GFR estimate was higher than the creatinine-based one (p < 0.0001). Concluding, we could not confirm our hypothesis (supported by the Polish results) that cystatin C level is altered by HNF1A mutations; thus, it cannot be used as a biomarker for HNF1A-MODY. In HNF1A-MODY, the cystatin C-based GFR estimate is higher than the creatinine-based one.
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Affiliation(s)
- Natalia Nowak
- Department of Metabolic Diseases, Jagiellonian University Medical College, 15 Kopernika Street, 31-501 Krakow, Poland
| | - Magdalena Szopa
- Department of Metabolic Diseases, Jagiellonian University Medical College, 15 Kopernika Street, 31-501 Krakow, Poland
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
- University Hospital, Krakow, Poland
| | - Gaya Thanabalasingham
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- The Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Tim J. McDonald
- NIHR Clinical Research Facility, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, Devon UK
| | - Kevin Colclough
- The Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Jan Skupien
- Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, MA USA
| | - Timothy J. James
- Department of Clinical Biochemistry, John Radcliffe Hospital, Oxford, UK
| | - Beata Kiec-Wilk
- Department of Metabolic Diseases, Jagiellonian University Medical College, 15 Kopernika Street, 31-501 Krakow, Poland
- University Hospital, Krakow, Poland
| | - Elzbieta Kozek
- Department of Metabolic Diseases, Jagiellonian University Medical College, 15 Kopernika Street, 31-501 Krakow, Poland
- University Hospital, Krakow, Poland
| | - Wojciech Mlynarski
- Department of Paediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Andrew T. Hattersley
- NIHR Clinical Research Facility, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, Devon UK
| | - Katharine R. Owen
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- The Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Maciej T. Malecki
- Department of Metabolic Diseases, Jagiellonian University Medical College, 15 Kopernika Street, 31-501 Krakow, Poland
- University Hospital, Krakow, Poland
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