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Chow E, Wang K, Lim CK, Tsoi ST, Fan B, Poon E, Luk AO, Ma RC, Ferrannini E, Mari A, Chen L, Chan JC. Dorzagliatin, a Dual-Acting Glucokinase Activator, Increases Insulin Secretion and Glucose Sensitivity in Glucokinase Maturity-Onset Diabetes of the Young and Recent-Onset Type 2 Diabetes. Diabetes 2023; 72:299-308. [PMID: 36342518 PMCID: PMC9871194 DOI: 10.2337/db22-0708] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022]
Abstract
Glucokinase (GK, gene symbol GCK) maturity-onset diabetes of the young (MODY) is caused by heterozygous inactivating mutations in GK and impaired glucose sensing. We investigated effects of dorzagliatin, a novel allosteric GK activator, on insulin secretion rates (ISRs) and β-cell glucose sensitivity (βCGS) in GCK-MODY and recent-onset type 2 diabetes. In a double-blind, randomized, crossover study, 8 participants with GCK-MODY and 10 participants with type 2 diabetes underwent 2-h 12 mmol/L hyperglycemic clamps following a single oral dose of dorzagliatin 75 mg or matched placebo. Effects of dorzagliatin on wild-type and mutant GK enzyme activity were investigated using an NADP+-coupled assay with glucose-6-phosphate dehydrogenase in vitro. In GCK-MODY, dorzagliatin significantly increased absolute and incremental second-phase ISRs versus placebo but not the acute insulin response. Dorzagliatin improved βCGS in GCK-MODY with an upward and leftward shift in ISR-glucose response. Dorzagliatin increased basal ISRs in type 2 diabetes, with smaller changes in second-phase ISRs versus GCK-MODY. In vitro, dorzagliatin directly reduced the glucose half saturation concentration of wild-type GK and selected GK mutants to varying degrees. Dorzagliatin directly restored enzyme activity of select GK mutants and enhanced wild-type GK activity, thereby correcting the primary defect of glucose sensing in GCK-MODY.
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Affiliation(s)
- Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
- Corresponding authors: Juliana C.N. Chan, , and Elaine Chow,
| | - Ke Wang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
| | - Cadmon K.P. Lim
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Sandra T.F. Tsoi
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Baoqi Fan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Poon
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Andrea O.Y. Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
| | - Ronald C.W. Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Ele Ferrannini
- Institute of Clinical Physiology, National Research Council of Italy (CNR), Pisa, Italy
| | - Andrea Mari
- Institute of Neuroscience, National Research Council of Italy (CNR), Padua, Italy
| | - Li Chen
- Hua Medicine, Shanghai, China
| | - Juliana C.N. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong, China
- Corresponding authors: Juliana C.N. Chan, , and Elaine Chow,
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Maltoni G, Franceschi R, Di Natale V, Al-Qaisi R, Greco V, Bertorelli R, De Sanctis V, Quattrone A, Mantovani V, Cauvin V, Zucchini S. Next Generation Sequencing Analysis of MODY-X Patients: A Case Report Series. J Pers Med 2022; 12:jpm12101613. [PMID: 36294752 PMCID: PMC9605085 DOI: 10.3390/jpm12101613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Classic criteria for a maturity-onset diabetes of the young (MODY) diagnosis are often unable to identify all subjects, and traditional Sanger sequencing, using a candidate gene approach, leads to a high prevalence of missed genetic diagnosis, classified as MODY-X. Next generation sequencing (NGS) panels provide a highly sensitive method even for rare forms. METHODS We investigated 28 pediatric subjects suspected for MODY-X, utilizing a 15-gene NGS panel for monogenic diabetes (MD). RESULTS NGS detected variants of uncertain significance (VUS), likely pathogenic or pathogenic for rarer subtypes of MODY, in six patients. We found variants in the wolframin gene (WFS1), traditionally not considered in MD genetic screening panels, in three patients; KCNJ11 gene mutation, typically responsible for neonatal diabetes and rarely causing isolated diabetes in adolescents; INS gene mutation; a variant in the HNF1B gene in a young male with diabetes on sulfonylurea treatment. CONCLUSION In our cohort, the availability of an NGS panel for MD was determined for the correct identification of MD subtypes in six patients with MODY-X. Our study underlines how a precise diagnosis utilizing NGS may have an impact on the management of different forms of MODY and, thus, lead to a tailored treatment and enable genetic counselling of other family members.
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Affiliation(s)
- Giulio Maltoni
- Pediatric Unit, IRCCS AOU, S. Orsola-Malpighi, 40138 Bologna, Italy
| | - Roberto Franceschi
- Pediatric Unit, S. Chiara Hospital of Trento, 38122 Trento, Italy
- Correspondence:
| | | | - Randa Al-Qaisi
- Pediatric Unit, IRCCS AOU, S. Orsola-Malpighi, 40138 Bologna, Italy
| | - Valentina Greco
- Advanced Molecular Diagnostic Laboratory, Department CIBIO-DMA, University of Trento, 38123 Trento, Italy
| | - Roberto Bertorelli
- Next Generation Sequencing Core Facility, LaBSSAH, Department CIBIO, University of Trento, 38123 Trento, Italy
| | - Veronica De Sanctis
- Next Generation Sequencing Core Facility, LaBSSAH, Department CIBIO, University of Trento, 38123 Trento, Italy
| | - Alessandro Quattrone
- Laboratory of Translational Genomics, Department CIBIO, University of Trento, 38123 Trento, Italy
| | - Vilma Mantovani
- Applied Biomedical Research Center, CRBA, S. Orsola-Malpighi, 40138 Bologna, Italy
| | - Vittoria Cauvin
- Pediatric Unit, S. Chiara Hospital of Trento, 38122 Trento, Italy
| | - Stefano Zucchini
- Pediatric Unit, IRCCS AOU, S. Orsola-Malpighi, 40138 Bologna, Italy
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Brandes GIG, Peixoto-Barbosa R, Meski APG, Giuffrida FMA, Reis AF. Granuloma annulare and necrobiosis lipoidica in a patient with HNF1A-MODY. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:2359-3997000000477. [PMID: 35551682 PMCID: PMC9832856 DOI: 10.20945/2359-3997000000477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022]
Abstract
Maturity-onset diabetes of the young (MODY) is a heterogeneous group of monogenic forms of diabetes mellitus with distinct clinical features. Clinical dermatological phenotypes in MODY patients are very rare in literature. This report describes a patient with HNF1A-MODY presenting with necrobiosis lipoidica (NL) and granuloma annulare (GA). A 39-year-old asymptomatic woman, with atypical diabetes diagnosed at age 17, has a confirmed HNF1A mutation on exon 2 (c.392G>A, p.R131Q), classified as Pathogenic by the ACMG guidelines. She has reasonable metabolic control using oral anti-diabetic medications and has no chronic diabetic complications. Clinical and histologic diagnoses of both NL and GA were made. We discuss these conditions and their association with MODY.
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Affiliation(s)
| | - Renata Peixoto-Barbosa
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, BA, Brasil
| | - Ana Paula Gomes Meski
- Departamento de Dermatologia, Hospital das Clínicas, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Fernando M A Giuffrida
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil,
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, BA, Brasil
- Fernando M. A. Giuffrida is joint senior author
| | - André F Reis
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
- André F. Reis is joint senior author
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A Comprehensive Analysis of Hungarian MODY Patients-Part II: Glucokinase MODY Is the Most Prevalent Subtype Responsible for about 70% of Confirmed Cases. Life (Basel) 2021; 11:life11080771. [PMID: 34440516 PMCID: PMC8400228 DOI: 10.3390/life11080771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/20/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023] Open
Abstract
MODY2 is caused by heterozygous inactivating mutations in the glucokinase (GCK) gene that result in persistent, stable and mild fasting hyperglycaemia (5.6–8.0 mmol/L, glycosylated haemoglobin range of 5.6–7.3%). Patients with GCK mutations usually do not require any drug treatment, except during pregnancy. The GCK gene is considered to be responsible for about 20% of all MODY cases, transcription factors for 67% and other genes for 13% of the cases. Based on our findings, GCK and HNF1A mutations together are responsible for about 90% of the cases in Hungary, this ratio being higher than the 70% reported in the literature. More than 70% of these patients have a mutation in the GCK gene, this means that GCK-MODY is the most prevalent form of MODY in Hungary. In the 91 index patients and their 72 family members examined, we have identified a total of 65 different pathogenic (18) and likely pathogenic (47) GCK mutations of which 28 were novel. In two families, de novo GCK mutations were detected. About 30% of the GCK-MODY patients examined were receiving unnecessary OAD or insulin therapy at the time of requesting their genetic testing, therefore the importance of having a molecular genetic diagnosis can lead to a major improvement in their quality of life.
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Franco LF, Szarf G, Dotto RP, Dib SA, Moises RS, Giuffrida FMA, Reis AF. Cardiovascular risk assessment by coronary artery calcium score in subjects with maturity-onset diabetes of the young caused by glucokinase mutations. Diabetes Res Clin Pract 2021; 176:108867. [PMID: 34023340 DOI: 10.1016/j.diabres.2021.108867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 04/13/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
AIMS Maturity-Onset Diabetes of the Young (MODY) caused by glucokinase (GCK) mutations is characterized by lifelong mild non-progressive hyperglycemia, with low frequency of coronary artery disease (CAD) compared to other types of diabetes. The aim of this study is to estimate cardiovascular risk by coronary artery calcification (CAC) score in this group. MATERIALS AND METHODS Twenty-nine GCK-MODY cases, 26 normoglycemic controls (recruited among non-affected relatives/spouses of GCK mutation carriers), and 24 unrelated individuals with type 2 diabetes were studied. Patients underwent CAC score evaluation by computed tomography and were classified by Agatston score ≥ or < 10. Framingham Risk scores of CAD in 10 years were calculated. RESULTS Median [interquartile range] CAC score in GCK-MODY was 0 [0,0], similar to controls (0 [0,0], P = 0.49), but lower than type 2 diabetes (39 [0, 126], P = 2.6 × 10-5). A CAC score ≥ 10 was seen in 6.9% of the GCK group, 7.7% of Controls (P = 1.0), and 54.2% of individuals with type 2 diabetes (P = 0.0006). Median Framingham risk score was lower in GCK than type 2 diabetes (3% vs. 13%, P = 4 × 10-6), but similar to controls (3% vs. 4%, P = 0.66). CONCLUSIONS CAC score in GCK-MODY is similar to control individuals from the same family and/or household and is significantly lower than type 2 diabetes. Besides demonstrating low risk of CAD in GCK-MODY, these findings may contribute to understanding the specific effect of hyperglycemia in CAD.
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Affiliation(s)
- Luciana F Franco
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Gilberto Szarf
- Departamento de Diagnóstico por Imagem, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Renata P Dotto
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sergio A Dib
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Regina S Moises
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Fernando M A Giuffrida
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Brazil.
| | - André F Reis
- Disciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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6
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de Santana LS, Caetano LA, Costa‐Riquetto AD, Franco PC, Dotto RP, Reis AF, Weinert LS, Silveiro SP, Vendramini MF, do Prado FA, Abrahão GCP, de Almeida AGFP, Tavares MDGR, Gonçalves WRB, Santomauro Junior AC, Halpern B, Jorge AAL, Nery M, Teles MG. Targeted sequencing identifies novel variants in common and rare MODY genes. Mol Genet Genomic Med 2019; 7:e962. [PMID: 31595705 PMCID: PMC6900361 DOI: 10.1002/mgg3.962] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 08/09/2019] [Accepted: 08/13/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Maturity-onset diabetes of the young (MODY) is a form of monogenic diabetes with autosomal dominant inheritance. To date, mutations in 11 genes have been frequently associated with this phenotype. In Brazil, few cohorts have been screened for MODY, all using a candidate gene approach, with a high prevalence of undiagnosed cases (MODY-X). METHODS We conducted a next-generation sequencing target panel (tNGS) study to investigate, for the first time, a Brazilian cohort of MODY patients with a negative prior genetic analysis. One hundred and two patients were selected, of which 26 had an initial clinical suspicion of MODY-GCK and 76 were non-GCK MODY. RESULTS After excluding all benign and likely benign variants and variants of uncertain significance, we were able to assign a genetic cause for 12.7% (13/102) of the probands. Three rare MODY subtypes were identified (PDX1/NEUROD1/ABCC8), and eight variants had not been previously described/mapped in genomic databases. Important clinical findings were evidenced in some cases after genetic diagnosis, such as MODY-PDX1/HNF1B. CONCLUSION A multiloci genetic approach allowed the identification of rare MODY subtypes, reducing the large percentage of MODY-X in Brazilian cases and contributing to a better clinical, therapeutic, and prognostic characterization of these rare phenotypes.
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Affiliation(s)
- Lucas S. de Santana
- Monogenic Diabetes GroupGenetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25School of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
| | - Lilian A. Caetano
- Monogenic Diabetes GroupGenetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25School of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
- Diabetes UnitClinics HospitalSchool of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
| | - Aline D. Costa‐Riquetto
- Monogenic Diabetes GroupGenetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25School of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
- Diabetes UnitClinics HospitalSchool of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
| | - Pedro C. Franco
- Monogenic Diabetes GroupGenetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25School of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
- Diabetes UnitClinics HospitalSchool of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
| | - Renata P. Dotto
- Departamento de MedicinaDisciplina de EndocrinologiaUniversidade Federal de São Paulo (UNIFESP)Sao PauloSPBrazil
| | - André F. Reis
- Departamento de MedicinaDisciplina de EndocrinologiaUniversidade Federal de São Paulo (UNIFESP)Sao PauloSPBrazil
| | | | | | - Marcio F. Vendramini
- Serviço de EndocrinologiaHospital do Servidor Público Estadual de São Paulo (HSPE‐SP)Sao PauloSPBrazil
| | - Flaviene A. do Prado
- Hospital Regional de Taguatinga da Secretaria de Saúde do Distrito FederalTaguatingaDFBrazil
| | | | | | | | | | - Augusto C. Santomauro Junior
- Serviço de Endocrinologia Prof. Dr. Fadlo Fraige FilhoHospital Beneficência Portuguesa de São Paulo (BP‐SP)Sao PauloSPBrazil
| | - Bruno Halpern
- Departamento de Endocrinologia e MetabologiaHospital das ClínicasFaculdade de MedicinaUniversidade de São Paulo (USP)Sao PauloSPBrazil
| | - Alexander A. L. Jorge
- Monogenic Diabetes GroupGenetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25School of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
| | - Marcia Nery
- Diabetes UnitClinics HospitalSchool of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
| | - Milena G. Teles
- Monogenic Diabetes GroupGenetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25School of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
- Diabetes UnitClinics HospitalSchool of MedicineUniversity of Sao Paulo (USP)Sao PauloSPBrazil
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Ben Khelifa S, Martinez R, Dandana A, Khochtali I, Ferchichi S, Castaño L. Maturity Onset Diabetes of the Young (MODY) in Tunisia: Low frequencies of GCK and HNF1A mutations. Gene 2018; 651:44-48. [DOI: 10.1016/j.gene.2018.01.081] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 01/14/2018] [Accepted: 01/24/2018] [Indexed: 12/16/2022]
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8
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P. S, D. TK, C. GPD, R. S, Zayed H. Determining the role of missense mutations in the POU domain of HNF1A that reduce the DNA-binding affinity: A computational approach. PLoS One 2017; 12:e0174953. [PMID: 28410371 PMCID: PMC5391926 DOI: 10.1371/journal.pone.0174953] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/18/2017] [Indexed: 12/21/2022] Open
Abstract
Maturity-onset diabetes of the young type 3 (MODY3) is a non-ketotic form of diabetes associated with poor insulin secretion. Over the past years, several studies have reported the association of missense mutations in the Hepatocyte Nuclear Factor 1 Alpha (HNF1A) with MODY3. Missense mutations in the POU homeodomain (POUH) of HNF1A hinder binding to the DNA, thereby leading to a dysfunctional protein. Missense mutations of the HNF1A were retrieved from public databases and subjected to a three-step computational mutational analysis to identify the underlying mechanism. First, the pathogenicity and stability of the mutations were analyzed to determine whether they alter protein structure and function. Second, the sequence conservation and DNA-binding sites of the mutant positions were assessed; as HNF1A protein is a transcription factor. Finally, the biochemical properties of the biological system were validated using molecular dynamic simulations in Gromacs 4.6.3 package. Two arginine residues (131 and 203) in the HNF1A protein are highly conserved residues and contribute to the function of the protein. Furthermore, the R131W, R131Q, and R203C mutations were predicted to be highly deleterious by in silico tools and showed lower binding affinity with DNA when compared to the native protein using the molecular docking analysis. Triplicate runs of molecular dynamic (MD) simulations (50ns) revealed smaller changes in patterns of deviation, fluctuation, and compactness, in complexes containing the R131Q and R131W mutations, compared to complexes containing the R203C mutant complex. We observed reduction in the number of intermolecular hydrogen bonds, compactness, and electrostatic potential, as well as the loss of salt bridges, in the R203C mutant complex. Substitution of arginine with cysteine at position 203 decreases the affinity of the protein for DNA, thereby destabilizing the protein. Based on our current findings, the MD approach is an important tool for elucidating the impact and affinity of mutations in DNA-protein interactions and understanding their function.
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Affiliation(s)
- Sneha P.
- School of BioSciences and Technology,Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Thirumal Kumar D.
- School of BioSciences and Technology,Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - George Priya Doss C.
- School of BioSciences and Technology,Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Siva R.
- School of BioSciences and Technology,Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Hatem Zayed
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
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9
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Santana LS, Caetano LA, Costa-Riquetto AD, Quedas EPS, Nery M, Collett-Solberg P, Boguszewski MCS, Vendramini MF, Crisostomo LG, Floh FO, Zarabia ZI, Kohara SK, Guastapaglia L, Passone CGB, Sewaybricker LE, Jorge AAL, Teles MG. Clinical application of ACMG-AMP guidelines in HNF1A and GCK variants in a cohort of MODY families. Clin Genet 2017; 92:388-396. [PMID: 28170077 DOI: 10.1111/cge.12988] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/31/2017] [Accepted: 02/01/2017] [Indexed: 01/05/2023]
Abstract
Maturity-onset diabetes of the young (MODY) is a form of monogenic diabetes with autosomal dominant inheritance. GCK -MODY and HNF1A -MODY are the prevalent subtypes. Currently, there is growing concern regarding the correct interpretation of molecular genetic findings. The American College of Medical Genetics and Genomics (ACMG) updated guidelines to interpret and classify molecular variants. This study aimed to determine the prevalence of MODY ( GCK / HNF1A ) in a large cohort of Brazilian families, to report variants related to phenotype, and to classify them according to ACMG guidelines. One hundred and nine probands were investigated, 45% with clinical suspicion of GCK -MODY and 55% with suspicion of HNF1A -MODY. Twenty-five different variants were identified in GCK gene (30 probands-61% of positivity), and 7 variants in HNF1A (10 probands-17% of positivity). Fourteen of them were novel (12- GCK /2- HNF1A ). ACMG guidelines were able to classify a large portion of variants as pathogenic (36%- GCK /86%- HNF1A ) and likely pathogenic (44%- GCK /14%- HNF1A ), with 16% (5/32) as uncertain significance. This allows us to determine the pathogenicity classification more efficiently, and also reinforces the suspected associations with the phenotype among novel variants.
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Affiliation(s)
- L S Santana
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - L A Caetano
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil.,Diabetes Unit, Clinics Hospital, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - A D Costa-Riquetto
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil.,Diabetes Unit, Clinics Hospital, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - E P S Quedas
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - M Nery
- Diabetes Unit, Clinics Hospital, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - P Collett-Solberg
- Department of Endocrinology, University of Rio de Janeiro State (UERJ), Rio de Janeiro, RJ, Brazil
| | - M C S Boguszewski
- Departamento de Pediatria, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - M F Vendramini
- Serviço de Endocrinologia, Hospital do Servidor Público Estadual de São Paulo (HSPE-SP), Sao Paulo, SP, Brazil
| | - L G Crisostomo
- Serviço de Endocrinologia, Hospital Israelita Albert Eisntein, Sao Paulo, SP, Brazil.,Faculdade de Medicina, Centro Universitário São Camilo, Sao Paulo, SP, Brazil
| | - F O Floh
- Serviço de Endocrinologia, Hospital Israelita Albert Eisntein, Sao Paulo, SP, Brazil
| | - Z I Zarabia
- Serviço de Endocrinologia, Hospital Infantil Dr. Jeser Amarante Faria, Joinville, SC, Brazil
| | - S K Kohara
- Serviço de Endocrinologia, Universidade da Região de Joinville (UNIVILLE), Joinville, SC, Brazil
| | - L Guastapaglia
- Serviço de Endocrinologia, Hospital do Servidor Público Municipal de São Paulo (HSPM-SP), Sao Paulo, SP, Brazil
| | - C G B Passone
- Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), Sao Paulo, SP, Brazil
| | - L E Sewaybricker
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - A A L Jorge
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - M G Teles
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Laboratory of Molecular & Cellular Endocrinology/LIM25, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil.,Diabetes Unit, Clinics Hospital, School of Medicine, University of Sao Paulo (USP), Sao Paulo, SP, Brazil
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10
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Magaña‐Cerino JM, Luna‐Arias JP, Labra‐Barrios ML, Avendaño‐Borromeo B, Boldo‐León XM, Martínez‐López MC. Identification and functional analysis of c.422_423InsT, a novel mutation of the HNF1A gene in a patient with diabetes. Mol Genet Genomic Med 2017; 5:50-65. [PMID: 28116330 PMCID: PMC5241209 DOI: 10.1002/mgg3.261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/07/2016] [Accepted: 10/11/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND HNF1A gene regulates liver-specific genes, and genes that have a role in glucose metabolism, transport, and secretion of insulin. HNF1A gene mutations are frequently associated with type 2 diabetes. HNF1A protein has three domains: the dimerization domain, the DNA-binding domain, and the trans-activation domain. Some mutations in the dimerization or DNA-binding domains have no influence on the normal allele, while others have dominant negative effects. The I27L, A98V, and S487N polymorphisms are common variants of the HNF1A gene; they have been found in T2D and non-diabetic subjects. METHODS AND RESULTS We searched for mutations in the first three exons of the HNF1A gen in an Amerindian population of 71 diabetic patients. DNA sequencing revealed the previously reported I27L polymorphism (c.79A>C) in 53% of diabetic patients and in 67% of the control group. Thus, the I27L/L27L polymorphism might be a marker of Amerindians. In addition, we found the c.422_423InsT mutation in the HNF1A gene of one patient, which had not been previously reported. This mutation resulted in a frame shift of the open reading frame and a new translation stop in codon 187, leading to a truncated polypeptide of 186 amino acids (Q141Hfs*47). This novel mutation affects the DNA-binding capacity of the mutant HNF1A protein by EMSA; its intracellular localization by fluorescence and confocal microscopy, and a dominant-negative effect affecting the DNA-binding capacity of the normal HNF1A by EMSA. We also studied the homology modeling structure to understand the effect of this mutation on its DNA-binding capacity and its dominant negative effect. CONCLUSION The HNF1A Q141Hfs*47 mutant polypeptide has no DNA-binding capacity and exerts a dominant negative effect on the HNF1A protein. Therefore, it might produce severe phenotypic effects on the expression levels of a set of β-cell genes. Consequently, its screening should be included in the genetic analysis of diabetic patients after more functional studies are performed.
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Affiliation(s)
- Jesús Miguel Magaña‐Cerino
- Centro de Investigación y PosgradoLaboratorio de Diagnóstico MolecularDivisión Académica de Ciencias de la Salud (DACS)Universidad Juárez Autónoma de Tabasco (UJAT)Ave. Gregorio Méndez Magaña. No 2838‐A, Col. Tamulté de las BarrancasVillahermosaC.P. 86150México
| | - Juan P. Luna‐Arias
- Departamento de Biología CelularCentro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV‐IPN)Ave. Instituto Politécnico Nacional 2508, Col. San Pedro ZacatencoCiudad de MéxicoC.P. 07360México
| | - María Luisa Labra‐Barrios
- Departamento de Biología CelularCentro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV‐IPN)Ave. Instituto Politécnico Nacional 2508, Col. San Pedro ZacatencoCiudad de MéxicoC.P. 07360México
| | - Bartolo Avendaño‐Borromeo
- Departamento de Biología CelularCentro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV‐IPN)Ave. Instituto Politécnico Nacional 2508, Col. San Pedro ZacatencoCiudad de MéxicoC.P. 07360México
| | - Xavier Miguel Boldo‐León
- Centro de Investigación y PosgradoLaboratorio de Diagnóstico MolecularDivisión Académica de Ciencias de la Salud (DACS)Universidad Juárez Autónoma de Tabasco (UJAT)Ave. Gregorio Méndez Magaña. No 2838‐A, Col. Tamulté de las BarrancasVillahermosaC.P. 86150México
| | - Mirian Carolina Martínez‐López
- Centro de Investigación y PosgradoLaboratorio de Diagnóstico MolecularDivisión Académica de Ciencias de la Salud (DACS)Universidad Juárez Autónoma de Tabasco (UJAT)Ave. Gregorio Méndez Magaña. No 2838‐A, Col. Tamulté de las BarrancasVillahermosaC.P. 86150México
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11
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Giuffrida FMA, Moises RS, Weinert LS, Calliari LE, Manna TD, Dotto RP, Franco LF, Caetano LA, Teles MG, Lima RA, Alves C, Dib SA, Silveiro SP, Dias-da-Silva MR, Reis AF. Maturity-onset diabetes of the young (MODY) in Brazil: Establishment of a national registry and appraisal of available genetic and clinical data. Diabetes Res Clin Pract 2017; 123:134-142. [PMID: 28012402 DOI: 10.1016/j.diabres.2016.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/12/2016] [Accepted: 10/19/2016] [Indexed: 01/10/2023]
Abstract
AIMS Maturity-Onset Diabetes of the Young (MODY) comprises a heterogeneous group of monogenic forms of diabetes caused by mutations in at least 14 genes, but mostly by mutations in Glucokinase (GCK) and hepatocyte nuclear factor-1 homeobox A (HNF1A). This study aims to establish a national registry of MODY cases in Brazilian patients, assessing published and unpublished data. METHODS 311 patients with clinical characteristics of MODY were analyzed, with unpublished data on 298 individuals described in 12 previous publications and 13 newly described cases in this report. RESULTS 72 individuals had GCK mutations, 9 described in Brazilian individuals for the first time. One previously unpublished novel GCK mutation, Gly178Ala, was found in one family. 31 individuals had HNF1A mutations, 2 described for the first time in Brazilian individuals. Comparisons of GCK probands vs HNF1A: age 16±11 vs 35±20years; age at diagnosis 11±8 vs 21±7years; BMI 19±6 vs 25±6kg/m2; sulfonylurea users 5 vs 83%; insulin users 5 vs 17%; presence of arterial hypertension 0 vs. 33%, all p<0.05. No differences were observed in lipids and C-peptide. CONCLUSIONS Most MODY cases in Brazil are due to GCK mutations. In agreement with other studied populations, novel mutations are common. Only 14% of patients with familial diabetes carry a HNF1A mutation. Diagnosis of other rare forms of MODY is still a challenge in Brazilian population, as well as adequate strategies to screen individuals for molecular diagnosis.
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Affiliation(s)
- Fernando M A Giuffrida
- Universidade do Estado da Bahia (UNEB), Salvador, Brazil; Disciplina de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | - Regina S Moises
- Disciplina de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Leticia S Weinert
- Endocrinology Unit - Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Luis E Calliari
- Faculdade de Medicina da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Thais Della Manna
- Instituto da Criança, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Renata P Dotto
- Disciplina de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Luciana F Franco
- Disciplina de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Lilian A Caetano
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Diabetes Unit, University of Sao Paulo (USP) Medical School, Sao Paulo, Brazil
| | - Milena G Teles
- Monogenic Diabetes Group, Genetic Endocrinology Unit and Diabetes Unit, University of Sao Paulo (USP) Medical School, Sao Paulo, Brazil
| | - Renata Andrade Lima
- Pediatric Endocrinology Unit, University Hospital Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Crésio Alves
- Pediatric Endocrinology Unit, University Hospital Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Sergio A Dib
- Disciplina de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sandra P Silveiro
- Endocrinology Unit - Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Magnus R Dias-da-Silva
- Disciplina de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Andre F Reis
- Disciplina de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
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12
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Abstract
Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes that accounts for at least 1 % of all cases of diabetes mellitus. MODY classically presents as non-insulin-requiring diabetes in lean individuals typically younger than 25 with evidence of autosomal dominant inheritance, but these criteria do not capture all cases and can also overlap with other diabetes types. Genetic diagnosis of MODY is important for selecting the right treatment, yet ~95 % of MODY cases in the USA are misdiagnosed. MODY prevalence and characteristics have been well-studied in some populations, such as the UK and Norway, while other ethnicities, like African and Latino, need much more study. Emerging next-generation sequencing methods are making more widespread study and clinical diagnosis increasingly feasible; at the same time, they are detecting other mutations in the same genes of unknown clinical significance. This review will cover the current epidemiological studies of MODY and barriers and opportunities for moving toward a goal of access to an appropriate diagnosis for all affected individuals.
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Affiliation(s)
- Jeffrey W Kleinberger
- Division of Endocrinology, Diabetes, and Nutrition and Program in Personalized and Genomic Medicine, Department of Medicine, University of Maryland School of Medicine, 660 West Redwood Street, Room 445C, Baltimore, MD, 21201, USA.
| | - Toni I Pollin
- Division of Endocrinology, Diabetes, and Nutrition and Program in Personalized and Genomic Medicine, Department of Medicine, University of Maryland School of Medicine, 660 West Redwood Street, Room 445C, Baltimore, MD, 21201, USA.
- University of Maryland School of Medicine, 660 West Redwood Street, Room 464, Baltimore, MD, 21201, USA.
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13
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Weinert LS, Giuffrida FMA, Silveiro SP, Bulcão C, Kunii IS, Dias-da-Silva MR, Reis AF. Pitfalls in the diagnosis of frameshift mutations in the glucokinase (GCK) gene and the contribution of an additional cloning sequencing tool. Diabetes Res Clin Pract 2015; 108:e3-4. [PMID: 25656763 DOI: 10.1016/j.diabres.2015.01.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 01/18/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Letícia S Weinert
- Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Postgraduate Fellowship Program in Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Fernando M A Giuffrida
- Centro de Endocrinologia do Estado da Bahia (CEDEBA), Salvador, Brazil; Universidade do Estado da Bahia (UNEB), Salvador, Brazil
| | - Sandra P Silveiro
- Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Postgraduate Fellowship Program in Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Caroline Bulcão
- Centro de Endocrinologia do Estado da Bahia (CEDEBA), Salvador, Brazil
| | - Ilda S Kunii
- Laboratory of Molecular and Translacional Endocrinology, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Magnus R Dias-da-Silva
- Laboratory of Molecular and Translacional Endocrinology, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - André F Reis
- Laboratory of Molecular and Translacional Endocrinology, Universidade Federal de São Paulo (UNIFESP), Brazil; Diabetes Center, Universidade Federal de São Paulo (UNIFESP), Brazil.
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14
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Weinert LS, Silveiro SP, Giuffrida FMA, Cunha VT, Bulcão C, Calliari LE, Della Manna T, Kunii IS, Dotto RP, Dias-da-Silva MR, Reis AF. Three unreported glucokinase (GCK) missense mutations detected in the screening of thirty-two Brazilian kindreds for GCK and HNF1A-MODY. Diabetes Res Clin Pract 2014; 106:e44-8. [PMID: 25174781 DOI: 10.1016/j.diabres.2014.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022]
Abstract
Thirty-two Brazilian families with MODY phenotype were screened for GCK and HNF1A mutations. GCK mutations were found in 8 families, all patients with mild asymptomatic hyperglycaemia; 3 of them are novel: p.Asp365Asn, p.Gly81Asp and p.Val253Leu. Previously described mutations in HNF1A were found in 2 families.
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Affiliation(s)
- Letícia S Weinert
- Endocrinology Unit-Hospital de Clínicas de Porto Alegre, Postgraduate Fellowship Program in Endocrinology-Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Sandra P Silveiro
- Endocrinology Unit-Hospital de Clínicas de Porto Alegre, Postgraduate Fellowship Program in Endocrinology-Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Fernando M A Giuffrida
- Centro de Endocrinologia do Estado da Bahia (CEDEBA), Salvador, Brazil; Universidade do Estado da Bahia (UNEB), Salvador, Brazil
| | - Vivian T Cunha
- Endocrinology Unit-Hospital de Clínicas de Porto Alegre, Postgraduate Fellowship Program in Endocrinology-Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Caroline Bulcão
- Centro de Endocrinologia do Estado da Bahia (CEDEBA), Salvador, Brazil
| | | | - Thais Della Manna
- Instituto da Criança, Hospital das Clínicas, Universidade de São Paulo (USP), Brazil
| | - Ilda S Kunii
- Laboratory of Molecular and Translacional Endocrinology, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Renata P Dotto
- Laboratory of Molecular and Translacional Endocrinology, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Magnus R Dias-da-Silva
- Laboratory of Molecular and Translacional Endocrinology, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - André F Reis
- Laboratory of Molecular and Translacional Endocrinology, Universidade Federal de São Paulo (UNIFESP), Brazil; Diabetes Center, Universidade Federal de São Paulo (UNIFESP), Brazil.
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15
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Ohki T, Utsu Y, Morita S, Karim MF, Sato Y, Yoshizawa T, Yamamura KI, Yamada K, Kasayama S, Yamagata K. Low serum level of high-sensitivity C-reactive protein in a Japanese patient with maturity-onset diabetes of the young type 3 (MODY3). J Diabetes Investig 2014; 5:513-6. [PMID: 25411618 PMCID: PMC4188108 DOI: 10.1111/jdi.12237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 11/12/2013] [Accepted: 11/27/2013] [Indexed: 12/23/2022] Open
Abstract
High-sensitivity C-reactive protein (hs-CRP) levels in European populations are lower in patients with maturity-onset diabetes of the young type 3 (MODY3) than in those with type 2 diabetes. hs-CRP levels have been suggested to be useful for discriminating MODY3 from type 2 diabetes. As hs-CRP levels are influenced by various factors including race and body mass index, it is worthwhile to examine whether hs-CRP can serve as a biomarker for MODY3 in Japanese. Here we describe the case of a Japanese MODY3 patient with a nonsense mutation in the HNF1A gene. Two measurements showed consistently lower hs-CRP levels (<0.05 and 0.09 mg/L) than in Japanese patients with type 1 and type 2 diabetes. Hepatic expression of Crp messenger ribonucleic acid was significantly decreased in Hnf1a knockout mice. The hs-CRP level might be a useful biomarker for MODY3 in both Japanese and European populations.
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Affiliation(s)
- Tsuyoshi Ohki
- Department of Medical Biochemistry Faculty of Life Sciences Institute of Resource Development and Analysis Kumamoto University Kumamoto Japan ; Division of Endocrinology and Metabolism Kurume University School of Medicine Kurume Japan
| | | | | | - Md Fazlul Karim
- Department of Medical Biochemistry Faculty of Life Sciences Institute of Resource Development and Analysis Kumamoto University Kumamoto Japan
| | - Yoshifumi Sato
- Department of Medical Biochemistry Faculty of Life Sciences Institute of Resource Development and Analysis Kumamoto University Kumamoto Japan
| | - Tatsuya Yoshizawa
- Department of Medical Biochemistry Faculty of Life Sciences Institute of Resource Development and Analysis Kumamoto University Kumamoto Japan
| | - Ken-Ichi Yamamura
- Division of Developmental Genetics Center for Animal Resources and Development Institute of Resource Development and Analysis Kumamoto University Kumamoto Japan
| | - Kentaro Yamada
- Division of Endocrinology and Metabolism Kurume University School of Medicine Kurume Japan
| | | | - Kazuya Yamagata
- Department of Medical Biochemistry Faculty of Life Sciences Institute of Resource Development and Analysis Kumamoto University Kumamoto Japan
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16
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DellaManna T, Silva MRD, Chacra AR, Kunii IS, Rolim AL, Furuzawa G, Maciel RMDB, Reis AF. Clinical follow-up of two Brazilian subjects with glucokinase-MODY (MODY2) with description of a novel mutation. ACTA ACUST UNITED AC 2013; 56:490-5. [PMID: 23295287 DOI: 10.1590/s0004-27302012000800005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 09/10/2012] [Indexed: 11/22/2022]
Abstract
Mutations in the glucokinase gene (GCK) account for many cases of monogenic diabetes featuring maturity-onset diabetes of the young type 2 (MODY2). The clinical pattern of this form of hyperglycemia is rather stable, with a slight elevation in blood glucose, which is usually not progressive. Patients rarely require pharmacological interventions and microvascular complications related to diabetes are unusual. We describe the clinical follow-up of two cases of MODY2 with two different mutations in GCK gene, one in exon 7, p.Glu265Lys (c.793 G> A), which has been previously described, and a novel one, in exon 2, p.Ser69Stop (c. 206C> G). The clinical course of both cases shows similarity in metabolic control of this form of diabetes over the years.
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Affiliation(s)
- Thais DellaManna
- Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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17
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Caetano LA, Jorge AAL, Malaquias AC, Trarbach EB, Queiroz MS, Nery M, Teles MG. Incidental mild hyperglycemia in children: two MODY 2 families identified in Brazilian subjects. ACTA ACUST UNITED AC 2013; 56:519-24. [PMID: 23295292 DOI: 10.1590/s0004-27302012000800010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 09/19/2012] [Indexed: 12/27/2022]
Abstract
Maturity-onset diabetes of the young (MODY) is characterized by an autosomal dominant mode of inheritance, early onset of hyperglycemia, and defects of insulin secretion. MODY subtypes described present genetic, metabolic, and clinical differences. MODY 2 is characterized by mild asymptomatic fasting hyperglycemia, and rarely requires pharmacological treatment. Hence, precise diagnosis of MODY is important for determining management and prognosis. We report two heterozygous GCK mutations identified during the investigation of short stature. Case 1: a prepubertal 14-year-old boy was evaluated for constitutional delay of growth and puberty. During follow-up, he showed abnormal fasting glucose (113 mg/dL), increased level of HbA1c (6.6%), and negative β-cell antibodies. His father and two siblings also had slightly elevated blood glucose levels. The mother had normal glycemia. A GCK heterozygous missense mutation, p.Arg191Trp, was identified in the proband. Eighteen family members were screened for this mutation, and 11 had the mutation in heterozygous state. Case 2: a 4-year-old boy investigated for short stature revealed no other laboratorial alterations than elevated glycemia (118 mg/dL); β-cell antibodies were negative. His father, a paternal aunt, and the paternal grandmother also had slightly elevated glycemia, whereas his mother had normal glycemia. A GCK heterozygous missense mutation, p.Glu221Lys, was identified in the index patient and in four family members. All affected patients had mild elevated glycemia. Individuals with normal glycemia did not harbor mutations. GCK mutation screening should be considered in patients with chronic mild early-onset hyperglycemia, family history of impaired glycemia, and negative β-cell antibodies.
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Affiliation(s)
- Lílian A Caetano
- Unidade de Endocrinologia Genética, Laboratório de Endocrinologia Molecular e Celular, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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18
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Giuffrida FMA, Calliari LE, Manna TD, Ferreira JG, Saddi-Rosa P, Kunii IS, Furuzawa GK, Dias-da-Silva MR, Reis AF. A novel glucokinase deletion (p.Lys32del) and five previously described mutations co-segregate with the phenotype of mild familial hyperglycaemia (MODY2) in Brazilian families. Diabetes Res Clin Pract 2013; 100:e42-5. [PMID: 23433541 DOI: 10.1016/j.diabres.2013.01.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 01/25/2013] [Indexed: 11/23/2022]
Abstract
Six Brazilian families with mild familial hyperglycaemia have been screened for glucokinase (GCK) mutations. All had mutations that co-segregated with the phenotype. One of the mutations, the deletion 96_98delAAG (p.Lys32del), had not been previously described, reinforcing the worldwide prevalence of GCK MODY and widespread existence of undetected new mutations.
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Affiliation(s)
- Fernando M A Giuffrida
- Laboratory of Molecular and Translational Endocrinology, Universidade Federal de São Paulo, São Paulo, Brazil
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19
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Nair VV, Chapla A, Arulappan N, Thomas N. Molecular diagnosis of maturity onset diabetes of the young in India. Indian J Endocrinol Metab 2013; 17:430-441. [PMID: 23869298 PMCID: PMC3712372 DOI: 10.4103/2230-8210.111636] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Diabetes is highly prevalent in India and the proportion of younger patients developing diabetes is on the increase. Apart from the more universally known type 1 diabetes and obesity related type 2 diabetes, monogenic forms of diabetes are also suspected to be prevalent in many young diabetic patients. The identification of the genetic basis of the disease not only guides in therapeutic decision making, but also aids in genetic counselling and prognostication. Genetic testing may establish the occurrence and frequency of early diabetes in our population. This review attempts to explore the utilities and horizons of molecular genetics in the field of maturity onset diabetes of the young (MODY), which include the commoner forms of monogenic diabetes.
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Affiliation(s)
- Veena V. Nair
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College Hospital, Vellore, India
| | - Aaron Chapla
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College Hospital, Vellore, India
| | - Nishanth Arulappan
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College Hospital, Vellore, India
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College Hospital, Vellore, India
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20
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Bonatto N, Nogaroto V, Svidnicki PV, Milléo FQ, Grassiolli S, Almeida MC, Vicari MR, Artoni RF. Variants of the HNF1α gene: A molecular approach concerning diabetic patients from southern Brazil. Genet Mol Biol 2012; 35:737-40. [PMID: 23271932 PMCID: PMC3526079 DOI: 10.1590/s1415-47572012005000061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/02/2012] [Indexed: 11/28/2022] Open
Abstract
Maturity Onset Diabetes of the Young (MODY) presents monogenic inheritance and mutation factors which have already been identified in six different genes. Given the wide molecular variation present in the hepatocyte nuclear factor-1α gene (HNF1α) MODY3, the aim of this study was to amplify and sequence the coding regions of this gene in seven patients from the Campos Gerais region, Paraná State, Brazil, presenting clinical MODY3 features. Besides the synonymous variations, A15A, L17L, Q141Q, G288G and T515T, two missense mutations, I27L and A98V, were also detected. Clinical and laboratory data obtained from patients were compared with the molecular findings, including the I27L polymorphism that was revealed in some overweight/obese diabetic patients of this study, this corroborating with the literature. We found certain DNA variations that could explain the hyperglycemic phenotype of the patients.
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Affiliation(s)
- Naieli Bonatto
- Programa de Pós-Graduação em Genética, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Viviane Nogaroto
- Programa de Pós-Graduação em Biologia Evolutiva, Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Paulo V. Svidnicki
- Programa de Pós-Graduação em Biologia Evolutiva, Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Fábio Q. Milléo
- Departamento de Cirurgia, Hospital Vicentino da Sociedade Beneficente São Camilo, Ponta Grossa, PR, Brazil
| | - Sabrina Grassiolli
- Programa de Pós-Graduação em Biologia Evolutiva, Departamento de Biologia Geral, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Mara C. Almeida
- Programa de Pós-Graduação em Biologia Evolutiva, Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Marcelo R. Vicari
- Programa de Pós-Graduação em Biologia Evolutiva, Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Roberto F. Artoni
- Programa de Pós-Graduação em Biologia Evolutiva, Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
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21
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Mota AJ, Brüggemann S, Costa FF. MODY 2: mutation identification and molecular ancestry in a Brazilian family. Gene 2012; 512:486-91. [PMID: 23085272 DOI: 10.1016/j.gene.2012.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 09/17/2012] [Accepted: 10/10/2012] [Indexed: 10/27/2022]
Abstract
Maturity Onset Diabetes of the Young (MODY) is a heterogeneous group of genetic diseases characterized by a primary defect in insulin secretion and hyperglycemia, non-ketotic disease, monogenic autosomal dominant mode of inheritance, age at onset less than 25 years, and lack of auto-antibodies. It accounts for 2-5% of all cases of non-type 1 diabetes. MODY subtype 2 is caused by mutations in the glucokinase (GCK) gene. In this study, we sequenced the GCK gene of two volunteers with clinical diagnosis for MODY2 and we were able to identify four mutations including one for a premature stop codon (c.76C>T). Based on these results, we have developed a specific PCR-RFLP assay to detect this mutation and tested 122 related volunteers from the same family. This mutation in the GCK gene was detected in 21 additional subjects who also had the clinical features of this genetic disease. In conclusion, we identified new GCK gene mutations in a Brazilian family of Italian descendance, with one due to a premature stop codon located in the second exon of the gene. We also developed a specific assay that is fast, cheap and reliable to detect this mutation. Finally, we built a molecular ancestry model based on our results for the migration of individuals carrying this genetic mutation from Northern Italy to Brazil.
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Affiliation(s)
- Adolfo J Mota
- Departamento de Biociências e Diagnóstico Oral, Faculdade de Odontologia de São José dos Campos, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), São José dos Campos, SP, Brazil.
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Osbak KK, Colclough K, Saint-Martin C, Beer NL, Bellanné-Chantelot C, Ellard S, Gloyn AL. Update on mutations in glucokinase (GCK), which cause maturity-onset diabetes of the young, permanent neonatal diabetes, and hyperinsulinemic hypoglycemia. Hum Mutat 2010; 30:1512-26. [PMID: 19790256 DOI: 10.1002/humu.21110] [Citation(s) in RCA: 339] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Glucokinase is a key regulatory enzyme in the pancreatic beta-cell. It plays a crucial role in the regulation of insulin secretion and has been termed the glucose sensor in pancreatic beta-cells. Given its central role in the regulation of insulin release it is understandable that mutations in the gene encoding glucokinase (GCK) can cause both hyper- and hypoglycemia. Heterozygous inactivating mutations in GCK cause maturity-onset diabetes of the young (MODY) subtype glucokinase (GCK), characterized by mild fasting hyperglycemia, which is present at birth but often only detected later in life during screening for other purposes. Homozygous inactivating GCK mutations result in a more severe phenotype presenting at birth as permanent neonatal diabetes mellitus (PNDM). A growing number of heterozygous activating GCK mutations that cause hypoglycemia have also been reported. A total of 620 mutations in the GCK gene have been described in a total of 1,441 families. There are no common mutations, and the mutations are distributed throughout the gene. The majority of activating mutations cluster in a discrete region of the protein termed the allosteric activator site. The identification of a GCK mutation in patients with both hyper- and hypoglycemia has implications for the clinical course and clinical management of their disorder.
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Affiliation(s)
- Kara K Osbak
- Diabetes Research Laboratories, Oxford Centre for Diabetes Endocrinology & Metabolism, University of Oxford, United Kingdom
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Solera J, Arias P, Amiñoso C, González-Casado I, Garre P, Herranz L, Villarroel A, Cruz M, Jáñez M, Pallardo LF, Gracia R. Identification of eight new mutations in the GCK gene by DHPLC screening in a Spanish population. Diabetes Res Clin Pract 2009; 85:20-3. [PMID: 19410318 DOI: 10.1016/j.diabres.2009.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Revised: 03/20/2009] [Accepted: 04/02/2009] [Indexed: 10/20/2022]
Abstract
Maturity onset diabetes of the young (MODY) is a genetically heterogeneous disorder characterized by autosomal dominant inheritance, altered function of pancreatic beta cells and early onset diabetes mellitus, usually before 25 years old. The prevalence of specific mutations of MODY genes differs considerably among different countries. In this study we analyzed 53 index cases from unrelated MODY families who are potential carriers of mutations in GCK gene. In addition, 122 relatives were also studied. We have identified eight new mutations in the GCK gene. One of them is a non-frameshift deletion involving Lysine 143. This amino acid is part of the conserved stretch of basic residues (KHKKL) which spans from residue 140 to 144. The non-frameshift deletion might implicate the affinity of GCK for GCKRP, and potentially the abnormal nuclear localization of GCK. Additional studies should be performed to confirm this possibility.
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Affiliation(s)
- Jesús Solera
- Servicio de Bioquímica, Instituto de Genética Médica y Molecular, Hospital Universitario La Paz, CIBERER, Madrid, Spain.
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24
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Giuffrida FMA, Furuzawa GK, Kasamatsu TS, Oliveira MM, Reis AF, Dib SA. HNF1A gene polymorphisms and cardiovascular risk factors in individuals with late-onset autosomal dominant diabetes: a cross-sectional study. Cardiovasc Diabetol 2009; 8:28. [PMID: 19490620 PMCID: PMC2696421 DOI: 10.1186/1475-2840-8-28] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Accepted: 06/02/2009] [Indexed: 11/24/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a genetically heterogeneous disease, hepatocyte nuclear factor-1 homeobox A (HNF1A) single-nucleotide polymorphisms (SNPs) playing a minor role in its pathogenesis. HNF1A is a frequent cause of monogenic diabetes, albeit with early-onset. Some uncommon subgroups like late-onset autosomal dominant diabetes mellitus (LOADDM) may present peculiar inheritance patterns with a stronger familial component. This study aims to investigate the relationship of HNF1A SNPs with cardiovascular risk factors in this group, as well as to characterize them in contrast with classical T2DM (CT2DM). Methods eighteen LOADDM (age at onset > 40 y.o.; diabetes in 3 contiguous generations, uniparental lineage) along with 48 CT2DM patients and 42 normoglycemic controls (N group) have been evaluated for cardiovascular risk factors and SNPs of HNF1A. Results LOADDM showed significantly higher frequencies of SNPs A98V (22.2% vs 2.1%, p = 0.02) and S487N (72.2% vs 43.8%, p = 0.049) of HNF1A compared to CT2DM. I27L did not show significant difference (66.7% vs 45.8%), but associated with lower risk of hypertriglyceridemia (OR 0.16, 95% CI 0.04–0.65, p = 0.01). "Protective effect" was independent from other well-known predictive risk factors for hypertriglyceridemia, such as waist circumference (OR 1.09 per 1 cm increase, p = 0.01) and HDL (OR 0.01 per 1 mmol/l, p = 0.005), after logistic regression. Conclusion Late onset autosomal dominant diabetes mellitus is clinically indistinguishable from classical type 2 diabetes individuals. However, LOADDM group is enriched for common HNF1A polymorphisms A98V and S487N. I27L showed "protective effect" upon hypertriglyceridemia in this sample of individuals, suggesting a role for HNF1A on diabetic individuals' lipid profile. These data contribute to the understanding of the complex interactions between genes, hyperglycemia and cardiovascular risk factors development in type 2 diabetes mellitus.
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Affiliation(s)
- Fernando M A Giuffrida
- Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Endocrinologia, R, Pedro de Toledo, 981 12o andar, Vila Clementino, Sao Paulo, SP - Brazil.
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Maraschin JDF, Kannengiesser C, Murussi N, Campagnolo N, Canani LH, Gross JL, Velho G, Grandchamp B, Silveiro SP. HNF1α mutations are present in half of clinically defined MODY patients in South-Brazilian individuals. ACTA ACUST UNITED AC 2008; 52:1326-31. [DOI: 10.1590/s0004-27302008000800020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Accepted: 10/23/2008] [Indexed: 11/22/2022]
Abstract
Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes mellitus characterized by autosomal dominant inheritance, early age of onset, and pancreatic beta cell dysfunction. Heterozygous mutations in at least seven genes can cause MODY. In the present study we investigated the relative prevalence of GCK (glucokinase) and HNF1α (hepatocyte nuclear factor 1α) mutations, the more frequent causes of MODY, in 13 South-Brazilian families with multiple cases of diabetes consistent with MODY. Heterozygous variants in GCK and HNF1α genes were observed respectively in one (7.7%), and six (46.2%) families. The six HNF1α variants are likely to cause diabetes in the families where they were observed. However, we could not ascertain whether the GCK Gly117Ser variant found in one family is a causal mutation. In conclusion, we have confirmed in a South-Brazilian population that HNF1α mutations are a common cause of monogenic diabetes in adults selected with strict clinical diagnostic criteria.
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