Voevoda M I, Ivanova A A, Shakhtshneider E V, Ovsyannikova A K, Mikhailova S V, Astrakova K S, Voevoda S M, Rymar O D
Research Institute of Internal and Preventive Medicine, Novosibirsk, Russia; Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, Novosibirsk, Russia.
Research Institute of Internal and Preventive Medicine, Novosibirsk, Russia.
Ter Arkh. 2016;88(4):117-124. doi: 10.17116/terarkh2016884117-124.
To verify the type of diabetes mellitus (DM) remains an extremely important problem in endocrinology, as along with types 1 and 2 DM there are rarer hereditary types of DM, including maturity-onset diabetes of the young (MODY). The latter is a genetic type of DM, which is characterized by an autosomal dominant inheritance. Eleven types of MODY (MODY 1 to MODY13) are identified; each is associated with mutations in the certain gene: HNF4A, GCK, HNF1A, PDX1, HNF1B, NEUROD1, KLF11, CEL, PAX4, INS, BLK, KCNJ11 and ABCC8. A molecular genetic testing for suspected MODY is conducted to verify the diagnosis and to define a subtype of MODY, patient management tactics, to predict the outcome of the disease and its complications in relation to the found subtype of MODY. It is also important to seek mutation causing MODY in terms of the early detection of MODY in the first-degree relatives of a proband, appropriate therapy of the disease, and prevention of its complications.
在内分泌学领域,确诊糖尿病(DM)的类型仍然是一个极其重要的问题,因为除了1型和2型糖尿病外,还有较为罕见的遗传性糖尿病类型,包括青年发病的成年型糖尿病(MODY)。后者是一种遗传性糖尿病类型,其特征为常染色体显性遗传。现已确定了11种MODY类型(MODY 1至MODY13);每种类型都与特定基因的突变有关:肝细胞核因子4α(HNF4A)、葡萄糖激酶(GCK)、肝细胞核因子1α(HNF1A)、胰岛素原基因(PDX1)、肝细胞核因子1β(HNF1B)、神经源性分化因子1(NEUROD1)、 Kruppel样因子11(KLF11)、羧肽酶E(CEL)、配对盒基因4(PAX4)、胰岛素(INS)、B淋巴细胞特异性酪氨酸蛋白激酶(BLK)、内向整流钾通道蛋白11(KCNJ11)和ATP结合盒转运体C8(ABCC8)。对疑似MODY患者进行分子遗传学检测,以确诊并确定MODY的亚型、患者管理策略、预测疾病及其并发症的转归与所发现MODY亚型的关系。从先证者一级亲属中早期发现MODY、对疾病进行适当治疗以及预防其并发症的角度来看,寻找导致MODY的突变也很重要。