Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea (the Republic of).
Internal Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of).
BMJ Open Diabetes Res Care. 2021 Jun;9(1). doi: 10.1136/bmjdrc-2021-002217.
INTRODUCTION: Monogenic diabetes is attributed to genetic variations in a single gene. Maturity-onset diabetes of the young (MODY) is the most common phenotype associated with monogenic diabetes, but is frequently misdiagnosed as either type 1 or type 2 diabetes. Increasing our basic understanding of genetic variations in MODY may help to improve the accuracy of providing the correct diagnosis and personalize subsequent treatment regimens in different racial populations. For this reason, this study was designed to identify nucleotide variants in early onset diabetes patients with clinically suspected MODY in a Korean population. RESEARCH DESIGN AND METHODS: Among 2908 Korean patients diagnosed with diabetes, we selected 40 patients who were diagnosed before 30 years old and were clinically suspected of MODY. Genetic testing was performed using a targeted gene sequencing panel that included 30 known monogenic diabetes genes. The pathogenicity of the identified variants was assessed according to the American College of Medical Genetics and Genomics and Association for Molecular Pathology (ACMG-AMP) guidelines. RESULTS: A total of six rare missense variants (p.Ala544Thr in HNF1A, p.Val601Ile and p.His103Tyr in ABCC8, p.Pro33Ala in PDX1, p.Gly18Glu in INS, and p.Arg164Gln in PAX4) in five distinct MODY genes were identified in five patients. In addition, a variant was identified in mitochondrial DNA at 3243A>G in one patient. The identified variants were either absent or detected at a rare frequency in the 1000 Genomes Project. These variants were classified as uncertain significance using the ACMG-AMP guidelines. CONCLUSION: Using a targeted gene sequencing panel, we identified seven variants in either MODY genes or mitochondrial DNA using a Korean patient population with early onset diabetes who were clinically suspected of MODY. This genetic approach provides the ability to compare distinct populations of racial and ethnic groups to determine whether specific gene is involved in their diagnosis of MODY.
简介:单基因糖尿病归因于单个基因的遗传变异。青年发病的成年型糖尿病(MODY)是与单基因糖尿病相关的最常见表型,但常被误诊为 1 型或 2 型糖尿病。增加我们对 MODY 中遗传变异的基本认识,可能有助于提高在不同种族人群中提供正确诊断的准确性,并使随后的治疗方案个体化。出于这个原因,本研究旨在鉴定韩国人群中临床疑似 MODY 的早发糖尿病患者中的核苷酸变异。
研究设计和方法:在 2908 名被诊断患有糖尿病的韩国患者中,我们选择了 40 名在 30 岁之前被诊断且临床疑似 MODY 的患者。使用包括 30 个已知单基因糖尿病基因的靶向基因测序面板进行基因检测。根据美国医学遗传学与基因组学学院和分子病理学协会 (ACMG-AMP) 指南评估鉴定变异的致病性。
结果:在五名患者中,在五个不同的 MODY 基因中发现了六种罕见的错义变异(HNF1A 中的 p.Ala544Thr、ABCC8 中的 p.Val601Ile 和 p.His103Tyr、PDX1 中的 p.Pro33Ala、INS 中的 p.Gly18Glu 和 PAX4 中的 p.Arg164Gln)和一个线粒体 DNA 中的 3243A>G 变异。在 1000 基因组计划中,这些变异要么不存在,要么检测到罕见频率。根据 ACMG-AMP 指南,这些变异被归类为意义不确定。
结论:使用靶向基因测序面板,我们在临床疑似 MODY 的早发糖尿病韩国患者中,使用一种基因测序面板,鉴定出 MODY 基因或线粒体 DNA 中的七个变异。这种遗传方法提供了比较不同种族和民族群体的能力,以确定特定基因是否参与他们的 MODY 诊断。
BMJ Open Diabetes Res Care. 2021-6
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