Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
OMICS. 2022 Apr;26(4):218-235. doi: 10.1089/omi.2022.0006. Epub 2022 Mar 23.
Maturity-onset diabetes of the young (MODY) is a highly heterogeneous group of monogenic and nonautoimmune diseases. Misdiagnosis of MODY is a widespread problem and about 5% of patients with type 2 diabetes mellitus and nearly 10% with type 1 diabetes mellitus may actually have MODY. Using next-generation DNA sequencing (NGS) to facilitate accurate diagnosis of MODY, this study investigated mutations in 13 MODY genes (, , , , , , , , , , , , and ). In addition, we comprehensively investigated the clinical phenotypic effects of the genetic variations identified. Fifty-one adult patients with suspected MODY and 64 healthy controls participated in the study. We identified 7 novel and 10 known missense mutations localized in , , , , , and genes in 29.4% of the patient sample. Importantly, we report several mutations that were classified as "deleterious" as well as those predicted as "benign." Notably, the p.R1103Q, p.V421I, I336T, p.N493H, p.L503P, p.S362P, and p.E69A mutations were identified for the first time as causative variants for MODY. More aggressive clinical features were observed in three patients with double- and triple-heterozygosity of - (p.E69A/p.S182R), -- (p.I336, p.G157R/p.R1103Q/p.A157A), and - (p.S362P/p.P261L). Interestingly, the clinical effects of the mutations appear to be exacerbated in the presence of obesity. In conclusion, NGS analyses of the adult patients with suspected MODY appear to be informative in a clinical context. These findings warrant further clinical diagnostic research and development in different world populations suffering from diabetes with genetic underpinnings.
青年发病型糖尿病(MODY)是一组高度异质性的单基因和非自身免疫性疾病。MODY 的误诊是一个普遍存在的问题,大约 5%的 2 型糖尿病患者和近 10%的 1 型糖尿病患者实际上可能患有 MODY。本研究使用下一代 DNA 测序(NGS)来促进 MODY 的准确诊断,检测了 13 个 MODY 基因(、、、、、、、、、、、和)的突变。此外,我们还全面研究了所鉴定遗传变异的临床表型效应。51 名疑似 MODY 的成年患者和 64 名健康对照者参与了本研究。我们在 29.4%的患者样本中发现了 7 个新的和 10 个已知的错义突变,定位于、、、、、和 基因。重要的是,我们报告了一些被归类为“有害”的突变以及一些被预测为“良性”的突变。值得注意的是,首次将 p.R1103Q、p.V421I、I336T、p.N493H、p.L503P、p.S362P 和 p.E69A 突变鉴定为 MODY 的致病变异。在三位同时携带双杂合和三重杂合性的患者中观察到更具侵袭性的临床特征:-(p.E69A/p.S182R)、--(p.I336、p.G157R/p.R1103Q/p.A157A)和-(p.S362P/p.P261L)。有趣的是,在肥胖的情况下, 突变的临床影响似乎会加剧。总之,对疑似 MODY 的成年患者进行 NGS 分析在临床背景下似乎具有信息性。这些发现需要在不同的具有遗传基础的糖尿病世界人群中进一步进行临床诊断研究和开发。