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RFX6杂合性移码变异导致青年发病的成年型糖尿病(MODY)伴难治性高脂血症:一例报告

RFX6 heterozygous frame-shift variation causes maturity-onset diabetes mellitus of the young (MODY) with refractory hyperlipidemia: a case report.

作者信息

Li Man, Wang Long, Xing Yuexian, Huang Xiaolin, Jia Fang, Xu Wendong, Luo Kaiming

机构信息

Department of Endocrinology, the Third Affiliated Hospital of Soochow University, Changzhou, China.

Changzhou Medical Center, Nanjing Medical University, Changzhou, China.

出版信息

AME Case Rep. 2025 Jun 25;9:84. doi: 10.21037/acr-24-266. eCollection 2025.

Abstract

BACKGROUND

Maturity-onset diabetes mellitus of the young (MODY) is a form of autosomal dominant inherited diabetes, featuring diverse clinical characteristics due to distinct pathogenic gene mutation sites. Reports on MODY caused by mutations are scarce, and it is prone to being misdiagnosed as type 1 or type 2 diabetes in clinical settings. To date, no cases have been reported regarding patients with gene mutations accompanied by refractory hyperlipidemia, and the treatment remains undetermined. We present a rare case of a 13-year-old Chinese girl who was admitted to the Third Affiliated Hospital of Soochow University with diabetes combined with refractory hyperlipidemia.

CASE DESCRIPTION

A 13-year-old adolescent female presented with persistent dry mouth, polydipsia, and polyuria. The physical examination accidentally found high blood glucose. She had refractory hyperlipidemia in the past and was treated with a variety of lipid-lowering programs, but her lipids were still poorly controlled. Due to the patient's early age of onset, the special type of diabetes cannot be excluded, and she is recommended to be further examined in our hospital.

CONCLUSIONS

We sequenced the MODY-related genes of the patient and her mother. heterozygous frame-shifting variants were found in the proband and her mother (NNM_173560:c.1500delT). The patient was eventually diagnosed with MODY. During the hospitalization, we treated the patient with insulin hypoglycemic treatment, and the patient's blood glucose was stable. Surprisingly, the patient's blood lipid also decreased significantly, and even without using any lipid-lowering drugs, the blood lipid remained at a low level.

摘要

背景

青年发病的成年型糖尿病(MODY)是常染色体显性遗传糖尿病的一种形式,由于致病基因突变位点不同而具有多样的临床特征。关于由[具体基因名称]突变引起的MODY的报道较少,在临床中容易被误诊为1型或2型糖尿病。迄今为止,尚未有关于伴有难治性高脂血症的[具体基因名称]基因突变患者的病例报道,且治疗方法仍未确定。我们报告了一例罕见病例,一名13岁中国女孩因糖尿病合并难治性高脂血症入住苏州大学附属第三医院。

病例描述

一名13岁青春期女性出现持续口干、多饮和多尿症状。体格检查意外发现血糖高。她过去患有难治性高脂血症,接受过多种降脂方案治疗,但血脂仍控制不佳。由于患者发病年龄早,不能排除特殊类型糖尿病,建议在我院进一步检查。

结论

我们对患者及其母亲的MODY相关基因进行了测序。在先证者及其母亲(NNM_173560:c.1500delT)中发现了[具体基因名称]杂合移码变异。患者最终被诊断为MODY。住院期间,我们对患者采用胰岛素降糖治疗,患者血糖稳定。令人惊讶的是,患者血脂也显著下降,即使未使用任何降脂药物,血脂仍维持在较低水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3570/12319597/ddea4b36b3fd/acr-09-24-266-f1.jpg

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