Lipoprotein composition in HNF1A-MODY: Differentiating between HNF1A-MODY and Type 2 diabetes

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• 作者：Tim J. McDonald^a ; ^b ; ^{Tim.McDonald@rdeft.nhs.uk} ; Jane McEneny^c ; Ewan R. Pearson^a ; ^d ; Gaya Thanabalasingham^e ; ^f ; Magdalena Szopa^g ; ^h ; Beverley M. Shields^a ; Sian Ellard^a ; Katharine R. Owen^e ; ^f ; Maciej T. Malecki^g ; ^h ; Andrew T. Hattersley^a ; Ian S. Young^c
• 关键词：HNF1A-MODY ; Diabetes ; Lipoproteins ; Type 2 diabetes ; HDL
• 刊名：Clinica Chimica Acta
• 出版年：2012
• 期刊代码：54_00098981
• 类别：med
• 出版时间：18 May, 2012
• 卷：413
• 期：9-10
• 页码：927-932
• 文件大小：410 K

摘要

Introduction

The young-onset diabetes seen in HNF1A-MODY is often misdiagnosed as Type 2 diabetes. Type 2 diabetes, unlike HNF1A-MODY, is associated with insulin resistance and a characteristic dyslipidaemia.

We aimed to compare the lipid profiles in HNF1A-MODY, Type 2 diabetes and control subjects and to determine if lipids can be used to aid the differential diagnosis of diabetes sub-type.

Methods

1)

14 subjects in each group (HNF1A-MODY, Type 2 diabetes and controls) were matched for gender and BMI. Fasting lipid profiles and HDL lipid constituents were compared in the 3 groups.

2)

HDL-cholesterol was assessed in a further 267 patients with HNF1A-MODY and 297 patients with a diagnosis of Type 2 diabetes to determine its discriminative value.

Results

1)

In HNF1A-MODY subjects, plasma-triglycerides were lower (1.36 vs. 1.93 mmol/l, p = 0.07) and plasma-HDL-cholesterol was higher than in subjects with Type 2 diabetes (1.47 vs. 1.15 mmol/l, p = 0.0008), but was similar to controls. Furthermore, in the isolated HDL; HDL-phospholipid and HDL-cholesterol ester content were higher in HNF1A-MODY, than in Type 2 diabetes (1.59 vs. 1.33 mmol/L, p = 0.04 and 1.10 vs. 0.83 mmol/L, p = 0.019, respectively), but were similar to controls (1.59 vs. 1.45 mmol/L, p = 0.35 and 1.10 vs. 1.21 mmol/L, p = 0.19, respectively).

2)

A plasma-HDL-cholesterol > 1.12 mmol/L was 75%sensitive and 64%specific (ROC AUC = 0.76) at discriminating HNF1A-MODY from Type 2 diabetes.

Conclusion

The plasma-lipid profiles of HNF1A-MODY and the lipid constituents of HDL are similar to non-diabetic controls. However, HDL-cholesterol was higher in HNF1A-MODY than in Type 2 diabetes and could be used as a biomarker to aid in the identification of patients with HNF1A-MODY.