Lipoprotein composition in HNF1A-MODY: differentiating between HNF1A-MODY and type 2 diabetes.

Abstract

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.

• Authors: Tim J McDonald, Jane McEneny, Ewan R Pearson, Gaya Thanabalasingham, Magdalena Szopa, Beverley M Shields, Sian Ellard, Katharine R Owen, Maciej T Malecki, Andrew T Hattersley, Ian S Young
• Journal: Clinica chimica acta; international journal of clinical chemistry (Clin Chim Acta) Vol. 413 Issue 9-10 Pg. 927-32 (May 18 2012) ISSN: 1873-3492 [Electronic] Netherlands
• PMID: 22360925 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier B.V. All rights reserved.

Chemical References

• Biomarkers
• Cholesterol, HDL
• Cholesterol, LDL
• HNF1A protein, human
• Hepatocyte Nuclear Factor 1-alpha
• Lipoproteins
• Triglycerides

Topics

• Adult
• Aged
• Biomarkers (blood)
• Case-Control Studies
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Diabetes Mellitus, Type 2 (blood, diagnosis)
• Female
• Hepatocyte Nuclear Factor 1-alpha (blood)
• Humans
• Lipoproteins (blood)
• Male
• Middle Aged
• Triglycerides (blood)