Abstract
A recent genome-wide association study identified hepatocyte nuclear factor 1-a (HNF1A) as a key regulator of fucosylation. We hypothesized that loss-of-function HNF1A mutations causal for maturity-onset diabetes of the young (MODY) would display altered fucosylation of N-linked glycans on plasma proteins and that glycan biomarkers could improve the efficiency of a diagnosis of HNF1A-MODY. In a pilot comparison of 33 subjects with HNF1A-MODY and 41 subjects with type 2 diabetes, 15 of 29 glycan measurements differed between the two groups. The DG9-glycan index, which is the ratio of fucosylated to nonfucosylated triantennary glycans, provided optimum discrimination in the pilot study and was examined further among additional subjects with HNF1A-MODY (n = 188), glucokinase (GCK)-MODY (n = 118), hepatocyte nuclear factor 4-α (HNF4A)-MODY (n = 40), type 1 diabetes (n = 98), type 2 diabetes (n = 167), and nondiabetic controls (n = 98). The DG9-glycan index was markedly lower in HNF1A-MODY than in controls or other diabetes subtypes, offered good discrimination between HNF1AMODY and both type 1 and type 2 diabetes (C statistic ≥0.90), and enabled us to detect three previously undetected HNF1A mutations in patients with diabetes. In conclusion, glycan profiles are altered substantially in HNF1A-MODY, and the DG9-glycan index has potential clinical value as a diagnostic biomarker of HNF1A dysfunction.
Original language | English |
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Journal | Diabetes |
Volume | 62 |
Issue number | 4 |
Pages (from-to) | 1329-37 |
Number of pages | 9 |
ISSN | 0046-0192 |
DOIs | |
Publication status | Published - Apr 2013 |
Keywords
- Adolescent
- Adult
- Biological Markers
- Diabetes Mellitus, Type 1
- Diabetes Mellitus, Type 2
- Female
- Gene Expression Regulation
- Hepatocyte Nuclear Factor 1-alpha
- Humans
- Male
- Middle Aged
- Mutation, Missense
- Polymorphism, Single Nucleotide
- Polysaccharides
- Reproducibility of Results
- Young Adult