The disorder, Maturity Onset of Diabetes of the young (MODY) is a monogenic form of Non-Insulin dependent Diabetes Mellitus (NIDDM), characterized by autosomal dominant mode of inheritance and onset is usually before ...The disorder, Maturity Onset of Diabetes of the young (MODY) is a monogenic form of Non-Insulin dependent Diabetes Mellitus (NIDDM), characterized by autosomal dominant mode of inheritance and onset is usually before 25 years of age. Clinical studies of subjects with the different forms of MODY indicate that each is associated with a different defect in the normal pattern of glucose stimulated insulin secretion. MODY can result from mutations in any one of the six different genes, one of which encodes the glycolytic enzyme Glucokinase, associated with MO-DY2 and the other five encode transcription factors HNF4-alpha associated with MODY 1, HNF1-alpha associated with MODY 3, IPF with MODY 4, HNF1-Beta with MODY 5 and NeuroD1 with MO-DY6. Studies related to mutations in the MODY genes have led to a better understanding of the genetic causes of the Beta cell dysfunction as genetic factors plays a great role in this disorder. Objective: To investigate the mutation pattern in the different transcription factor genes with special reference to HNF1-alpha which are highly penetrant with 63% mutation carriers manifesting clinical diabetes by the age of 25 years. Hence study of mutation pattern in this gene is essential in our population i.e. Eastern Indian population. Our study is focused on HNF1-alpha related to MODY 3, which is the most common one. Methods: In our study enzyme amplification (PCR) of the 10 target exons of the said gene with simultaneous mutation detection in them by PCR-SSCP (Polymerase chain reaction-single strand conformational polymorphism) reaction analysis method was attempted by screening of exon 1 - 10 with respect to normal healthy controls without Diabetes Mellitus. The nature of the specific mutations was also determined by sequencing. Result: It was observed that maximum number of variations exist in exon 5 of HNF1-alpha gene which may be referred to as “Mutational Hotspot” in our Eastern Indian population. Conclusions: Since maximum number of variations exists in exon 5 of the said gene, hence one can initially go for exon5 followed by other exons, while screening for pathogenic MODY 3 mutations in the responsible gene by PCR-SSCP method.展开更多
目的 探索包含青少年起病的成人型糖尿病(maturity-onset diabetes of the young,MODY)患者的2型糖尿病家族中可能存在的MODY基因的致病突变。方法 选择MODY基因中突变率最高的葡萄糖激酶(GCK,MODY2)和肝细胞核因子1α(HNF-1α,MODY3)...目的 探索包含青少年起病的成人型糖尿病(maturity-onset diabetes of the young,MODY)患者的2型糖尿病家族中可能存在的MODY基因的致病突变。方法 选择MODY基因中突变率最高的葡萄糖激酶(GCK,MODY2)和肝细胞核因子1α(HNF-1α,MODY3)基因的微卫星多态遗传标志在2个包含临床MODY患者的中国人2型糖尿病家系中进行连锁分析,对HNF-1α基因进行全基因外显子的突变筛查-DNA序列直接测定以明确具体的核苷酸突变和所编码的氨基酸的改变。结果 HNF-1α基因标志物在家系50001中MODY3的最大LOD值达到2.38(θ=0.00),家系50002中,MODY3最大LOD值达到3.59(θ=0.00);两家系均未发现与MODY2连锁的依据。DNA直接测序发现在家系50001中所有家族成员外显子7中存在一个杂合多态Ser487Asn(AGC/AAC),该多态在正常人中也可见到;家系50002中NIDDM/MODY个体MODY3基因外显子5编码区存在一个杂合错义突变Tyr322Asn(TAT→AAT)。结论 GCK基因内或附近的基因变异不是本家系糖尿病的主要致病原因;家系50001中,HNF-1α基因的启动子和所有外显子内没有发现明确的致病突变,但不能否定内含子或其他调节区域的变异可能的致病倾向;由于本家系遗传标志D12S86与糖尿病的连锁LOD最大值达到2.38(θ=0.00),所以也不能排除HNF-1α基因附近其他未知?展开更多
目的采用高通量测序(NGS)研究MODY分子基础,了解新疆地区MODY检出情况和临床特征。方法选取2015年1月至2020年9月于我院内分泌科收治的早发DM患者321例,对其中69例进行基因检测,筛查出携带MODY突变基因的患者14例,分析先证者及家系成员...目的采用高通量测序(NGS)研究MODY分子基础,了解新疆地区MODY检出情况和临床特征。方法选取2015年1月至2020年9月于我院内分泌科收治的早发DM患者321例,对其中69例进行基因检测,筛查出携带MODY突变基因的患者14例,分析先证者及家系成员临床特征。结果 14例携带MODY突变基因患者,其中MODY1(HNF4A)1例、MODY2(GCK)2例、MODY3(HNF1A)1例、MODY4(PDX1)2例、MODY5(HNF1B)1例、MODY6(NEUROD1)1例、MODY7(KLF11)2例、MODY9(PAX4)1例、MODY10(INS)2例、MODY12(ABCC8)1例。对携带GCK c. A1398G p. X466W患者及其家系成员进行家系分析并确诊为MODY2。结论对DM检出年龄早、DM病程长但血糖控制较好且C-P水平降低缓慢的患者,不使用或使用小剂量Ins可良好控制血糖。应对DM家族史患者进行诊断性基因检测,以避免误诊及漏诊。NGS有助于正确诊断MODY亚型。展开更多
文摘The disorder, Maturity Onset of Diabetes of the young (MODY) is a monogenic form of Non-Insulin dependent Diabetes Mellitus (NIDDM), characterized by autosomal dominant mode of inheritance and onset is usually before 25 years of age. Clinical studies of subjects with the different forms of MODY indicate that each is associated with a different defect in the normal pattern of glucose stimulated insulin secretion. MODY can result from mutations in any one of the six different genes, one of which encodes the glycolytic enzyme Glucokinase, associated with MO-DY2 and the other five encode transcription factors HNF4-alpha associated with MODY 1, HNF1-alpha associated with MODY 3, IPF with MODY 4, HNF1-Beta with MODY 5 and NeuroD1 with MO-DY6. Studies related to mutations in the MODY genes have led to a better understanding of the genetic causes of the Beta cell dysfunction as genetic factors plays a great role in this disorder. Objective: To investigate the mutation pattern in the different transcription factor genes with special reference to HNF1-alpha which are highly penetrant with 63% mutation carriers manifesting clinical diabetes by the age of 25 years. Hence study of mutation pattern in this gene is essential in our population i.e. Eastern Indian population. Our study is focused on HNF1-alpha related to MODY 3, which is the most common one. Methods: In our study enzyme amplification (PCR) of the 10 target exons of the said gene with simultaneous mutation detection in them by PCR-SSCP (Polymerase chain reaction-single strand conformational polymorphism) reaction analysis method was attempted by screening of exon 1 - 10 with respect to normal healthy controls without Diabetes Mellitus. The nature of the specific mutations was also determined by sequencing. Result: It was observed that maximum number of variations exist in exon 5 of HNF1-alpha gene which may be referred to as “Mutational Hotspot” in our Eastern Indian population. Conclusions: Since maximum number of variations exists in exon 5 of the said gene, hence one can initially go for exon5 followed by other exons, while screening for pathogenic MODY 3 mutations in the responsible gene by PCR-SSCP method.
文摘目的 探索包含青少年起病的成人型糖尿病(maturity-onset diabetes of the young,MODY)患者的2型糖尿病家族中可能存在的MODY基因的致病突变。方法 选择MODY基因中突变率最高的葡萄糖激酶(GCK,MODY2)和肝细胞核因子1α(HNF-1α,MODY3)基因的微卫星多态遗传标志在2个包含临床MODY患者的中国人2型糖尿病家系中进行连锁分析,对HNF-1α基因进行全基因外显子的突变筛查-DNA序列直接测定以明确具体的核苷酸突变和所编码的氨基酸的改变。结果 HNF-1α基因标志物在家系50001中MODY3的最大LOD值达到2.38(θ=0.00),家系50002中,MODY3最大LOD值达到3.59(θ=0.00);两家系均未发现与MODY2连锁的依据。DNA直接测序发现在家系50001中所有家族成员外显子7中存在一个杂合多态Ser487Asn(AGC/AAC),该多态在正常人中也可见到;家系50002中NIDDM/MODY个体MODY3基因外显子5编码区存在一个杂合错义突变Tyr322Asn(TAT→AAT)。结论 GCK基因内或附近的基因变异不是本家系糖尿病的主要致病原因;家系50001中,HNF-1α基因的启动子和所有外显子内没有发现明确的致病突变,但不能否定内含子或其他调节区域的变异可能的致病倾向;由于本家系遗传标志D12S86与糖尿病的连锁LOD最大值达到2.38(θ=0.00),所以也不能排除HNF-1α基因附近其他未知?
文摘目的采用高通量测序(NGS)研究MODY分子基础,了解新疆地区MODY检出情况和临床特征。方法选取2015年1月至2020年9月于我院内分泌科收治的早发DM患者321例,对其中69例进行基因检测,筛查出携带MODY突变基因的患者14例,分析先证者及家系成员临床特征。结果 14例携带MODY突变基因患者,其中MODY1(HNF4A)1例、MODY2(GCK)2例、MODY3(HNF1A)1例、MODY4(PDX1)2例、MODY5(HNF1B)1例、MODY6(NEUROD1)1例、MODY7(KLF11)2例、MODY9(PAX4)1例、MODY10(INS)2例、MODY12(ABCC8)1例。对携带GCK c. A1398G p. X466W患者及其家系成员进行家系分析并确诊为MODY2。结论对DM检出年龄早、DM病程长但血糖控制较好且C-P水平降低缓慢的患者,不使用或使用小剂量Ins可良好控制血糖。应对DM家族史患者进行诊断性基因检测,以避免误诊及漏诊。NGS有助于正确诊断MODY亚型。
