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

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

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    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 nondiabetic 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. (C) 2012 Elsevier B.V. All rights reserved.

    Original languageEnglish
    Pages (from-to)927-932
    Number of pages6
    JournalClinica Chimica Acta
    Volume413
    Issue number9-10
    DOIs
    Publication statusPublished - 2012

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