Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)

Detalhes bibliográficos
Autor(a) principal: Amaral, Sara
Data de Publicação: 2023
Outros Autores: Palha, Ana, Bogalho, Paula, Silva-Nunes, José
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/151621
Resumo: person
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spelling Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)a series of 10 patients from a single diabetes centerChronic kidney diseaseDiabetesHNF1BMaturity-onset diabetes mellitusMODYInternal MedicineEndocrinology, Diabetes and MetabolismSDG 3 - Good Health and Well-beingpersonBackground: Maturity-Onset Diabetes of the Young (MODY) is an autosomal dominant condition and represents 1–5% of all cases of diabetes mellitus. MODY is often misdiagnosed as type 1 or type 2 diabetes. The rare subtype 5 (HNF1B-MODY) is due to hepatocyte nuclear factor 1β (HNF1B) molecular alteration and is remarkable for its multisystemic phenotypes characterized by a broad spectrum of pancreatic and extra-pancreatic clinical manifestations. Methods: Retrospective study of patients with HNF1B-MODY diagnosis followed in the Centro Hospitalar Universitário Lisboa Central (Lisbon, Portugal). Demographic data, medical history, clinical and laboratory data, follow-up and treatment procedures were obtained from electronic medical records. Results: We found 10 patients with HNF1B variants (7 index cases). The median age at diabetes diagnosis was 28 (IQR 24) years and the median age at HNF1B-MODY diagnosis was 40.5 (IQR 23) years. Six patients were initially misclassified as type 1 and 4 as type 2 diabetes. The average time between diabetes diagnosis and the diagnosis of HNF1B-MODY was 16.5 years. Diabetes was the first manifestation in half of the cases. The other half presented with kidney malformations and chronic kidney disease at pediatric age as the first manifestation. All these patients were submitted to kidney transplantation. Long-term diabetes complications included retinopathy (4/10), peripheral neuropathy (2/10) and ischemic cardiomyopathy (1/10). Other extra-pancreatic manifestations included liver test alterations (4/10) and congenital malformation of the female reproductive tract (1/6). History of a first-degree relative with diabetes and/or nephropathy diagnosed at a young age was present in 5 of the 7 index cases. Conclusions: Despite being a rare disease, HNF1B-MODY is underdiagnosed and often misclassified. It should be suspected in patients with diabetes and CKD, especially when diabetes appears at a young age, a family history is present, and nephropathy appears before/shortly after the diagnosis of diabetes. Presence of unexplained liver disease increases the degree of suspicion for HNF1B-MODY. Early diagnosis is important to minimize complications and to allow familial screening and pre-conception genetic counseling. Trial registration not applicable due to the retrospective nature of the study, non-interventional.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNAmaral, SaraPalha, AnaBogalho, PaulaSilva-Nunes, José2023-04-05T22:16:10Z2023-02-152023-02-15T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/151621engPURE: 54505730https://doi.org/10.1186/s13098-022-00964-0info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:34:04Zoai:run.unl.pt:10362/151621Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:54:39.816537Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
a series of 10 patients from a single diabetes center
title Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
spellingShingle Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
Amaral, Sara
Chronic kidney disease
Diabetes
HNF1B
Maturity-onset diabetes mellitus
MODY
Internal Medicine
Endocrinology, Diabetes and Metabolism
SDG 3 - Good Health and Well-being
title_short Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
title_full Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
title_fullStr Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
title_full_unstemmed Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
title_sort Maturity-onset diabetes of the young secondary to HNF1B variants (HNF1B-MODY)
author Amaral, Sara
author_facet Amaral, Sara
Palha, Ana
Bogalho, Paula
Silva-Nunes, José
author_role author
author2 Palha, Ana
Bogalho, Paula
Silva-Nunes, José
author2_role author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Amaral, Sara
Palha, Ana
Bogalho, Paula
Silva-Nunes, José
dc.subject.por.fl_str_mv Chronic kidney disease
Diabetes
HNF1B
Maturity-onset diabetes mellitus
MODY
Internal Medicine
Endocrinology, Diabetes and Metabolism
SDG 3 - Good Health and Well-being
topic Chronic kidney disease
Diabetes
HNF1B
Maturity-onset diabetes mellitus
MODY
Internal Medicine
Endocrinology, Diabetes and Metabolism
SDG 3 - Good Health and Well-being
description person
publishDate 2023
dc.date.none.fl_str_mv 2023-04-05T22:16:10Z
2023-02-15
2023-02-15T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/151621
url http://hdl.handle.net/10362/151621
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv PURE: 54505730
https://doi.org/10.1186/s13098-022-00964-0
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