Yıl: 2022 Cilt: 12 Sayı: 2 Sayfa Aralığı: 99 - 107 Metin Dili: İngilizce DOI: 10.4274/jarem.galenos.2022.26818 İndeks Tarihi: 04-10-2022

Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations

Öz:
Objective: Maturity-onset diabetes of the youth (MODY) is a genetically and clinically heterogeneous group of diseases which is often misdiagnosed as type 1 diabetes or type 2 diabetes. The aim of this study is to identify the occurence of mutations in subjects classified clinically as having MODY, and to determine phenotypic features and their long-term monitering consequences. Methods: Eighteen probands were selected based on the clinical criteria of MODY. Firstly, in patients with mild stable fasting hyperglycemia who did not progress, Sanger sequencing of GCK gene was performed as GCK-MODY was the most common cause of persistent and incidental hyperglycemia in the pediatric population. Patients without a GCK gene mutation or without mild fasting hyperglycemia were analysed by using targeted next-generation sequence for seven known monogenic genes of diabetes (ABCC8, GCK, HNF1A, HNF1B, HNF4A, INS, KCNJ11) to identify the molecular pathology. Results: We identified 11 GCK, 2 HNF1A, 2 KCNJ11 mutations in 18 probands. Eleven of them (73%) were previously reported and 4 of them (27%) were assessed as novel mutations. In two patients who were treated with insulin before the molecular analysis, insulin was switched to sulfonylurea and glibenclamide, after determination of pathogenic variants in HNF1A and KCNJ11, respectively. Retinopathy or nephropathy was not detected among the patients. Conclusion: The MODY has a large spectrum of clinical presentations. We detected 4 novel mutations among our cohort. Although GCK-MODY was the most frequent type of our study population, identification of rare MODY types and follow-up of these patients would help us better understand monogenic diabetes.
Anahtar Kelime:

MODY Olgularının Değerlendirilmesi ve Uzun Dönem İzlem Sonuçları, Yeni Mutasyonların Tanımlanması

Öz:
Amaç: Gençlerin erişkin tipi diyabeti (Maturity onset diabetes of young - MODY), genellikle tip 1 diyabet veya tip 2 diyabet olarak yanlış teşhis edilebilen, genetik ve klinik olarak heterojen bir hastalık grubudur. Bu çalışmanın amacı, klinik olarak MODY olarak sınıflandırılan olgularda mutasyonlarını, fenotipik özelliklerini tespit etmek ve bunların uzun vadeli izlem sonuçlarını göstermektir. Yöntemler: MODY klinik kriterlerine göre 18 olgu seçildi. İlk olarak, pediatrik popülasyonda kalıcı, tesadüfi hipergliseminin en yaygın nedeni GCKMODY olduğundan, ilerleyici olmayan, hafif stabil açlık hiperglisemisi olan hastalarda, GCK geninin Sanger dizilemesi yapıldı. GCK gen mutasyonu olmayan veya hafif açlık hiperglisemisi olmayan hastalar, moleküler patolojiyi belirlemek için bilinen yedi monogenik diyabet geni (ABCC8, GCK, HNF1A, HNF1B, HNF4A, INS, KCNJ11) için hedeflenen yeni nesil diziyle analiz edildi. Bulgular: On sekiz probandda 11 GCK, 2 HNF1A, 2 KNCJ11 mutasyonu belirledik. Bunların 11’i (%73) daha önce tespit edilmiş ve 4’ü (%27) yeni mutasyonlar olarak değerlendirilmiştir. Moleküler analizden önce insülin ile tedavi edilen iki hastada, sırasıyla HNF1A ve KCNJ11’de patojenik varyantların belirlenmesinden sonra tedaviler sülfonilüre ve glibenklamid olarak değiştirildi. Hastalar arasında retinopati veya nefropati saptanmadı. Sonuç: MODY, geniş bir klinik sunum yelpazesine sahiptir. Kohortumuzda 4 yeni mutasyon tespit ettik. GCK-MODY çalışma popülasyonumuzda en sık görülen tip olmasına rağmen, nadir MODY tiplerinin belirlenmesi ve bu hastaların takibi monogenik diyabeti daha iyi anlamamıza yardımcı olacaktır.
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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA SAGSAK E, Onder Camas A, Peltek Kendirci H, Yildiz M, Akgun-Dogan O (2022). Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. , 99 - 107. 10.4274/jarem.galenos.2022.26818
Chicago SAGSAK ELIF,Onder Camas Asan,Peltek Kendirci Havva Nur,Yildiz Metin,Akgun-Dogan Ozlem Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. (2022): 99 - 107. 10.4274/jarem.galenos.2022.26818
MLA SAGSAK ELIF,Onder Camas Asan,Peltek Kendirci Havva Nur,Yildiz Metin,Akgun-Dogan Ozlem Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. , 2022, ss.99 - 107. 10.4274/jarem.galenos.2022.26818
AMA SAGSAK E,Onder Camas A,Peltek Kendirci H,Yildiz M,Akgun-Dogan O Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. . 2022; 99 - 107. 10.4274/jarem.galenos.2022.26818
Vancouver SAGSAK E,Onder Camas A,Peltek Kendirci H,Yildiz M,Akgun-Dogan O Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. . 2022; 99 - 107. 10.4274/jarem.galenos.2022.26818
IEEE SAGSAK E,Onder Camas A,Peltek Kendirci H,Yildiz M,Akgun-Dogan O "Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations." , ss.99 - 107, 2022. 10.4274/jarem.galenos.2022.26818
ISNAD SAGSAK, ELIF vd. "Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations". (2022), 99-107. https://doi.org/10.4274/jarem.galenos.2022.26818
APA SAGSAK E, Onder Camas A, Peltek Kendirci H, Yildiz M, Akgun-Dogan O (2022). Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. JAREM, 12(2), 99 - 107. 10.4274/jarem.galenos.2022.26818
Chicago SAGSAK ELIF,Onder Camas Asan,Peltek Kendirci Havva Nur,Yildiz Metin,Akgun-Dogan Ozlem Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. JAREM 12, no.2 (2022): 99 - 107. 10.4274/jarem.galenos.2022.26818
MLA SAGSAK ELIF,Onder Camas Asan,Peltek Kendirci Havva Nur,Yildiz Metin,Akgun-Dogan Ozlem Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. JAREM, vol.12, no.2, 2022, ss.99 - 107. 10.4274/jarem.galenos.2022.26818
AMA SAGSAK E,Onder Camas A,Peltek Kendirci H,Yildiz M,Akgun-Dogan O Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. JAREM. 2022; 12(2): 99 - 107. 10.4274/jarem.galenos.2022.26818
Vancouver SAGSAK E,Onder Camas A,Peltek Kendirci H,Yildiz M,Akgun-Dogan O Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations. JAREM. 2022; 12(2): 99 - 107. 10.4274/jarem.galenos.2022.26818
IEEE SAGSAK E,Onder Camas A,Peltek Kendirci H,Yildiz M,Akgun-Dogan O "Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations." JAREM, 12, ss.99 - 107, 2022. 10.4274/jarem.galenos.2022.26818
ISNAD SAGSAK, ELIF vd. "Evaluation and Long-term Monitoring of Patients with MODY, and Description of Novel Mutations". JAREM 12/2 (2022), 99-107. https://doi.org/10.4274/jarem.galenos.2022.26818