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Thanabalasingham, G.; Shah, N.; Vaxillaire, M.; Hansen, T.; Tuomi, T.; Gašperíková, D.; Szopa, M.; Tjora, E.; James, T. J.; Kokko, P.; Loiseleur, F.; Andersson, E.; Gaget, S.; Isomaa, B.; Nowak, N.; Raeder, H.; Stanik, J.; Njolstad, P. R.; Malecki, M. T.; Klimes, I.; Groop, L.; Pedersen, O.; Froguel, P.; McCarthy, M. I.; Gloyn, A. L.; Owen, K. R.
Diabetologia, 11/2011, Letnik: 54, Številka: 11Journal Article
Aims/hypothesis An accurate molecular diagnosis of diabetes subtype confers clinical benefits; however, many individuals with monogenic diabetes remain undiagnosed. Biomarkers could help to prioritise patients for genetic investigation. We recently demonstrated that high-sensitivity C-reactive protein (hsCRP) levels are lower in UK patients with hepatocyte nuclear factor 1 alpha (HNF1A)-MODY than in other diabetes subtypes. In this large multi-centre study we aimed to assess the clinical validity of hsCRP as a diagnostic biomarker, examine the genotype–phenotype relationship and compare different hsCRP assays. Methods High-sensitivity CRP levels were analysed in individuals with HNF1A-MODY ( n = 457), glucokinase (GCK)-MODY ( n = 404), hepatocyte nuclear factor 4 alpha (HNF4A)-MODY ( n = 54) and type 2 diabetes ( n = 582) from seven European centres. Three common assays for hsCRP analysis were evaluated. We excluded 121 participants (8.1%) with hsCRP values >10 mg/l. The discriminative power of hsCRP with respect to diabetes aetiology was assessed by receiver operating characteristic curve-derived C-statistic. Results In all centres and irrespective of the assay method, meta-analysis confirmed significantly lower hsCRP levels in those with HNF1A-MODY than in those with other aetiologies ( z score −21.8, p < 5 × 10 −105 ). HNF1A-MODY cases with missense mutations had lower hsCRP levels than those with truncating mutations (0.03 vs 0.08 mg/l, p < 5 × 10 −5 ). High-sensitivity CRP values between assays were strongly correlated ( r 2 ≥ 0.91, p ≤ 1 × 10 −5 ). Across the seven centres, the C-statistic for distinguishing HNF1A-MODY from young adult-onset type 2 diabetes ranged from 0.79 to 0.97, indicating high discriminative accuracy. Conclusions/interpretation In the largest study to date, we have established that hsCRP is a clinically valid biomarker for HNF1A-MODY in European populations. Given the modest costs and wide availability, hsCRP could translate rapidly into clinical practice, considerably improving diagnosis rates in monogenic diabetes.
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Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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