Traditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetes
<p>Background: Young adults with diabetes in Asia represent a heterogeneous group. Using traditional clinical criteria to preselect individuals for testing for maturity-onset diabetes of the young (MODY) may exclude a large proportion from testing. High-sensitivity C-reactive protein (hs-CRP)...
| Главные авторы: | , , , , , |
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| Формат: | Journal article |
| Язык: | English |
| Опубликовано: |
SAGE Publications
2018
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| _version_ | 1826260586284974080 |
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| author | Rama Chandran, S Bhalshankar, J Farhad Vasanwala, R Zhao, Y Owen, K Su-Lyn Gardner, D |
| author_facet | Rama Chandran, S Bhalshankar, J Farhad Vasanwala, R Zhao, Y Owen, K Su-Lyn Gardner, D |
| author_sort | Rama Chandran, S |
| collection | OXFORD |
| description | <p>Background: Young adults with diabetes in Asia represent a heterogeneous group. Using traditional clinical criteria to preselect individuals for testing for maturity-onset diabetes of the young (MODY) may exclude a large proportion from testing. High-sensitivity C-reactive protein (hs-CRP) has shown promise as a biomarker to differentiate hepatic nuclear factor 1 alpha (HNF1A)-MODY from type 2 diabetes. We aimed to compare the use of hs-CRP as a biomarker versus traditional criteria, to guide testing for HNF1A-MODY among a cohort of young adults with diabetes in Singapore.</p><p> Methods: A total of 252 adults (age of onset ⩽45 years) and 20 children with diabetes were recruited. Using traditional criteria (family history of diabetes and onset of diabetes ⩽25 years) and an hs-CRP cut off of ⩽0.5 mg/l, 125 and 37 adults, respectively, were identified for HNF1A gene testing. All children underwent HNF1A gene testing.</p><p> Results: Five adults (5/143, 3.5%) with HNF1A-MODY were identified. There were no HNF1A gene mutations among the children. Traditional criteria correctly identified all five HNF1A-MODY individuals (5/125, 4%), while applying an hs-CRP level of ⩽0.5 mg/l selected just 1 of these 5 for HNF1A gene testing (1/37, 2.7%). None of those with a positive GAD antibody or undetectable C-peptide level had HNF1A-MODY.</p><p> Conclusion: The use of hs-CRP to guide screening for HNF1A-MODY among Asian young adults with diabetes did not improve the diagnostic yield. Applying a combination of age of onset of diabetes under 25 years and a family history of diabetes alone could guide targeted HNF1A-MODY screening in Asians, with an expected yield of 4% diagnosed with HNF1A-MODY among those screened.</p> |
| first_indexed | 2024-03-06T19:08:01Z |
| format | Journal article |
| id | oxford-uuid:15d2bb5a-af36-4215-bcf1-27f2ecb58676 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:08:01Z |
| publishDate | 2018 |
| publisher | SAGE Publications |
| record_format | dspace |
| spelling | oxford-uuid:15d2bb5a-af36-4215-bcf1-27f2ecb586762022-03-26T10:27:36ZTraditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:15d2bb5a-af36-4215-bcf1-27f2ecb58676EnglishSymplectic Elements at OxfordSAGE Publications2018Rama Chandran, SBhalshankar, JFarhad Vasanwala, RZhao, YOwen, KSu-Lyn Gardner, D<p>Background: Young adults with diabetes in Asia represent a heterogeneous group. Using traditional clinical criteria to preselect individuals for testing for maturity-onset diabetes of the young (MODY) may exclude a large proportion from testing. High-sensitivity C-reactive protein (hs-CRP) has shown promise as a biomarker to differentiate hepatic nuclear factor 1 alpha (HNF1A)-MODY from type 2 diabetes. We aimed to compare the use of hs-CRP as a biomarker versus traditional criteria, to guide testing for HNF1A-MODY among a cohort of young adults with diabetes in Singapore.</p><p> Methods: A total of 252 adults (age of onset ⩽45 years) and 20 children with diabetes were recruited. Using traditional criteria (family history of diabetes and onset of diabetes ⩽25 years) and an hs-CRP cut off of ⩽0.5 mg/l, 125 and 37 adults, respectively, were identified for HNF1A gene testing. All children underwent HNF1A gene testing.</p><p> Results: Five adults (5/143, 3.5%) with HNF1A-MODY were identified. There were no HNF1A gene mutations among the children. Traditional criteria correctly identified all five HNF1A-MODY individuals (5/125, 4%), while applying an hs-CRP level of ⩽0.5 mg/l selected just 1 of these 5 for HNF1A gene testing (1/37, 2.7%). None of those with a positive GAD antibody or undetectable C-peptide level had HNF1A-MODY.</p><p> Conclusion: The use of hs-CRP to guide screening for HNF1A-MODY among Asian young adults with diabetes did not improve the diagnostic yield. Applying a combination of age of onset of diabetes under 25 years and a family history of diabetes alone could guide targeted HNF1A-MODY screening in Asians, with an expected yield of 4% diagnosed with HNF1A-MODY among those screened.</p> |
| spellingShingle | Rama Chandran, S Bhalshankar, J Farhad Vasanwala, R Zhao, Y Owen, K Su-Lyn Gardner, D Traditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetes |
| title | Traditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetes |
| title_full | Traditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetes |
| title_fullStr | Traditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetes |
| title_full_unstemmed | Traditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetes |
| title_short | Traditional clinical criteria outperform high-sensitivity C-reactive protein for the screening of hepatic nuclear factor 1 alpha maturity-onset diabetes of the young among young Asians with diabetes |
| title_sort | traditional clinical criteria outperform high sensitivity c reactive protein for the screening of hepatic nuclear factor 1 alpha maturity onset diabetes of the young among young asians with diabetes |
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