High-Sensitivity CRP Discriminates HNF1A-MODY From Other Subtypes of Diabetes
- Tim J. McDonald, MSC1,2⇓,
- Beverley M. Shields, PHD1,
- Jane Lawry, BSC2,
- Katharine R. Owen, MD3,4,
- Anna L. Gloyn, DPHIL3,4,
- Sian Ellard, PHD1,5 and
- Andrew T. Hattersley, DM1
- 1Peninsula College of Medicine and Dentistry (University of Exeter), Peninsula NIHR Clinical Research Facility, Exeter, Devon, U.K.
- 2Royal Devon and Exeter NHS Foundation Trust, Department of Clinical Chemistry, Exeter, Devon, U.K.
- 3University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, U.K.
- 4Churchill Hospital, Oxford National Institute for Health Research Biomedical Research Centre, Oxford, U.K.
- 5Royal Devon and Exeter NHS Foundation Trust, Department of Molecular Genetics, Exeter, U.K.
- Corresponding author: Tim J. McDonald, .
OBJECTIVE Maturity-onset diabetes of the young (MODY) as a result of mutations in hepatocyte nuclear factor 1-α (HNF1A) is often misdiagnosed as type 1 diabetes or type 2 diabetes. Recent work has shown that high-sensitivity C-reactive protein (hs-CRP) levels are lower in HNF1A-MODY than type 1 diabetes, type 2 diabetes, or glucokinase (GCK)-MODY. We aim to replicate these findings in larger numbers and other MODY subtypes.
RESEARCH DESIGN AND METHODS hs-CRP levels were assessed in 750 patients (220 HNF1A, 245 GCK, 54 HNF4-α [HNF4A], 21 HNF1-β (HNF1B), 53 type 1 diabetes, and 157 type 2 diabetes).
RESULTS hs-CRP was lower in HNF1A-MODY (median [IQR] 0.3 [0.1–0.6] mg/L) than type 2 diabetes (1.40 [0.60–3.45] mg/L; P < 0.001) and type 1 diabetes (1.10 [0.50–1.85] mg/L; P < 0.001), HNF4A-MODY (1.45 [0.46–2.88] mg/L; P < 0.001), GCK-MODY (0.60 [0.30–1.80] mg/L; P < 0.001), and HNF1B-MODY (0.60 [0.10–2.8] mg/L; P = 0.07). hs-CRP discriminated HNF1A-MODY from type 2 diabetes with hs-CRP <0.75 mg/L showing 79% sensitivity and 70% specificity (receiver operating characteristic area under the curve = 0.84).
CONCLUSIONS hs-CRP levels are lower in HNF1A-MODY than other forms of diabetes and may be used as a biomarker to select patients for diagnostic HNF1A genetic testing.
This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc11-0323/-/DC1.
- Received February 16, 2011.
- Accepted May 14, 2011.
- © 2011 by the American Diabetes Association.
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