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. 2011 Aug;34(8):1860-2.
doi: 10.2337/dc11-0323. Epub 2011 Jun 23.

High-sensitivity CRP discriminates HNF1A-MODY from other subtypes of diabetes

Tim J McDonald  1 , Beverley M Shields, Jane Lawry, Katharine R Owen, Anna L Gloyn, Sian Ellard, Andrew T Hattersley
Affiliations

High-sensitivity CRP discriminates HNF1A-MODY from other subtypes of diabetes

Tim J McDonald et al. Diabetes Care. 2011 Aug.

Abstract

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.

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Figures

Figure 1
Figure 1
Boxplot to show serum hs-CRP in type 1 diabetes (n = 53), type 2 diabetes (n = 157), HNF1A-MODY (n = 220), HNF4A-MODY (n = 54), HNF1B-MODY (n = 21), and GCK-MODY (n = 245). Box, median and IQR; whiskers, data range. ○, outliers (>1.5× IQR); ★, extreme values (>3× IQR). The data exclude all subjects with hs-CRP levels >10 mg/L.
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References

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