Exp Clin Endocrinol Diabetes 2011; 119(3): 182-185
DOI: 10.1055/s-0030-1262816
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Maturity-Onset Diabetes of the Young (MODY) caused by a Novel Nonsense Mutation E41X in the HNF-1α Gene

S. Buchbinder1 , M. Zorn1 , A. Bierhaus1 , P. P. Nawroth1 , M. Müller2 , T. Schilling1
  • 1University of Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany
  • 2University of Heidelberg, Department of Internal Medicine 4, Heidelberg, Germany
Further Information

Publication History

received 18.05.2010 first decision 18.05.2010

accepted 08.07.2010

Publication Date:
05 August 2010 (online)

Abstract

The most common cause of Maturity-Onset Diabetes of the Young (MODY) are mutations in the Hepatic Nuclear Factor 1α (HNF-1α) gene, resulting in MODY3. In a family afflicted with diabetes, a novel nonsense mutation in HNF-1α, E41X, causing a termination codon behind the dimerization domain, was found. The penetrance in individuals older than 25 years was 81.8%. The age at manifestation of diabetes ranged from 18 to 63 years, only 2 out of 10 diabetic individuals developed the disease at ages younger than 25 years. Although diabetes duration lasted up to 35 years in this family, only one family member suffered from diabetic complications. Additional polymorphisms in HNF-1α, I27L and S487N, were found in this pedigree. Despite its biological inactivity, S487N polymorphism led in combination with E41X to a significant earlier manifestation of diabetes, whereas I27L polymorphism or increased Body Mass Index (BMI) did not. In spite of the severe gene defect, which truncates the protein behind the dimerization domain, the phenotype of E41X was relatively benign without frequent diabetic complications.

References

  • 1 Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.  Diabet Med. 1998;  15 539-553
  • 2 Bellanne-Chantelot C, Carette C, Riveline JP. et al . The type and the position of HNF1A mutation modulate age at diagnosis of diabetes in patients with maturity-onset diabetes of the young (MODY)-3.  Diabetes. 2008;  57 503-508
  • 3 Chiu KC, Chuang LM, Ryu JM. et al . The I27L amino acid polymorphism of hepatic nuclear factor-1alpha is associated with insulin resistance.  J Clin Endocrinol Metab. 2000;  85 2178-2183
  • 4 Chouard T, Blumenfeld M, Bach I. et al . A distal dimerization domain is essential for DNA-binding by the atypical HNF1 homeodomain.  Nucleic Acids Res. 1990;  18 5853-5863
  • 5 Elbein SC, Teng K, Yount P. et al . Linkage and molecular scanning analyses of MODY3/hepatocyte nuclear factor-1 alpha gene in typical familial type 2 diabetes: evidence for novel mutations in exons 8 and 10.  J Clin Endocrinol Metab. 1998;  83 2059-2065
  • 6 Ellard S. Hepatocyte nuclear factor 1 alpha (HNF-1 alpha) mutations in maturity-onset diabetes of the young.  Hum Mutat. 2000;  16 377-385
  • 7 Ellard S, Colclough K. Mutations in the genes encoding the transcription factors hepatocyte nuclear factor 1 alpha (HNF1A) and 4 alpha (HNF4A) in maturity-onset diabetes of the young.  Hum Mutat. 2006;  27 854-869
  • 8 Fajans SS, Bell GI, Polonsky KS. Molecular mechanisms and clinical pathophysiology of maturity-onset diabetes of the young.  N Engl J Med. 2001;  345 971-980
  • 9 Frayling TM, Evans JC, Bulman MP. et al . beta-cell genes and diabetes: molecular and clinical characterization of mutations in transcription factors.  Diabetes. 2001;  50 (Suppl.1) S94-S100
  • 10 Harries LW, Ellard S, Stride A. et al . Isomers of the TCF1 gene encoding hepatocyte nuclear factor-1 alpha show differential expression in the pancreas and define the relationship between mutation position and clinical phenotype in monogenic diabetes.  Hum Mol Genet. 2006;  15 2216-2224
  • 11 Isomaa B, Henricsson M, Lehto M. et al . Chronic diabetic complications in patients with MODY3 diabetes.  Diabetologia. 1998;  41 467-473
  • 12 Klupa T, Warram JH, Antonellis A. et al . Determinants of the development of diabetes (maturity-onset diabetes of the young-3) in carriers of HNF-1alpha mutations: evidence for parent-of-origin effect.  Diabetes Care. 2002;  25 2292-2301
  • 13 Lehto M, Tuomi T, Mahtani MM. et al . Characterization of the MODY3 phenotype. Early-onset diabetes caused by an insulin secretion defect.  J Clin Invest. 1997;  99 582-591
  • 14 Luco RF, Maestro MA, del Pozo N. et al . A conditional model reveals that induction of hepatocyte nuclear factor-1alpha in Hnf1alpha-null mutant beta-cells can activate silenced genes postnatally, whereas overexpression is deleterious.  Diabetes. 2006;  55 2202-2211
  • 15 Owen K, Hattersley AT. Maturity-onset diabetes of the young: from clinical description to molecular genetic characterization.  Best Pract Res Clin Endocrinol Metab. 2001;  15 309-323
  • 16 Shih DQ, Screenan S, Munoz KN. et al . Loss of HNF-1alpha function in mice leads to abnormal expression of genes involved in pancreatic islet development and metabolism.  Diabetes. 2001;  50 2472-2480
  • 17 Stride A, Shepherd M, Frayling TM. et al . Intrauterine hyperglycemia is associated with an earlier diagnosis of diabetes in HNF-1alpha gene mutation carriers.  Diabetes Care. 2002;  25 2287-2291
  • 18 Tack CJ, Ellard S, Hattersley AT. A severe clinical phenotype results from the co-inheritance of type 2 susceptibility genes and a hepatocyte nuclear factor-1alpha mutation.  Diabetes Care. 2000;  23 424-425
  • 19 The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus . Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.  Diabetes Care. 1997;  20 1183-1197
  • 20 Tomei L, Cortese R, De Francesco R. A POU-A related region dictates DNA binding specificity of LFB1/HNF1 by orienting the 2 XL-homeodomains in the dimer.  EMBO J. 1992;  11 4119-4129
  • 21 Urhammer SA, Rasmussen SK, Kaisaki PJ. et al . Genetic variation in the hepatocyte nuclear factor-1 alpha gene in Danish Caucasians with late-onset NIDDM.  Diabetologia. 1997;  40 473-475
  • 22 Yamagata K, Oda N, Kaisaki PJ. et al . Mutations in the hepatocyte nuclear factor-1alpha gene in maturity-onset diabetes of the young (MODY3).  Nature. 1996;  384 455-458

Correspondence

T. SchillingMD 

Department of Internal

Medicine 1

University of Heidelberg

Im Neuenheimer Feld 410

69120 Heidelberg

Germany

Phone: +49/6221/568 605

Fax: +49/711/278 30309

Email: Tobias_Schilling@med.uni-heidelberg.de

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