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Human gain-of-function variants in HNF1A confer protection from diabetes but independently increase hepatic secretion of atherogenic lipoproteins

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DeForest, Natalie, Kavitha, Babu, Hu, Siqi, Isaac, Roi, Krohn, Lynne, Wang, Minxian, Du, Xiaomi, De Arruda Saldanha, Camila +14 more·2023·Cell Genomics

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Abstract

Abstract Loss-of-function mutations in Hepatocyte Nuclear Factor 1A (HNF1A) are known to cause rare forms of diabetes and alter hepatic physiology through unclear mechanisms. In the general population, 1:100 individuals carry a rare protein-coding variant in HNF1A , most of unknown functional consequence. To characterize the full allelic series, we performed deep mutational scanning of 11,970 protein-coding HNF1A variants in human hepatocytes and clinical correlation with 553,246 exome-sequenced individuals. Surprisingly, we found ∼1:5 rare protein-coding HNF1A variants found in the general population cause molecular gain-of-function (GOF), increasing the transcriptional activity of HNF1A by up to 50%. GOF in HNF1A conferred protection from type 2 diabetes (T2D) (OR=0.60, p=8.4 x 10 -7 ), but not against coronary artery disease. Independently of T2D, increased hepatic expression of HNF1A promoted a pro-inflammatory and pro-atherogenic serum profile mediated in part by enhanced transcription of risk genes including PCSK9 . In summary, ∼1:300 individuals carry a GOF variant in HNF1A that protects carriers from diabetes but enhances hepatic secretion of metabolic disease risk factors.

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Authors
DeForest, N., Kavitha, B., Hu, S., Isaac, R., Krohn, L., Wang, M., Du, X., De Arruda Saldanha, C., Gylys, J., Merli, E., Abagyan, R., Najmi, L., Mohan, V., Flannick, J., Peloso, G. M., Gordts, P. L. S. M., Heinz, S., Deaton, A. M., Khera, A. V., Olefsky, J., Radha, V., & Majithia, A. R.
Affiliations
  • University of California San Diego (US)
  • University of Madras (IN)
  • Alnylam Pharmaceuticals (United States) (US)
  • Broad Institute (US)
  • Madras Diabetes Research Foundation (IN)
  • Boston University (US)
Corresponding author
Majithia, Amit R.
Venue
Cell Genomics
Publisher
Elsevier BV
Published
2023-07
Volume
3
Issue
7
Pages
100339
ISSN
2666-979X (ISSN-L)
OpenAlex
W4381572831
Cited by
21
References
11
Citations by year
2026: 4 · 2025: 7 · 2024: 7 · 2023: 2 · 2022: 1
FWCI
3.18
Type
journal article
Language
en
Open access
Locations
  • Cell Genomics (publishedVersion, cc-by-nc-nd)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
Funders
  • University of California, Los Angeles (P30 DK063491, T32 GM008666)
  • National Heart, Lung, and Blood Institute (S10 OD026929, R01HL142711, R01HL127564)
  • National Institute of General Medical Sciences (R01GM129523)
  • National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK123422, 1R01DK125490, 1R03DK113328, P30DK120515, P30DK063491)
  • University of California, San Diego
  • NIH
  • Alnylam Pharmaceuticals
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords
HNF1A, gain-of-function mutations, atherogenic lipoproteins, hepatic lipoprotein secretion, deep mutational scanning, ANGPTL3, PCSK9, transcriptional activity, genetic risk variants, allelic series

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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