High-sensitivity CRP discriminates HNF1A-MODY from other subtypes of diabetes
Open accessAbstract
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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Low hs-CRP can be used in identifying those more likely to have HNF1A-MODY as opposed to other forms of diabetes, supporting genetic testing in such individuals.
“It has been reported that low hs-CRP can be used in identifying those more likely to have HNF1A-MODY as opposed to other forms of diabetes, supporting genetic testing in such individuals (174).”
From 2. Diagnosis and Classification of Diabetes: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [174]
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- Authors
- McDonald, T. J., Shields, B. M., Lawry, J., Owen, K. R., Gloyn, A. L., Ellard, S., & Hattersley, A. T.
- Affiliations
- Peninsula College of Medicine and Dentistry (University of Exeter), Peninsula NIHR Clinical Research Facility, Exeter, Devon, U.K.
- University of Exeter (GB)
- Royal Devon & Exeter NHS Foundation Trust (GB)
- Churchill Hospital (GB)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-07-16
- Volume
- 34
- Issue
- 8
- Pages
- 1860-1862
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3142017
- OpenAlex
- W2041046475
- Cited by
- 105
- References
- 12
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 9 · 2019: 8 · 2018: 16 · 2017: 3 · 2016: 3 · 2015: 6 · 2014: 5 · 2013: 10 · 2012: 9
- FWCI
- 5.79
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Royal Devon and Exeter Research Repository (Royal Devon and Exeter) (submittedVersion)
- Funders
- Centre of Excellence for Environmental Decisions, Australian Research Council
- Royal Devon and Exeter NHS Foundation Trust
- National Institute for Health and Care Research (DHCS/07/07/008)
- University of Exeter
- European Commission (223211)
- Medical Research Council
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- HNF1A-MODY, maturity-onset diabetes of the young, high-sensitivity C-reactive protein, HNF1A, type 1 diabetes, type 2 diabetes, GCK-MODY, diabetes subtypes, biomarkers, genetic testing selection, misdiagnosis
- MeSH terms
- Adult, C-Reactive Protein, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Mutation, Hepatocyte Nuclear Factor 1-alpha, Young Adult
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