实用医学杂志 ›› 2022, Vol. 38 ›› Issue (14): 1725-1730.doi: 10.3969/j.issn.1006⁃5725.2022.14.003

• 专题报道 • 上一篇    下一篇

青少年发病的成人型糖尿病2型的临床与分子遗传学研究

周知子 李秀珍 徐爱晶 梅慧芬 林云婷 曾春华 毛晓健 饶敏 刘丽   

  1. 广州医科大学附属广州市妇女儿童医疗中心遗传与内分泌科(广州510623)

  • 出版日期:2022-07-25 发布日期:2022-07-25
  • 通讯作者: 李秀珍 E⁃mail:13725100840@163.com
  • 基金资助:
    广东省医学科学技术研究基金(编号:A2019376);广东省科技发展专项资金(编号:2017A020215111)

Clinical and molecular features in Maturity⁃onset diabetes of the young type 2

ZHOU Zhizi,LI Xiuzhen,XU Aijing,MEI Huifen,LIN Yunting,ZENG Chunhua,MAO Xiaojian,RAO Min,LIU Li
  

  1. Department of Genetics and EndocrinologyGuangzhou Women and Childrens Medical CenterGuangzhou Medical UniversityGuangzhou 510623China 

  • Online:2022-07-25 Published:2022-07-25
  • Contact: LI Xiuzhen E⁃mail:13725100840@163.com

摘要:

目的 探讨青少年发病的成人型糖尿病 2 型(maturity⁃onset diabetes of the young type 2,MO⁃DY2)的临床特征及 GCK 基因变异类型特点,分析 GCK 基因型与临床表型的关系。方法 分析 2011 年 4 月至 2021 年 10 月在广州市妇女儿童医疗中心内分泌科临床诊断为 MODY2 的 32 例患儿临床资料,并进行 GCK 基因 Sanger 测序及家系调查,对未检出 GCK 基因变异的患儿父母亲进行全外显子检测,分析其分子遗传学特征。结果 32例患儿(男19例,女13例),起病年龄1 d ~ 18岁,中位数为8岁,空腹血糖均轻度升高,均值(6.7 ± 0.6)mmol/L,糖化血红蛋白均值(5.90 ± 0.96)%,均无高血糖症状。31例患儿随访4 ~ 75个月血糖维持稳定。32 例患儿共发现 GCK 基因 30 个不同杂合变异,其中 5 例为新发变异,2 例患儿为自发变异。结论 MODY2 患儿轻度高血糖生后即可出现,不同的 GCK 基因变异所导致的临床表型无明显差异,无家族史但临床高度提示 MODY2 的患儿也应行 GCK 基因分析,以免造成漏诊,并对家系相关成员进行筛查,有助于优化治疗方案,本组研究未发现GCK 基因热点变异。

关键词: 基因型, 表型, GCK 基因, 糖尿病

Abstract:

Objective Toinvestigate the clinical phenotype and molecular genetic characteristics of Maturity⁃ onset diabetes of the youngtype 2(MOYD2),and to explore the correlations between GCK genotype and clinical phenotypes. Methods From April 2011 to October 2021,clinical data of 32 children diagnosed with MODY2 in Department of Endocrinology of Guangzhou Women and Children′s Medical Center were collected. Sanger sequenc⁃ ing and family investigation for GCK gene were conducted. Parents of the children without GCK gene variation were assayed for the whole exon profile and their molecular genetic characteristics were analyzed in depth. Results A total of 32 children(male=19 and female=13)with the onset age ranging from 1⁃day to 18⁃year old were included and the medium value was approximately 8⁃ year old. Fasting blood glucose was slightly elevated in all patients with mean value of(6.7 ± 0.6)mmol/L,and the mean value of HbA1c was(5.9 ± 0.96%). All patients didn′t present the symptoms caused by hyperglycemia. The levels of blood glucose in the 31 patients remained stable during the follow⁃up 4 months till 75 months. A total of 30 different heterozygous variants were found in the 32 children including 5 new variants and 2 spontaneous variants. Conclusions Mild hyperglycemia occurred in children with⁃ MODY2 after birthand there was no significant difference for the clinical phenotypes caused by different GCK gene variations. Children with no family history but highly suggestive of MODY2 should undergo GCK gene sequencing to avoid missed diagnosis,and relevant family members should be screened to aid the optimization of treatment plan. No hot spot variation of GCK gene was found in this study. 

Key words:

genotype, phenotype, glucokinase gene, diabetes