Genetic mutations associated with neonatal diabetes mellitus in Omani patients

J Pediatr Endocrinol Metab. 2018 Jan 26;31(2):195-204. doi: 10.1515/jpem-2017-0284.

Abstract

Background: Neonatal diabetes mellitus (NDM) is a rare disorder worldwide where diabetes is diagnosed in the first 6 months of life. However, Oman has a relatively high incidence of NDM.

Methods: In this study, we investigated the genetic etiologies underlying NDM and their prevalence in Oman. We collected a cohort of 24 NDM patients, with and without genetic diagnosis, referred to our center from 2007 to 2015. All patients without a genetic diagnosis were tested for mutations in 23 NDM-associated genes using a custom-targeted next-generation sequencing (NGS) panel and methylation analysis of the 6q24 locus.

Results: A genetic abnormality was detected in 15/24 (62.5%) of our Omani NDM patients. We report the detection of 6q24 methylation abnormalities and KCNJ11 mutations for the first time in Omani NDM patients. Unlike Western populations where NDM is predominantly due to mutations in the KCNJ11, ABCC8 and INS genes, NDM due to homozygous GCK gene mutations were most prevalent in Oman, having been observed in seven out of 15 NDM patients in whom we established the genetic etiology. This reflects the high degree of consanguinity which makes recessive conditions more likely.

Conclusions: The results of this study are likely to impact any future strategy to introduce genetic testing for NDM disorders within the national healthcare system in Oman.

Keywords: genetics; mutation; neonatal diabetes; next-generation sequencing.

MeSH terms

  • Adaptor Proteins, Signal Transducing / chemistry
  • Adaptor Proteins, Signal Transducing / genetics
  • Adaptor Proteins, Signal Transducing / metabolism
  • Amino Acid Substitution
  • Chromosomes, Human, Pair 6 / metabolism
  • Cohort Studies
  • Consanguinity
  • DNA Methylation
  • DNA Mutational Analysis
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / genetics*
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / physiopathology
  • Exons
  • Female
  • Germinal Center Kinases
  • Glucose Transporter Type 2 / chemistry
  • Glucose Transporter Type 2 / genetics*
  • Glucose Transporter Type 2 / metabolism
  • Humans
  • Infant
  • Infant, Newborn
  • Interleukin-2 Receptor alpha Subunit / chemistry
  • Interleukin-2 Receptor alpha Subunit / genetics
  • Interleukin-2 Receptor alpha Subunit / metabolism
  • Male
  • Mutation*
  • Oman / epidemiology
  • Pedigree
  • Potassium Channels, Inwardly Rectifying / chemistry
  • Potassium Channels, Inwardly Rectifying / genetics*
  • Potassium Channels, Inwardly Rectifying / metabolism
  • Prevalence
  • Protein Serine-Threonine Kinases / chemistry
  • Protein Serine-Threonine Kinases / genetics*
  • Protein Serine-Threonine Kinases / metabolism

Substances

  • Adaptor Proteins, Signal Transducing
  • Germinal Center Kinases
  • Glucose Transporter Type 2
  • IL2RA protein, human
  • Interleukin-2 Receptor alpha Subunit
  • Kir6.2 channel
  • Potassium Channels, Inwardly Rectifying
  • SLC2A2 protein, human
  • LRBA protein, human
  • Protein Serine-Threonine Kinases

Supplementary concepts

  • 6q24-Related Transient Neonatal Diabetes Mellitus
  • Diabetes Mellitus, Permanent Neonatal