The importance of combined NGS and MLPA genetic tests for differential diagnosis of maturity onset diabetes of the young

Endokrynol Pol. 2019;70(1):28-36. doi: 10.5603/EP.a2018.0064. Epub 2018 Sep 27.

Abstract

Introduction: Maturity onset diabetes of the young (MODY) is a rare form of monogenic diabetes. Being clinically and genetically heterogeneous, it is often misdiagnosed as type 1 or type 2 diabetes, leading to inappropriate therapy. MODY is caused by a single gene mutation. Thirteen genes, defining 13 subtypes, have been identified to cause MODY. A correct diagnosis is important for the right therapy, prognosis, and genetic counselling.

Material and methods: Twenty-nine unrelated paediatric patients clinically suspected of having MODY diabetes were analysed using TruSight One panel for next-generation sequencing (NGS) and multiplex ligation-dependent probe amplification (MLPA) assay.

Results: In this study we identified variants in MODY genes in 22 out of 29 patients (75.9%). Using two genetic tests, NGS and MLPA, we detected both single nucleotide variants and large deletions in patients. Most of the patients harboured a variant in the GCK gene (11/22), followed by HNF1B (5/22). The rest of the variants were found in the NEUROD1 and HNF1A genes. We identified one novel variant in the GCK gene: c.596T>C, p.Val199Ala. The applied genetic tests excluded the suspected diagnosis of MODY in two patients and revealed variants in other genes possibly associated with the patient's clinical phenotype.

Conclusions: In our group of MODY patients most variants were found in the GCK gene, followed by variants in HNF1B, NEUROD1, and HNF1A genes. The combined NGS and MLPA-based genetic tests presented a comprehensive approach for analysing patients with suspected MODY diabetes and provided a successful differential diagnosis of MODY subtypes.

Keywords: MLPA; MODY; NGS; differential diagnosis.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / genetics
  • Diagnosis, Differential
  • Female
  • Genetic Testing*
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Male
  • Multiplex Polymerase Chain Reaction
  • Mutation*
  • Sequence Analysis, DNA
  • Young Adult

Supplementary concepts

  • Mason-Type Diabetes