Apolipoprotein M can discriminate HNF1A‐MODY from Type 1 diabetes. Issue 2 (21st January 2013)

• Record Type: Journal Article
• Authors: Mughal, S. A.; Park, R.; Nowak, N.; Gloyn, A. L.; Karpe, F.; Matile, H.; Malecki, M. T.; McCarthy, M. I.; Stoffel, M.; Owen, K. R.
• Is Part Of: Diabetic medicine. Volume 30:Issue 2(2013:Feb.)
• Page Start: 246
• Page End: 250
• Publication Date: 2013-01-21
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12066
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" xml:lang="en" id="dme12066-abs-0001"> <title>Abstract</title> <sec id="dme12066-sec-0001" sec-type="section"> <title>Aims</title> <p>Missed diagnosis of maturity‐onset diabetes of the young (MODY) has led to an interest in biomarkers that enable efficient prioritization of patients for definitive molecular testing. Apolipoprotein M (apoM) was suggested as a biomarker for hepatocyte nuclear factor 1 alpha (HNF1A)‐MODY because of its reduced expression in <italic>Hnf1a</italic><sup><italic>–/–</italic></sup> mice. However, subsequent human studies examining apoM as a biomarker have yielded conflicting results. We aimed to evaluate apoM as a biomarker for HNF1A‐MODY using a highly specific and sensitive ELISA.</p> </sec> <sec id="dme12066-sec-0002" sec-type="section"> <title>Methods</title> <p>ApoM concentration was measured in subjects with HNF1A‐MODY (<italic>n </italic>= 69), Type 1 diabetes (<italic>n </italic>= 50), Type 2 diabetes (<italic>n </italic>= 120) and healthy control subjects (<italic>n </italic>= 100). The discriminative accuracy of apoM and of the apoM/HDL ratio for diabetes aetiology was evaluated.</p> </sec> <sec id="dme12066-sec-0003" sec-type="section"> <title>Results</title> <p>Mean (standard deviation) serum apoM concentration (μmol/l) was significantly lower for subjects with HNF1A‐MODY [0.86 (0.29)], than for those with Type 1 diabetes [1.37 (0.26), <italic>P </italic>= 3.1 × 10<sup>–18</sup>) and control subjects [1.34 (0.22), <italic>P </italic>= 7.2 × 10<sup>–19</sup>). There was no significant difference in apoM concentration between subjects with HNF1A‐MODY and Type 2 diabetes [0.89 (0.28), <italic>P </italic>= 0.13]. The C‐statistic measure of discriminative accuracy for apoM was 0.91 for HNF1A‐MODY vs. Type 1 diabetes, indicating high discriminative accuracy. The apoM/HDL ratio was significantly lower in HNF1A‐MODY than other study groups. However, this ratio did not perform well in discriminating HNF1A‐MODY from either Type 1 diabetes (C‐statistic = 0.79) or Type 2 diabetes (C‐statistic = 0.68).</p> </sec> <sec id="dme12066-sec-0004" sec-type="section"> <title>Conclusions</title> <p>We confirm an earlier report that serum apoM levels are lower in HNF1A‐MODY than in controls. Serum apoM provides good discrimination between HNF1A‐MODY and Type 1 diabetes and warrants further investigation for clinical utility in diabetes diagnostics.</p> </sec> </abstract>