hsCRP may differentiate HNF1A-MODY from Type 2 diabetes
MedWire News: Findings from a UK study indicate that patients with maturity onset diabetes of the young, resulting from HNF1A mutations (HNF1A-MODY), have lower levels of high-sensitivity C-reactive protein (hsCRP) than patients with other forms of diabetes.
The results, presented at the 2011 Diabetes UK Annual Conference in London this week, suggest that hsCRP may be a useful biomarker for identifying diabetic patients with HNF1A-MODY, say the study investigators.
The team, led by Timothy McDonald from the University of Exeter, measured the plasma hsCRP levels of 540 patients with MODY due to mutations in the transcription factor genes HNF1A (n=220), HNF4A (n=54), HNF1B (n=21), and in the glucokinase gene GCK (n=245).
These levels were then compared with those of 53 and 157 confirmed Type 1 and Type 2 diabetics, respectively.
McDonald and colleagues found that the median hsCRP level of patients with HNF1A-MODY was lower than that of Type 1 and Type 2 diabetics, at 0.69 versus 1.47 and 2.36 mg/l, respectively.
When these results were compared with the hsCRP levels of patients with other forms of MODY, the researchers noted that the median hsCRP level of HNF1A-MODY patients was also noticeably lower than that of patients with HNF4A-, GCK-, and HNF1B-MODY, who had respective median levels of 2.20, 1.27, and 2.65 mg/l.
Further analysis using a receiver-operator characteristic curve revealed that hsCRP exceeding a cut-off level of 0.75 mg/l differentiated between HNF1A-MODY and Type 2 diabetes with an acceptable sensitivity of 79%, and specificity of 70%.
This hsCRP cut-off level also allowed the discrimination of HNF1A-MODY from all other types of diabetes, with a respective sensitivity and specificity of 71% and 69%.
Speaking at the conference, McDonald concluded that with an average, albeit acceptable sensitivity and specificity, hsCRP measurement "would not be best used as a selective test on its own, but rather in conjunction with [a patient's] background risk, to form a likelihood ratio."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Lauretta Ihonor