Clinical application of ACMG-AMP guidelines in HNF1A and GCK variants in a cohort of MODY families

Clin Genet. 2017 Oct;92(4):388-396. doi: 10.1111/cge.12988. Epub 2017 Apr 12.

Abstract

Maturity-onset diabetes of the young (MODY) is a form of monogenic diabetes with autosomal dominant inheritance. GCK -MODY and HNF1A -MODY are the prevalent subtypes. Currently, there is growing concern regarding the correct interpretation of molecular genetic findings. The American College of Medical Genetics and Genomics (ACMG) updated guidelines to interpret and classify molecular variants. This study aimed to determine the prevalence of MODY ( GCK / HNF1A ) in a large cohort of Brazilian families, to report variants related to phenotype, and to classify them according to ACMG guidelines. One hundred and nine probands were investigated, 45% with clinical suspicion of GCK -MODY and 55% with suspicion of HNF1A -MODY. Twenty-five different variants were identified in GCK gene (30 probands-61% of positivity), and 7 variants in HNF1A (10 probands-17% of positivity). Fourteen of them were novel (12- GCK /2- HNF1A ). ACMG guidelines were able to classify a large portion of variants as pathogenic (36%- GCK /86%- HNF1A ) and likely pathogenic (44%- GCK /14%- HNF1A ), with 16% (5/32) as uncertain significance. This allows us to determine the pathogenicity classification more efficiently, and also reinforces the suspected associations with the phenotype among novel variants.

Keywords: ACMG; GCK; HNF1A; MODY.

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / genetics*
  • Diabetes Mellitus, Type 2 / pathology
  • Female
  • Germinal Center Kinases
  • Hepatocyte Nuclear Factor 1-alpha / genetics*
  • Humans
  • Male
  • Mutation
  • Phenotype
  • Protein Serine-Threonine Kinases / genetics*
  • Young Adult

Substances

  • Germinal Center Kinases
  • HNF1A protein, human
  • Hepatocyte Nuclear Factor 1-alpha
  • Protein Serine-Threonine Kinases

Supplementary concepts

  • Mason-Type Diabetes