Maturity-onset diabetes of the young (MODY) is a clinicallyheterogeneous group of disorders characterized by nonketoticdiabetes mellitus, an autosomal dominant mode of inheritance,an onset usually before the age of 25 years and frequently inchildhood or adolescence, and a primary defect in the functionof the beta cells of the pancreas. MODY can result from mutationsin any one of at least six different genes (Table 1). One ofthese genes encodes the glycolytic enzyme glucokinase (associatedwith MODY 2),3 and the other five encode transcription factors:hepatocyte nuclear factor (HNF) 4 (associated with MODY 1),4. . . [Full Text of this Article]
Clinical Presentation
Function of the Gene Products Implicated in MODY
Glucokinase
HNF-1, HNF-1, and HNF-4
IPF-1
NeuroD1 (BETA2)
Clinical Features of Subtypes of MODY
MODY 2
MODY 1 and MODY 3
MODY 4
MODY 5
MODY Associated with Mutations in Other Genes
Mutations in MODY-Related Genes in Type 2 Diabetes
Genetic Screening for MODY
Conclusions
Source Information
From the Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Michigan Health System, Ann Arbor (S.S.F.); the Howard Hughes Medical Institute and Departments of Biochemistry and Molecular Biology, Medicine, and Human Genetics, University of Chicago, Chicago (G.I.B.); and the Departments of Medicine and Cell Biology and Physiology, Washington University School of Medicine, St. Louis (K.S.P.).
Address reprint requests to Dr. Fajans at 3920 Taubman Ctr., Box 0354, University Hospitals, Ann Arbor, MI 48109-0354, or at sfajans@umich.edu.
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Odom, D. T., Zizlsperger, N., Gordon, D. B., Bell, G. W., Rinaldi, N. J., Murray, H. L., Volkert, T. L., Schreiber, J., Rolfe, P. A., Gifford, D. K., Fraenkel, E., Bell, G. I., Young, R. A.
(2004). Control of Pancreas and Liver Gene Expression by HNF Transcription Factors. Science
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(2004). Metabolic and Endocrine Effects of a Polyunsaturated Fatty Acid-Rich Diet in Polycystic Ovary Syndrome. J. Clin. Endocrinol. Metab.
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Cockburn, B. N., Bermano, G., Boodram, L.-L. G., Teelucksingh, S., Tsuchiya, T., Mahabir, D., Allan, A. B., Stein, R., Docherty, K., Bell, G. I.
(2004). Insulin Promoter Factor-1 Mutations and Diabetes in Trinidad: Identification of a Novel Diabetes-Associated Mutation (E224K) in an Indo-Trinidadian Family. J. Clin. Endocrinol. Metab.
89: 971-978
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Pezzolesi, M. G., Nam, M., Nagase, T., Klupa, T., Dunn, J. S., Mlynarski, W. M., Rich, S. S., Warram, J. H., Krolewski, A. S.
(2004). Examination of Candidate Chromosomal Regions for Type 2 Diabetes Reveals a Susceptibility Locus on Human Chromosome 8p23.1. Diabetes
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Harries, L. W., Hattersley, A. T., Ellard, S.
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Maestro, M. A., Boj, S. F., Luco, R. F., Pierreux, C. E., Cabedo, J., Servitja, J. M., German, M. S., Rousseau, G. G., Lemaigre, F. P., Ferrer, J.
(2003). Hnf6 and Tcf2 (MODY5) are linked in a gene network operating in a precursor cell domain of the embryonic pancreas. Hum Mol Genet
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(2003). Regulation of Apolipoprotein M Gene Expression by MODY3 Gene Hepatocyte Nuclear Factor-1{alpha}: Haploinsufficiency Is Associated With Reduced Serum Apolipoprotein M Levels. Diabetes
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McKinney, J., Cao, H., Behme, M. T., Mahon, J. L., Hegele, R. A.
(2003). Maturity-Onset Diabetes of the Young (MODY) Mutation in Type 2 Diabetes and Latent Autoimmune Diabetes of the Adult. Diabetes Care
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Aguilar-Salinas, C. A., Monroy, O. V., Gomez-Perez, F. J., Chavez, A. G., Esqueda, A. L., Cuevas, V. M., Rull-Rodrigo, J. A., Conyer, R. T.
(2003). Characteristics of Patients With Type 2 Diabetes in Mexico: Results from a large population-based nationwide survey. Diabetes Care
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Kulkarni, R. N., Almind, K., Goren, H. J., Winnay, J. N., Ueki, K., Okada, T., Kahn, C. R.
(2003). Impact of Genetic Background on Development of Hyperinsulinemia and Diabetes in Insulin Receptor/Insulin Receptor Substrate-1 Double Heterozygous Mice. Diabetes
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Almind, K., Kulkarni, R. N., Lannon, S. M., Kahn, C. R.
(2003). Identification of Interactive Loci Linked to Insulin and Leptin in Mice With Genetic Insulin Resistance. Diabetes
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Eeckhoute, J., Moerman, E., Bouckenooghe, T., Lukoviak, B., Pattou, F., Formstecher, P., Kerr-Conte, J., Vandewalle, B., Laine, B.
(2003). Hepatocyte Nuclear Factor 4{alpha} Isoforms Originated from the P1 Promoter Are Expressed in Human Pancreatic {beta}-Cells and Exhibit Stronger Transcriptional Potentials than P2 Promoter-Driven Isoforms. Endocrinology
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Lee, Y.-H., Magnuson, M. A., Muppala, V., Chen, S.-S.
(2003). Liver-Specific Reactivation of the Inactivated Hnf-1{alpha} Gene: Elimination of Liver Dysfunction To Establish a Mouse MODY3 Model. Mol. Cell. Biol.
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Bjorkhaug, L., Sagen, J. V., Thorsby, P., Sovik, O., Molven, A., Njolstad, P. R.
(2003). Hepatocyte Nuclear Factor-1{alpha} Gene Mutations and Diabetes in Norway. J. Clin. Endocrinol. Metab.
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Iwasaki, N., Cox, N. J., Wang, Y.-Q., Schwarz, P. E.H., Bell, G. I., Honda, M., Imura, M., Ogata, M., Saito, M., Kamatani, N., Iwamoto, Y.
(2003). Mapping Genes Influencing Type 2 Diabetes Risk and BMI in Japanese Subjects. Diabetes
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(2002). Genetics of Obesity and Type 2 Diabetes: Tracking Pathogenic Traits During the Predisease Period. Diabetes
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(2002). Experimental Models of Transcription Factor-Associated Maturity-Onset Diabetes of the Young. Diabetes
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Krempler, F., Esterbauer, H., Weitgasser, R., Ebenbichler, C., Patsch, J. R., Miller, K., Xie, M., Linnemayr, V., Oberkofler, H., Patsch, W.
(2002). A Functional Polymorphism in the Promoter of UCP2 Enhances Obesity Risk but Reduces Type 2 Diabetes Risk in Obese Middle-Aged Humans. Diabetes
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(2002). Crystal Structure of the HNF4alpha Ligand Binding Domain in Complex with Endogenous Fatty Acid Ligand. J. Biol. Chem.
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Pritchard, J. K., Cox, N. J.
(2002). The allelic architecture of human disease genes: common disease-common variant... or not?. Hum Mol Genet
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(2002). A role for glutathione peroxidase in protecting pancreatic beta cells against oxidative stress in a model of glucose toxicity. Proc. Natl. Acad. Sci. USA
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BERNASSOLA, F., FEDERICI, M., CORAZZARI, M., TERRINONI, A., HRIBAL, M. L., DE LAURENZI, V., RANALLI, M., MASSA, O., SESTI, G., IRWIN MCLEAN, W.H., CITRO, G., BARBETTI, F., MELINO, G.
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White, M. F.
(2002). IRS proteins and the common path to diabetes. Am. J. Physiol. Endocrinol. Metab.
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Wang, H., Chu, W., Das, S. K., Ren, Q., Hasstedt, S. J., Elbein, S. C.
(2002). Liver Pyruvate Kinase Polymorphisms Are Associated With Type 2 Diabetes in Northern European Caucasians. Diabetes
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Furuta, H., Furuta, M., Sanke, T., Ekawa, K., Hanabusa, T., Nishi, M., Sasaki, H., Nanjo, K.
(2002). Nonsense and Missense Mutations in the Human Hepatocyte Nuclear Factor-1{beta} Gene (TCF2) and Their Relation to Type 2 Diabetes in Japanese. J. Clin. Endocrinol. Metab.
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