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  • Title: Insights from basic adjunctive examinations of GCK-MODY, HNF1A-MODY, and type 2 diabetes: A systemic review and meta-analysis.
    Author: Liu J, Xiao X, Zhang Q, Yu M.
    Journal: J Diabetes; 2023 Jun; 15(6):519-531. PubMed ID: 37226652.
    Abstract:
    BACKGROUND: Glucokinase maturity-onset diabetes of the young (GCK-MODY) is difficult to distinguish from other diabetic forms. This article aims to characterize the differences in results from routine examinations between GCK-MODY and hepatocyte nuclear factor 1-α (HNF1A)-MODY or type 2 diabetes (T2D) patients in different periods of diabetes. METHODS: Ovid Medline, Embase, and the Cochrane Library were searched up until October 9, 2022 for articles containing baseline characteristics of GCK-MODY, HNF1A-MOFY, and T2D, excluding pregnant women. The pooled standardized mean differences were derived using a random-effects model. RESULTS: Compared to HNF1A-MODY, GCK-MODY patients had lower indicators of glucose metabolism. Total triglycerides (TG) (-0.93 [-1.66, -0.21] mmol/l) were consistently lower in GCK-MODY patients in the all-family-members subgroup analysis. Compared to T2D, GCK-MODY patients were younger at diagnosis and had lower body mass index (BMI), lower high-sensitivity C-reactive protein (hsCRP) (-0.60 [-0.75, -0.44] mg/l), lower fasting C-peptide (FCP), and lower 2-hour postprandial glucose (2-h PG). Indicators of glycated hemoglobin (HbA1c) and fasting blood glucose (FPG) were consistently lower in subgroup studies with all family members of GCK-MODY patients as well. CONCLUSIONS: Lower HbA1c, FPG, 2-h PG, and change in 2-h PG may help to diagnose GCK-MODY differentially from HNF1A-MODY at an early stage, and lower TG may strengthen such a diagnosis in the follow-up stages. Younger age combined with lower BMI, FCP, hsCRP, and 2-h PG may be useful to distinguish GCK-MODY from MODY-like T2D, whereas results of glucose metabolism indicators such as HbA1c and FPG may not help physicians until after a long follow-up period. 【摘要】 背景 青少年起病的成人型糖尿病(MODY)2 型(GCK-MODY)很难与其他类型的糖尿病区分。本文旨在探讨GCK-MODY与肝细胞核因子1α(HNF1A)-MODY或2型糖尿病患者在糖尿病不同阶段的常规检查结果的差异。方法 通过Ovid Medline、Embase和Cochrane图书馆检索截至2022年10月9日的文献，收集包含GCK-MODY、HNF1A-MODY和2型糖尿病基线特征的研究，排除孕妇。采用随机效应模型计算汇总标准化均数差。结果 与HNF1A-MODY相比，GCK-MODY患者的葡萄糖代谢指标较低。在全家庭成员亚组分析中，GCK-MODY患者的总甘油三酯(TG)[-0.93(-1.66，-0.21)mmol/L]始终较低。与2型糖尿病患者相比，GCK-MODY患者的诊断年龄较小，体质指数(BMI)较低，高敏C-反应蛋白(hsCRP)较低[-0.60(-0.75，-0.44)mg/L]，空腹C肽(FCP)较低，餐后2小时血糖(2h PG)较低。HbA1C 和空腹血糖(FPG)指标在包括GCK-MODY患者所有家族成员的亚组研究中也一致较低。结论 较低的HbA1C 、FPG、2hPG和2hPG的变化可帮助在早期阶段区分GCK-MODY与HNF1A-MODY，而较低的TG在随访阶段可增强此类诊断。较年轻的年龄结合较低的BMI、FCP、hsCRP和2hPG可能有助于区分GCK-MODY和类MODY的2型糖尿病，而HbA1C 和FPG等糖尿病代谢指标的结果可能需要长期随访后才能对医生有所帮助。.
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