High-sensitivity C-reactive protein does not improve the differential diagnosis of HNF1A-MODY and familial young-onset type 2 diabetes: A grey zone analysis
| Autor: | C, Bellanné-Chantelot, J, Coste, C, Ciangura, M, Fonfrède, C, Saint-Martin, C, Bouché, E, Sonnet, R, Valéro, D-J, Lévy, D, Dubois-Laforgue, J, Timsit, C, Vincent-Dejean |
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| Přispěvatelé: | Nutrition, obésité et risque thrombotique (NORT), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine endocrine system Pathology medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Young onset 030209 endocrinology & metabolism Type 2 diabetes Gastroenterology Diagnosis Differential Young Adult 03 medical and health sciences 0302 clinical medicine Endocrinology Diabetes mellitus Internal medicine Internal Medicine Humans Medicine Prospective Studies Child ComputingMilieux_MISCELLANEOUS Aged Aged 80 and over Receiver operating characteristic biology business.industry C-reactive protein General Medicine Middle Aged [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism medicine.disease HNF1A Grey zone C-Reactive Protein 030104 developmental biology Diabetes Mellitus Type 2 ROC Curve biology.protein Female Differential diagnosis business |
| Zdroj: | Diabetes and Metabolism Diabetes and Metabolism, Elsevier Masson, 2016 Diabetes & Metabolism Diabetes & Metabolism, Elsevier Masson, 2016 |
| ISSN: | 1262-3636 1878-1780 |
| Popis: | Low plasma levels of high-sensitivity C-reactive protein (hs-CRP) have been suggested to differentiate hepatocyte nuclear factor 1 alpha-maturity-onset diabetes of the young (HNF1A-MODY) from type 2 diabetes (T2D). Yet, differential diagnosis of HNF1A-MODY and familial young-onset type 2 diabetes (F-YT2D) remains a difficult challenge. Thus, this study assessed the added value of hs-CRP to distinguish between the two conditions.This prospective multicentre study included 143 HNF1A-MODY patients, 310 patients with a clinical history suggestive of HNF1A-MODY, but not confirmed genetically (F-YT2D), and 215 patients with T2D. The ability of models, including clinical characteristics and hs-CRP to predict HNF1A-MODY was analyzed, using the area of the receiver operating characteristic (AUROC) curve, and a grey zone approach was used to evaluate these models in clinical practice.Median hs-CRP values were lower in HNF1A-MODY (0.25mg/L) than in F-YT2D (1.14mg/L) and T2D (1.70mg/L) patients. Clinical parameters were sufficient to differentiate HNF1A-MODY from classical T2D (AUROC: 0.99). AUROC analyses to distinguish HNF1A-MODY from F-YT2D were 0.82 for clinical features and 0.87 after including hs-CRP. For the grey zone analysis, the lower boundary was set to miss1.5% of true positives in non-tested subjects, while the upper boundary was set to perform 50% of genetic tests in individuals with no HNF1A mutation. On comparing HNF1A-MODY with F-YT2D, 65% of patients were classified in between these categories - in the zone of diagnostic uncertainty - even after adding hs-CRP to clinical parameters.hs-CRP does not improve the differential diagnosis of HNF1A-MODY and F-YT2D. |
| Databáze: | OpenAIRE |
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