1. Mutations in KCNJ11 are associated with the development of autosomal dominant, early-onset type 2 diabetes
- Author
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Theodore C. Friedman, Guang He, Limei Liu, Taishan Zheng, Takao Yasuda, Hai-rong Hu, Langen Zhuang, Yanjun Liu, Mingming Zhao, Kunsan Xiang, Bo Feng, and Kazuaki Nagashima
- Subjects
Male ,Kir6.2 ,Potassium Channels ,Glycated Hemoglobin A ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,DNA Mutational Analysis ,Type 2 diabetes ,KATP Channels ,Medicine ,2.1 Biological and endogenous factors ,KCNJ11 ,Aetiology ,Child ,Early onset ,Kcnj11 gene ,Diabetes ,Middle Aged ,Inwardly Rectifying ,Pedigree ,Asians ,Public Health and Health Services ,Female ,Type 2 ,Adult ,Adolescent ,Clinical Sciences ,Mutation, Missense ,Article ,Paediatrics and Reproductive Medicine ,Endocrinology & Metabolism ,Asian People ,Internal Medicine ,Diabetes Mellitus ,Genetics ,Humans ,Potassium Channels, Inwardly Rectifying ,Metabolic and endocrine ,Aged ,Glycated Hemoglobin ,business.industry ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,medicine.disease ,Familial early-onset type 2 diabetes mellitus ,Diabetes Mellitus, Type 2 ,Amino Acid Substitution ,Immunology ,Mutation ,Etiology ,Missense ,business - Abstract
Aims/hypothesisMore than 90% of Chinese familial early-onset type 2 diabetes mellitus is genetically unexplained. To investigate the molecular aetiology, we identified and characterised whether mutations in the KCNJ11 gene are responsible for these families.MethodsKCNJ11 mutations were screened for 96 familial early-onset type 2 diabetic probands and their families. Functional significance of the identified mutations was confirmed by physiological analysis, molecular modelling and population survey.ResultsThree novel KCNJ11 mutations, R27H, R192H and S116F117del, were identified in three families with early-onset type 2 diabetes mellitus. Mutated KCNJ11 with R27H or R192H markedly reduced ATP sensitivity (E23K>R27H>C42R>R192H>R201H), but no ATP-sensitive potassium channel currents were detected in the loss-of-function S116F117del channel in vitro. Molecular modelling indicated that R192H had a larger effect on the channel ATP-binding pocket than R27H, which may qualitatively explain why the ATP sensitivity of the R192H mutation is seven times less than R27H. The shape of the S116F117del channel may be compressed, which may explain why the mutated channel had no currents. Discontinuation of insulin and implementation of sulfonylureas for R27H or R192H carriers and continuation/switch to insulin therapy for S116F117del carriers resulted in good glycaemic control.Conclusions/interpretationOur results suggest that genetic diagnosis for the KCNJ11 mutations in familial early-onset type 2 diabetes mellitus may help in understanding the molecular aetiology and in providing more personalised treatment for these specific forms of diabetes in Chinese and other Asian patients.
- Published
- 2013