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Published on: August 8, 2022
Molecular background and clinical characteristics of HNF1A MODY in a Polish population
J Skupien1, S Gorczynska-Kosiorz, T Klupa
1Department of Metabolic Diseases, Jagiellonian University, Medical College, 15, Kopernika Street, 31-501 Krakow, Poland.
Purpose:
Knowing the molecular background of monogenic diabetes in affected individuals influences the clinical practice. Mutations in the HNF1A gene are the most frequent cause of MODY. The aim of the present study was to identify the genetic and clinical characteristics of HNF1A MODY in a Polish population, and the prevalence of diabetic complications and renal malformations.
Methods:
We identified 47 families with the early-onset, autosomal-dominant form of diabetes that met the criteria of MODY. Mutation screening involved direct sequencing of the HNF1A gene. Patients' characteristics included clinical data, anthropometric measurements and biochemical parameters. The search for renal malformations involved ultrasound examination of all HNF1A mutation carriers.
Results:
We identified 13 HNF1A MODY families and examined 56 mutation carriers, including 46 diabetic patients. The average HbA(1c) level among the diabetics was 7.5%. We identified diabetic retinopathy in 47.7% of the MODY patients, while diabetic nephropathy was present in 25%. In five HNF1A mutation carriers from three families, renal developmental malformations were identified, including one functioning kidney in two (3.6%) of them.
Conclusion:
This first systematic search for HNF1A mutations in a Polish population revealed that they are a frequent cause of MODY. In this population, HNF1A mutation carriers were characterized by a high prevalence of diabetic complications. In addition, renal developmental abnormalities were found in some mutation carriers.
Insights
Hepatocyte Nuclear Factor 1-Alpha (HNF1A) gene mutations are a common cause of monogenic diabetes (MODY) in Poland. This study found a high prevalence of diabetic complications and renal abnormalities in HNF1A mutation carriers.
Area of Science:
- Genetics
- Endocrinology
- Nephrology
Background:
- Monogenic diabetes, particularly Maturity-Onset Diabetes of the Young (MODY), has diverse genetic underpinnings.
- Mutations in the HNF1A gene are the most common genetic cause of MODY worldwide.
- Understanding the molecular basis of diabetes is crucial for effective clinical management.
Purpose of the Study:
- To investigate the genetic and clinical features of HNF1A-MODY in the Polish population.
- To determine the prevalence of diabetic complications in individuals with HNF1A mutations.
- To assess the occurrence of renal malformations in HNF1A mutation carriers.
Main Methods:
- Identified 47 families with early-onset, autosomal-dominant diabetes meeting MODY criteria.
- Conducted direct sequencing of the HNF1A gene for mutation screening.
- Collected clinical, anthropometric, and biochemical data from patients.
- Performed ultrasound examinations to detect renal malformations in mutation carriers.
Main Results:
- Identified 13 families with HNF1A-MODY, involving 56 mutation carriers (46 with diabetes).
- Average HbA1c among diabetic patients was 7.5%.
- Prevalence of diabetic retinopathy was 47.7%, and diabetic nephropathy was 25%.
- Renal developmental malformations were found in 5 carriers (3.6%), including two with a single functioning kidney.
Conclusions:
- HNF1A mutations are a frequent cause of MODY in the Polish population.
- HNF1A mutation carriers in this cohort exhibited a high incidence of diabetic complications.
- Renal developmental abnormalities are a notable finding in some HNF1A mutation carriers.
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