Minimal incidence of neonatal/infancy onset diabetes in Italy is 1:90,000 live births

Acta Diabetologica - Tập 49 - Trang 405-408 - 2011
D. Iafusco1, O. Massa2, B. Pasquino3, C. Colombo2, L. Iughetti4, C. Bizzarri5, C. Mammì6, D. Lo Presti7, T. Suprani8, R. Schiaffini5, Colin G. Nichols9, L. Russo2, V. Grasso10, F. Meschi11, R. Bonfanti11, S. Brescianini12, F. Barbetti2,13
1Department of Pediatrics, Second University of Naples, Naples, Italy
2Laboratory of Mendelian Diabetes, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
3Department of Pediatrics, Regional Hospital, Bolzano, Italy
4Department of Pediatrics, University of Modena and Reggio Emilia, Modena, Italy
5Endocrine Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
6Medical Genetics Unit, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
7Department of Pediatrics, University of Catania, Catania, Italy
8Department of Pediatrics, Maurizio Bufalini Hospital, Cesena, Italy
9Department of Cell Biology and Physiology, Washington University School of Medicine, MO, USA
10Department of Laboratory Medicine, “Tor Vergata” University Hospital, Rome, Italy
11Department of Pediatrics, H S Raffaele Hospital and Scientific Institute, Milan, Italy
12Department of Epidemiology, Istituto Superiore di Sanità, Rome, Italy
13Department of Internal Medicine, University of Tor Vergata, Rome, Italy

Tóm tắt

Until early 2000, permanent and transient neonatal diabetes mellitus (NDM), defined as diabetes with onset within 6 weeks from birth that requires insulin therapy for at least 2 weeks, were considered exceedingly rare conditions, with a global incidence of 1:500,000–1:400,000 live births. The new definition of NDM recently adopted, that includes patients with diabetes onset within 6 months of age, has prompted studies that have set the incidence of the permanent form alone between 1:210,000 and 1:260,000 live births. Aim of the present work was to ascertain the incidence of NDM (i.e. permanent + transient form) in Italy for years 2005–2010. Patients referred to the Italian reference laboratory for NDM between years 2005 and 2010 and screened for mutations in common NDM genes (KCNJ11, ABCC8, and INS) and for uniparental isodisomy of chromosome 6 (UDP6) were reviewed. A questionnaire aimed at identifying NDM cases investigated in other laboratories was sent to 54 Italian reference centers for pediatric diabetes. Twenty-seven patients with NDM born between 2005 and 2010 were referred to the reference laboratory. In this group, a mutation of either KCNJ11, ABCC8 or INS was found in 18 patients, and a case with UDP6 was identified. Questionnaires revealed 4 additional cases with transient neonatal diabetes due to UDP6. Incidence of NDM was calculated at 1:90,000 (CI: 1:63,000–1:132,000) live births. Thus, with the definition currently in use, about 6 new cases with NDM are expected to be born in Italy each year.

Tài liệu tham khảo

Aguilar-Bryan L, Bryan J (2008) Neonatal diabetes mellitus. Endocr Rev 29:265–291 Murphy R, Ellard S, Hattersley AT (2008) Clinical implications of a molecular genetic classification of monogenic β-cell diabetes. Nat Clin Pract End Met 4:200–213 Russo L, Iafusco D, Brescianini S, Nocerino V, Bizzarri C, Toni S, Cerutti F, Monciotti C, Pesavento R, Iughetti L, Bernardini L, Bonfanti R, Gargantini L, Vanelli M, Aguilar-Bryan L, Stazi A, Grasso V, Colombo C, Barbetti F, The Early Diabetes Study Group of ISPED (2011) Permanent diabetes during the first year of life: multiple gene screening in 54 patients. Diabetologia 54:1693–1701 Colombo C, Porzio O, Liu M, Massa O, Vasta M, Salardi S, Beccaria L, Monciotti C, Toni S, Pedersen O, Hansen T, Federici L, Pesavento R, Cadario F, Federici G, Ghirri P, Arvan P, Iafusco D, Barbetti F, The Early onset diabetes Study Group of the Italian Society of Pediatric Endocrinology, Diabetes (SIEDP) (2008) Seven mutations in the human insulin gene linked to permanent neonatal/infancy-onset diabetes mellitus. J Clin Invest 118:2148–2156 von Mühlendahl KE, Herkenhoff H (1995) Long-term course of neonatal diabetes. N Engl J Med 333:704–708 Shield JPH, Gardner RJ, Wadsworth EJK, Whiteford ML, James RS, Robinson DO, Baum JD, Temple IK (1997) Aetiopathology and genetic basis of neonatal diabetes. Arch Dis Child 76:F39–F42 Metz C, Cavé H, Bertrand AM, Deffert C, Gueguen-Giroux B, Czernichow P, Polak M (2002) Neonatal diabetes mellitus: chromosomal analysis in transient and permanent cases. J Pediatr 141:483–489 Iafusco D, Stazi MA, Cotichini R, Cotellessa M, Martinucci ME, Mazzella M, Cherubini V, Barbetti F, Martinetti M, Cerutti F, Prisco F, The Early Onset Diabetes Study Group of the Italian Society of Paediatric Endocrinology, Diabetology (2002) Permanent diabetes mellitus in the first year of life. Diabetologia 45:798–804 Gloyn AL, Pearson ER, Antcliff JF, Proks P, Bruining GJ, Slingerland AS, Howard N, Srinivasan S, Silva JMCL, Molnes J, Edghill EL, Frayling TM, Temple IK, Mackay D, Shiled JPH, Sumnik Z, van Rhijn A, Wales JKH, Clark P, Gorman S, Aisenberg J, Ellard S, Njolstad PR, Ashcroft FM, Hattersley AT (2004) Activating mutations in the gene encoding the ATP-sensitive potassium channel subunit Kir6.2 gene and permanent neonatal diabetes. N Engl J Med 350:1838–1849 Massa O, Iafusco D, D’Amato E, Gloyn AL, Hattersley AT, Pasquino B, Tonini G, Dammacco F, Zanette G, Meschi F, Porzio O, Bottazzo GF, Crinò A, Lorini R, Cerutti F, Vanelli M, Barbetti F, The Early Onset Diabetes Study Group of the Italian Society of Pediatric Endocrinology, Diabetology (2005) KCNJ11 activating mutations in Italian patients with permanent neonatal diabetes. Hum Mutat 25:22–27 Stanik J, Gasperikova D, Paskova M, Barak L, Javorkova J, Jancova E, Cljakova M, Hlava P, Michalek J, Flanagan SE, Pearson E, Hattersley AT, Ellard S, Klimes I (2007) Prevalence of permanent neonatal diabetes in Slovakia and successful replacement of insulin with sulfonylurea therapy in KCNJ11 and ABCC8 mutation carriers. J Clin Endocrinol Metab 92:1276–1282 Slingerland AS, Shields BM, Flanagan SE, Bruining GJ, Noordam K, Gach A, Mlynarski W, Malecki MT, Hattersley AT, Ellard S (2009) Referral rates for diagnostic testing support an incidence of permanent neonatal diabetes in three European countries of at least 1 in 260,000 live births. Diabetologia 52:1683–1685 Jarosz-Chobot P, Deja G, Polanska J (2010) Epidemiology of type 1 diabetes among Silesian children aged 0–14 years, 1989–2005. Acta Diabetol 47:29–33 Flanagan SE, Clauin S, Bellané-Chantelot C, de Lonlay P, Harries LW, Gloyn AL, Ellard S (2009) Update of mutations in the genes encoding the pancreatic beta-cell KATP channel subunits Kir6.2 (KCNJ11) and sulfonylurea receptor 1 (ABCC8) in diabetes mellitus and hyperinsulinism. Hum Mutat 30:170–180 Prisco F, Iafusco D, Franzese A, Sulli N, Barbetti F (2000) MODY 2 presenting as neonatal hyperglycemia: a need to re-shape the definition of “neonatal diabetes”? Diabetologia 43:1331–1332 Grulich-Henn J, Wagner V, Thont A, Schober E, Marg W, Kapellen TM, Haberland H, Raile K, Ellard S, Flanagan SE, Hattersley AT, Holl RW (2010) Entities and frequency of neonatal diabetes: data from the diabetes documentation and quality management system (DPV). Diabetic Med 27:709–712