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Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group

BACKGROUND: Hyperinsulinism results from inappropriate insulin secretion during hypoglycaemia. Down syndrome is causally linked to a number of endocrine disorders including Type 1 diabetes and neonatal diabetes. We noted a high number of individuals with Down syndrome referred for hyperinsulinism ge...

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Autores principales: Hewat, Thomas I., Laver, Thomas W., Houghton, Jayne A. L., Männistö, Jonna M. E., Alvi, Sabah, Brearey, Stephen P., Cody, Declan, Dastamani, Antonia, De los Santos La Torre, Miguel, Murphy, Nuala, Rami‐Merhar, Birgit, Wefers, Birgit, Huopio, Hanna, Banerjee, Indraneel, Johnson, Matthew B., Flanagan, Sarah E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons A/S 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9310623/
https://www.ncbi.nlm.nih.gov/pubmed/35294086
http://dx.doi.org/10.1111/pedi.13333
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author Hewat, Thomas I.
Laver, Thomas W.
Houghton, Jayne A. L.
Männistö, Jonna M. E.
Alvi, Sabah
Brearey, Stephen P.
Cody, Declan
Dastamani, Antonia
De los Santos La Torre, Miguel
Murphy, Nuala
Rami‐Merhar, Birgit
Wefers, Birgit
Huopio, Hanna
Banerjee, Indraneel
Johnson, Matthew B.
Flanagan, Sarah E.
author_facet Hewat, Thomas I.
Laver, Thomas W.
Houghton, Jayne A. L.
Männistö, Jonna M. E.
Alvi, Sabah
Brearey, Stephen P.
Cody, Declan
Dastamani, Antonia
De los Santos La Torre, Miguel
Murphy, Nuala
Rami‐Merhar, Birgit
Wefers, Birgit
Huopio, Hanna
Banerjee, Indraneel
Johnson, Matthew B.
Flanagan, Sarah E.
author_sort Hewat, Thomas I.
collection PubMed
description BACKGROUND: Hyperinsulinism results from inappropriate insulin secretion during hypoglycaemia. Down syndrome is causally linked to a number of endocrine disorders including Type 1 diabetes and neonatal diabetes. We noted a high number of individuals with Down syndrome referred for hyperinsulinism genetic testing, and therefore aimed to investigate whether the prevalence of Down syndrome was increased in our hyperinsulinism cohort compared to the population. METHODS: We identified individuals with Down syndrome referred for hyperinsulinism genetic testing to the Exeter Genomics Laboratory between 2008 and 2020. We sequenced the known hyperinsulinism genes in all individuals and investigated their clinical features. RESULTS: We identified 11 individuals with Down syndrome in a cohort of 2011 patients referred for genetic testing for hyperinsulinism. This represents an increased prevalence compared to the population (2.5/2011 expected vs. 11/2011 observed, p = 6.8 × 10(−5)). A pathogenic ABCC8 mutation was identified in one of the 11 individuals. Of the remaining 10 individuals, five had non‐genetic risk factors for hyperinsulinism resulting from the Down syndrome phenotype: intrauterine growth restriction, prematurity, gastric/oesophageal surgery, and asparaginase treatment for leukaemia. For five individuals no risk factors for hypoglycaemia were reported although two of these individuals had transient hyperinsulinism and one was lost to follow‐up. CONCLUSIONS: Down syndrome is more common in patients with hyperinsulinism than in the population. This is likely due to an increased burden of non‐genetic risk factors resulting from the Down syndrome phenotype. Down syndrome should not preclude genetic testing as coincidental monogenic hyperinsulinism and Down syndrome is possible.
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spelling pubmed-93106232022-07-29 Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group Hewat, Thomas I. Laver, Thomas W. Houghton, Jayne A. L. Männistö, Jonna M. E. Alvi, Sabah Brearey, Stephen P. Cody, Declan Dastamani, Antonia De los Santos La Torre, Miguel Murphy, Nuala Rami‐Merhar, Birgit Wefers, Birgit Huopio, Hanna Banerjee, Indraneel Johnson, Matthew B. Flanagan, Sarah E. Pediatr Diabetes Monogenic Diabetes and Other Genetic Disorders of Glucose Metabolism BACKGROUND: Hyperinsulinism results from inappropriate insulin secretion during hypoglycaemia. Down syndrome is causally linked to a number of endocrine disorders including Type 1 diabetes and neonatal diabetes. We noted a high number of individuals with Down syndrome referred for hyperinsulinism genetic testing, and therefore aimed to investigate whether the prevalence of Down syndrome was increased in our hyperinsulinism cohort compared to the population. METHODS: We identified individuals with Down syndrome referred for hyperinsulinism genetic testing to the Exeter Genomics Laboratory between 2008 and 2020. We sequenced the known hyperinsulinism genes in all individuals and investigated their clinical features. RESULTS: We identified 11 individuals with Down syndrome in a cohort of 2011 patients referred for genetic testing for hyperinsulinism. This represents an increased prevalence compared to the population (2.5/2011 expected vs. 11/2011 observed, p = 6.8 × 10(−5)). A pathogenic ABCC8 mutation was identified in one of the 11 individuals. Of the remaining 10 individuals, five had non‐genetic risk factors for hyperinsulinism resulting from the Down syndrome phenotype: intrauterine growth restriction, prematurity, gastric/oesophageal surgery, and asparaginase treatment for leukaemia. For five individuals no risk factors for hypoglycaemia were reported although two of these individuals had transient hyperinsulinism and one was lost to follow‐up. CONCLUSIONS: Down syndrome is more common in patients with hyperinsulinism than in the population. This is likely due to an increased burden of non‐genetic risk factors resulting from the Down syndrome phenotype. Down syndrome should not preclude genetic testing as coincidental monogenic hyperinsulinism and Down syndrome is possible. John Wiley & Sons A/S 2022-03-23 2022-06 /pmc/articles/PMC9310623/ /pubmed/35294086 http://dx.doi.org/10.1111/pedi.13333 Text en © 2022 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Monogenic Diabetes and Other Genetic Disorders of Glucose Metabolism
Hewat, Thomas I.
Laver, Thomas W.
Houghton, Jayne A. L.
Männistö, Jonna M. E.
Alvi, Sabah
Brearey, Stephen P.
Cody, Declan
Dastamani, Antonia
De los Santos La Torre, Miguel
Murphy, Nuala
Rami‐Merhar, Birgit
Wefers, Birgit
Huopio, Hanna
Banerjee, Indraneel
Johnson, Matthew B.
Flanagan, Sarah E.
Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group
title Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group
title_full Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group
title_fullStr Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group
title_full_unstemmed Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group
title_short Increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group
title_sort increased referrals for congenital hyperinsulinism genetic testing in children with trisomy 21 reflects the high burden of non‐genetic risk factors in this group
topic Monogenic Diabetes and Other Genetic Disorders of Glucose Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9310623/
https://www.ncbi.nlm.nih.gov/pubmed/35294086
http://dx.doi.org/10.1111/pedi.13333
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