OBJECTIVE: To report studies on an elderly patient with moderate NIDDM associated with marked fasting hyperinsulinemia. RESEARCH DESIGN AND METHODS: The propositus and several family members were studied by a combination of clinical, biochemical, and molecular genetic approaches to define the underlying genetic defect. RESULTS: Fasting levels of contrainsulin hormones were normal, and resistance to exogenous insulin was absent. Gel filtration and reverse-phase high-performance liquid chromatography revealed elevated amounts of a structurally abnormal proinsulin intermediate (AC proinsulin). A study of the family of the propositus showed the same abnormality in 4 of 5 members in 3 successive generations. Genetic analysis revealed a point mutation affecting residue 65 of human proinsulin (Arg-->His) in one allele of the insulin gene in the propositus, a defect similar to that described previously in 3 other apparently unrelated lineages. CONCLUSIONS: This family exhibits a clear-cut relationship between increasing age and metabolic decompensation in all the hyperproinsulinemic members, suggesting that (inherited) metabolic stress and age both contribute to development of diabetes mellitus.
OBJECTIVE: To report studies on an elderly patient with moderate NIDDM associated with marked fasting hyperinsulinemia. RESEARCH DESIGN AND METHODS: The propositus and several family members were studied by a combination of clinical, biochemical, and molecular genetic approaches to define the underlying genetic defect. RESULTS: Fasting levels of contrainsulin hormones were normal, and resistance to exogenous insulin was absent. Gel filtration and reverse-phase high-performance liquid chromatography revealed elevated amounts of a structurally abnormal proinsulin intermediate (AC proinsulin). A study of the family of the propositus showed the same abnormality in 4 of 5 members in 3 successive generations. Genetic analysis revealed a point mutation affecting residue 65 of humanproinsulin (Arg-->His) in one allele of the insulin gene in the propositus, a defect similar to that described previously in 3 other apparently unrelated lineages. CONCLUSIONS: This family exhibits a clear-cut relationship between increasing age and metabolic decompensation in all the hyperproinsulinemic members, suggesting that (inherited) metabolic stress and age both contribute to development of diabetes mellitus.
Authors: R Duggirala; M P Stern; B D Mitchell; L J Reinhart; P A Shipman; O C Uresandi; W K Chung; R L Leibel; C N Hales; P O'Connell; J Blangero Journal: Am J Hum Genet Date: 1996-09 Impact factor: 11.025
Authors: Julie Støy; Donald F Steiner; Soo-Young Park; Honggang Ye; Louis H Philipson; Graeme I Bell Journal: Rev Endocr Metab Disord Date: 2010-09 Impact factor: 6.514