Metabolic syndrome in a teenager as a clinical picture of R482W LMNA mutation

2014
journal article
article
dc.abstract.enMetabolic Syndrome (MS) can be diagnosed from the age of 10 years, when the coexistence of abdominal obesity, glucose metabolism disorders, dyslipidemia, and hypertension is observed. A binding part of MS is insulin resistance. Severe insulin resistance may be caused by a mutation in lamin (LMNA) gene. A teenager with MS due to mutation in LMNA gene is presented. A 17.5-yr-old Caucasian girl was admitted to the hospital with the suspicion of diabetes mellitus due to causal blood glucose 393 mg/dl (21.8 mmol/l), without typical diabetic symptoms. Since the age of 13 years she had been presented with excessive weight gain, hirsutism, and oligomenorrhoea. Her family history was positive for diabetes and partial lipodystrophy in three generations. Physical examination revealed abdominal obesity (waist-circumference 86 cm, BMI 27 kg/m2), android/cushingoidal habitus, acanthosis nigricans in axillae and neck, hirsutism, enlarged liver, and pseudohypertrophy of muscles of limbs with partial lipodystrophy. Based on oral glucose tolerance test diabetes was diagnosed (HOMA-IR 14). HbA1c was 9.2% (78 mmol/mol). Diabetes autoantibodies were negative. Lab tests revealed also dyslipidemia (total cholesterol 6.42 mmol/l, triglicerydes 7.42 mmol/l, HDL cholesterol 0.73 mmol/l) and elevated liver enzymes. Ultrasonography revealed steatosis hepatis and polycystic ovaries. Genetic tests confirmed that she is a carrier of heterozygous missense mutation (c.1444C>T; R482W) in the LMNA gene. Lifestyle changes, metformin dosage 500 mg three times a day and ursodeoxycholic acid were introduced as her therapy. After 4 months of this treatment HbA1c levels dropped 5.8% (40 mmol/mol). Moreover an improvement of lipid profile, liver tests and 2 kg body weight loss were observed. Diabetes mellitus as a component of MS in a young obese patient should be diagnosed individually. When other nontypical for diabetes mellitus clinical signs and symptoms exist with positive, multigenerational family history, genetic causes of MS should be taken into consideration.pl
dc.affiliationWydział Lekarski : Instytut Pediatriipl
dc.cm.date2020-01-07
dc.cm.id77595
dc.contributor.authorWędrychowicz, Anna - 133751 pl
dc.contributor.authorBorowiec, Maciejpl
dc.contributor.authorHogendorf, Ananpl
dc.contributor.authorMłynarski, Wojciech Michałpl
dc.contributor.authorStarzyk, Jerzy - 133488 pl
dc.date.accessioned2020-01-17T09:04:00Z
dc.date.available2020-01-17T09:04:00Z
dc.date.issued2014pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number3pl
dc.description.points5pl
dc.description.publication0,55pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume1pl
dc.identifier.articleid111pl
dc.identifier.doi10.14437/2377-7206-1-111pl
dc.identifier.eissn2469-5688pl
dc.identifier.issn2377-7206pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/137837
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa 3.0 Polska*
dc.rights.licenceCC-BY
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/legalcode*
dc.share.typeotwarte czasopismo
dc.subject.eninsulin resistancepl
dc.subject.enmetabolic syndromepl
dc.subject.enfamiliar partial lipodystrophypl
dc.subject.enFLPSpl
dc.subtypeArticlepl
dc.titleMetabolic syndrome in a teenager as a clinical picture of R482W LMNA mutationpl
dc.title.journalDiabetes Research and Treatmentpl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
Metabolic Syndrome (MS) can be diagnosed from the age of 10 years, when the coexistence of abdominal obesity, glucose metabolism disorders, dyslipidemia, and hypertension is observed. A binding part of MS is insulin resistance. Severe insulin resistance may be caused by a mutation in lamin (LMNA) gene. A teenager with MS due to mutation in LMNA gene is presented. A 17.5-yr-old Caucasian girl was admitted to the hospital with the suspicion of diabetes mellitus due to causal blood glucose 393 mg/dl (21.8 mmol/l), without typical diabetic symptoms. Since the age of 13 years she had been presented with excessive weight gain, hirsutism, and oligomenorrhoea. Her family history was positive for diabetes and partial lipodystrophy in three generations. Physical examination revealed abdominal obesity (waist-circumference 86 cm, BMI 27 kg/m2), android/cushingoidal habitus, acanthosis nigricans in axillae and neck, hirsutism, enlarged liver, and pseudohypertrophy of muscles of limbs with partial lipodystrophy. Based on oral glucose tolerance test diabetes was diagnosed (HOMA-IR 14). HbA1c was 9.2% (78 mmol/mol). Diabetes autoantibodies were negative. Lab tests revealed also dyslipidemia (total cholesterol 6.42 mmol/l, triglicerydes 7.42 mmol/l, HDL cholesterol 0.73 mmol/l) and elevated liver enzymes. Ultrasonography revealed steatosis hepatis and polycystic ovaries. Genetic tests confirmed that she is a carrier of heterozygous missense mutation (c.1444C>T; R482W) in the LMNA gene. Lifestyle changes, metformin dosage 500 mg three times a day and ursodeoxycholic acid were introduced as her therapy. After 4 months of this treatment HbA1c levels dropped 5.8% (40 mmol/mol). Moreover an improvement of lipid profile, liver tests and 2 kg body weight loss were observed. Diabetes mellitus as a component of MS in a young obese patient should be diagnosed individually. When other nontypical for diabetes mellitus clinical signs and symptoms exist with positive, multigenerational family history, genetic causes of MS should be taken into consideration.
dc.affiliationpl
Wydział Lekarski : Instytut Pediatrii
dc.cm.date
2020-01-07
dc.cm.id
77595
dc.contributor.authorpl
Wędrychowicz, Anna - 133751
dc.contributor.authorpl
Borowiec, Maciej
dc.contributor.authorpl
Hogendorf, Anan
dc.contributor.authorpl
Młynarski, Wojciech Michał
dc.contributor.authorpl
Starzyk, Jerzy - 133488
dc.date.accessioned
2020-01-17T09:04:00Z
dc.date.available
2020-01-17T09:04:00Z
dc.date.issuedpl
2014
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
3
dc.description.pointspl
5
dc.description.publicationpl
0,55
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
1
dc.identifier.articleidpl
111
dc.identifier.doipl
10.14437/2377-7206-1-111
dc.identifier.eissnpl
2469-5688
dc.identifier.issnpl
2377-7206
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/137837
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa 3.0 Polska
dc.rights.licence
CC-BY
dc.rights.uri*
http://creativecommons.org/licenses/by/3.0/legalcode
dc.share.type
otwarte czasopismo
dc.subject.enpl
insulin resistance
dc.subject.enpl
metabolic syndrome
dc.subject.enpl
familiar partial lipodystrophy
dc.subject.enpl
FLPS
dc.subtypepl
Article
dc.titlepl
Metabolic syndrome in a teenager as a clinical picture of R482W LMNA mutation
dc.title.journalpl
Diabetes Research and Treatment
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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