Cardio and cerebrovascular risk in maturity onset diabetes of young comparable to type 1 & 2 diabetes patients

A new study found that maturity-onset diabetes of the young (MODY) that is detected by genetic analysis has a greater prevalence than clinical diagnosis and has a risk of incident cardiovascular and cerebrovascular events comparable to that of type 1 and type 2 diabetes. The study results were published in The Journal of Clinical Endocrinology and Metabolism. 

Maturity-onset diabetes of the young (MODY), a rare cause of diabetes, is a group of monogenic disorders characterized by autosomal dominantly inherited non-insulin dependent forms of diabetes classically presenting in adolescence or young adults before the age of 25 years. Diagnosing MODY or type 1 or 2 diabetes in the early stages is necessary to avoid cardiovascular and cerebrovascular complications. Researchers conducted a study to compare the incident risk of cardio-cerebrovascular events in maturity-onset diabetes of the young (MODY), type 1 diabetes, and type 2 diabetes. 

Using whole exome sequencing (WES) type 1 diabetes, type 2 diabetes, and MODY were diagnosed. The occurrence of the first major adverse cardiovascular events (MACE), including acute myocardial infarction, heart failure, stroke, unstable angina pectoris, and cardio-cerebrovascular-related mortality was the primary endpoint. Cox proportional hazards models were applied and adjusted to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the incident risk of MACE in type 1 diabetes, type 2 diabetes, MODY, and MODY subgroups in comparison with people without diabetes (control group).

Key findings: 

• Type 1 diabetes, type 2 diabetes, and MODY accounted for 2.7%, 68.1%, and 11.4% of 26198 diabetic participants from the UK Biobank.
• Nearly 1028 MACEs occurred in the control group, 70 events in type 1 diabetes patients, 5020 events in type 2 diabetes patients, and 717 events in MODY during a median follow-up of 13 years.
• The hazard OF MACE in HNF1B-MODY was highest among MODY subgroups. 

Thus, during a follow-up of 13 years, it was found that T1 diabetes, MODY, and T2 diabetes had a 2.15-, 5.8- and 7-fold increase in MACE risk compared to healthy individuals.  

Further reading: Wu HX, Chu TY, Iqbal J, et al. Cardio-cerebrovascular Outcomes in MODY, Type 1 Diabetes, and Type 2 Diabetes: A Prospective Cohort Study [published online ahead of print, 2023 Apr 24]. J Clin Endocrinol Metab. 2023;dgad233. doi: 10.1210/clinem/dgad233