%0 Journal Article
%T Monogenic diabetes in adults: A multi-ancestry study reveals strong disparities in diagnosis rates and clinical presentation.
%A Mifsud F
%A Saint-Martin C
%A Dubois-Laforgue D
%A Bouvet D
%A Timsit J
%A Bellanné-Chantelot C
%A  
%A Mifsud F
%A Saint-Martin C
%A Dubois-Laforgue D
%A Bouvet D
%A Timsit J
%A Bellanné-Chantelot C
%A  
%J Diabetes Res Clin Pract
%V 188
%N 0
%D Jun 2022
%M 35533745
%F 8.18
%R 10.1016/j.diabres.2022.109908
%X <B>OBJECTIVE: </B>Identification of monogenic diabetes (MgD) conveys benefits for patients' care. Algorithms for selecting the patients to be genetically tested have been established in EuroCaucasians, but not in non-EuroCaucasian individuals. We assessed the diagnosis rate, the phenotype of MgD, and the relevance of selection criteria, according to ancestry in patients referred for a suspected MgD.<BR><B>METHODS: </B>Seven genes (GCK, HNF1A, HNF4A, HNF1B, ABCC8, KCNJ11, INS) were analyzed in 1975 adult probands (42% non-EuroCaucasians), selected on the absence of diabetes autoantibodies and ≥2 of the following criteria: age ≤40 years and body mass index <30 kg/m2 at diagnosis, and a family history of diabetes in ≥2 generations.<BR><B>RESULTS: </B>Pathogenic/likely pathogenic variants were identified in 6.2% of non-EuroCaucasian and 23.6% of EuroCaucasian patients (OR 0.21, [0.16-0.29]). Diagnosis rate was low in all non-EuroCaucasian subgroups (4.1-11.8%). Common causes of MgD (GCK, HNF1A, HNF4A), but not rare causes, were less frequent in non-EuroCaucasians than in EuroCaucasians (4.1%, vs. 21.1%, OR 0.16 [0.11-0.23]). Using ethnicity-specific body mass index cutoffs increased the diagnosis rate in several non-EuroCaucasian subgroups.<BR><B>CONCLUSIONS: </B>The diagnosis rate of MgD is low in non-EuroCaucasian patients, but may be improved by tailoring selection criteria according to patients'ancestry.