基础医学与临床 ›› 2025, Vol. 45 ›› Issue (4): 505-510.doi: 10.16352/j.issn.1001-6325.2025.04.0505

• 研究论文 • 上一篇    下一篇

2例A型胰岛素抵抗综合征患者携带胰岛素受体基因c.3449T>C突变

王慧萍1, 任卫东2, 任雁林3, 史丽2*   

  1. 河北北方学院附属第一医院 1.国际医疗部;2.内分泌科;
    3.生殖医学科,河北 张家口 075000
  • 收稿日期:2024-11-14 修回日期:2025-02-20 出版日期:2025-04-05 发布日期:2025-03-24
  • 通讯作者: *only1055667626@163.com
  • 基金资助:
    河北省医学科学研究课题(20241510)

Two patients with type A insulin resistance syndrome carried mutation with insulin receptor gene c.3449T>C

WANG Huiping1, REN Weidong2, REN Yanlin3, SHI Li2*   

  1. 1. Department of International Medical Services;
    2. Department of Endocrinology;
    3. Department of Reproductive Medicine, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Received:2024-11-14 Revised:2025-02-20 Online:2025-04-05 Published:2025-03-24

摘要: 目的 报道2例A型胰岛素抵抗综合征病例,发现新的胰岛素受体基因突变。方法 收集其临床资料、实验室检查、影像学检查及胰岛素受体基因(INSR)突变结果,并回顾性分析国内外学者报道的A型胰岛素抵抗综合征病例。结果 1例有口干多饮及高雄激素血症,另1例有原发性闭经,均存在胰岛素抵抗,2例患儿的胰岛素受体基因发生杂合错义突变 c.3449T>C (p.L1150P),2例患儿母亲均携带此突变,父亲均无此突变。此突变型在国内外均未见报道。文献复习提示:此病发病年龄小,女性多见,BMI为(20.37±5.47)kg/m2,空腹血糖4.50 mmol/L(4.10,13.00),胰岛素抵抗的比例为100%,92.0%有黑棘皮样变,睾酮增高的比例为81.3%,糖尿病并发症出现较早。结论 对于严重胰岛素抵抗的患儿,基因分析有助于病因诊断。

关键词: A型胰岛素抵抗综合征, 基因突变

Abstract: Objective To report two cases of type A insulin resistance syndrome with new insulin receptor gene mutations. Methods Clinical data, laboratory examination, imaging examination and mutation scanning of insulin receptor gene were collected, and type A insulin resistance syndrome reported by domestic and foreign scholars were analyzed retrospectively. Results One case had dry mouth, polydipsia and hyperandrogenemia, and another case had primary amenorrhea, both of them had insulin resistance. Two cases had heterozygous missense mutation in insulin receptor gene C.3449T>c (p.L1150P). The mothers of the two probands all carried this mutation, while the fathers did not. This mutation has not been reported previously. Literature review shows that the onset age of this disease is young, and it is more common in women. BMI 20.37±5.47 kg/m2, fasting blood-glucose 4.50 mmol/L(4.10,13.00), the proportion of insulin resistance is 100%, 92.0% has acanthoid nigricans, and the proportion of Testosterone above normal is 81.3%, diabetes complications appear earlier. Conclusions Genetic analysis is helpfulfor the etiological diagnosis in children with severe insulin resistance.

Key words: type A insulin resistance syndrome, genetic mutations

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