Skip to main content
Top
Published in: BMC Endocrine Disorders 1/2019

Open Access 01-12-2019 | Maturity-Onset Diabetes of the Young | Research article

HNF1A gene p.I27L is associated with early-onset, maturity-onset diabetes of the young-like diabetes in Turkey

Authors: Selvihan Beysel, Nilnur Eyerci, Ferda Alparslan Pinarli, Muhammed Kizilgul, Ozgur Ozcelik, Mustafa Caliskan, Erman Cakal

Published in: BMC Endocrine Disorders | Issue 1/2019

Login to get access

Abstract

Background

The molecular basis of the Turkish population with suspected maturity-onset diabetes of the young (MODY) has not been identified. This is the first study to investigate the association between HNF1A-gene single-nucleotide polymorphisms (SNPs) and having early-onset, MODY-like diabetes mellitus in the Turkish population.

Methods

All diabetic patients (N = 565) who presented to our clinic between 2012 and 2015 with a clinical suspicion of MODY were included in the study. Analysis of HNF1A, HNFB, HNF4A, GCK gene mutations was performed using real-time polymerase chain reaction sequencing. After genetic analysis, diabetics (n = 46) with HNF1A, HNF1B, HNF4A, GCK gene mutations (diagnosed as MODY) and diabetics (n = 30) with HNF1B, HNF4A, GCK gene SNPs were excluded. Patients with early-onset, MODY-like diabetes (n = 486) and non-diabetic controls (n = 263) were included. Genetic analyses for the HNF1A gene p.S487 N (rs2464196), p.A98V (rs1800574) and p.I27L (rs1169288) SNPs were performed using Sanger-based DNA sequencing among the control group.

Results

p.S487 N and p.A98V was similar between the diabetics and controls in dominant and recessive models with no association (each, p > 0.05). p.I27L GT/TT carriers (GT/TT vs. GG, OR = 1.68, 95% CI: [1. 21-2.13]; p = 0.035) and p.I27L TT carriers had increased risk of having MODY-like diabetes (GT/GG vs. TT, OR = 1.56, 95% CI: [1. 14-2.57]; p = 0.048). Family inheritance of diabetes was significantly more common in patients with the p.I27L TT genotype. The p.I27L SNP was modestly associated with having diabetes after adjusting for body mass index and age (β = 1.45, 95% CI: [1. 2-4.2]; p = 0.036).

Conclusions

The HNF1A gene p.I27L SNP was modestly associated with having early-onset, MODY-like diabetes in the Turkish population. HNF1A gene p.I27L SNP might contribute to age at diabetes diagnosis and family inheritance.
Appendix
Available only for authorised users
Literature
1.
go back to reference Balamurugan K, Bjørkhaug L, Mahajan S, Kanthimathi S, Njølstad PR, Srinivasan N, Mohan V, Radha V. Structure-function studies of HNF1A (MODY3) gene mutations in South Indian patients with monogenic diabetes. Clin Genet. 2016;90:486–95. Balamurugan K, Bjørkhaug L, Mahajan S, Kanthimathi S, Njølstad PR, Srinivasan N, Mohan V, Radha V. Structure-function studies of HNF1A (MODY3) gene mutations in South Indian patients with monogenic diabetes. Clin Genet. 2016;90:486–95.
2.
go back to reference Holmkvist J, Cervin C, Lyssenko V, Winckler W, Anevski D, Cilio C, Almgren P, Berglund G, Nilsson P, Tuomi T, et al. Common variants in HNF-1 alpha and risk of type 2 diabetes. Diabetologia. 2006;49:2882–91.CrossRef Holmkvist J, Cervin C, Lyssenko V, Winckler W, Anevski D, Cilio C, Almgren P, Berglund G, Nilsson P, Tuomi T, et al. Common variants in HNF-1 alpha and risk of type 2 diabetes. Diabetologia. 2006;49:2882–91.CrossRef
3.
go back to reference Weedon MN, Owen KR, Shields B, Hitman G, Walker M, McCarthy MI, Hattersley AT, Frayling TM. A large-scale association analysis of common variation of the HNF1alpha gene with type 2 diabetes in the U.K. Caucasian population. Diabetes. 2005;54:2487–91.CrossRef Weedon MN, Owen KR, Shields B, Hitman G, Walker M, McCarthy MI, Hattersley AT, Frayling TM. A large-scale association analysis of common variation of the HNF1alpha gene with type 2 diabetes in the U.K. Caucasian population. Diabetes. 2005;54:2487–91.CrossRef
4.
go back to reference Winckler W, Burtt NP, Holmkvist J, Cervin C, de Bakker PIW, Sun M, Almgren P, Tuomi T, Gaudet D, Hudson TJ, et al. Association of common variation in the HNF1alpha gene region with risk of type 2 diabetes. Diabetes. 2005;54:2336–42.CrossRef Winckler W, Burtt NP, Holmkvist J, Cervin C, de Bakker PIW, Sun M, Almgren P, Tuomi T, Gaudet D, Hudson TJ, et al. Association of common variation in the HNF1alpha gene region with risk of type 2 diabetes. Diabetes. 2005;54:2336–42.CrossRef
5.
go back to reference Scott RA, Lagou V, Welch RP, Wheeler E, Montasser ME, Luan J, Mägi R, Strawbridge RJ, Rehnberg E, Gustafsson S, et al. Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways. Nat Genet. 2012;44:991–1005.CrossRef Scott RA, Lagou V, Welch RP, Wheeler E, Montasser ME, Luan J, Mägi R, Strawbridge RJ, Rehnberg E, Gustafsson S, et al. Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways. Nat Genet. 2012;44:991–1005.CrossRef
6.
go back to reference Cho YS, Chen C-H, Hu C, Long J, Ong RTH, Sim X, Takeuchi F, Wu Y, Go MJ, Yamauchi T, et al. Meta-analysis of genome-wide association studies identifies eight new loci for type 2 diabetes in east Asians. Nat Genet. 2012;44:67–72.CrossRef Cho YS, Chen C-H, Hu C, Long J, Ong RTH, Sim X, Takeuchi F, Wu Y, Go MJ, Yamauchi T, et al. Meta-analysis of genome-wide association studies identifies eight new loci for type 2 diabetes in east Asians. Nat Genet. 2012;44:67–72.CrossRef
7.
go back to reference DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) Consortium, Asian Genetic Epidemiology Network Type 2 Diabetes (AGEN-T2D) Consortium, South Asian Type 2 Diabetes (SAT2D) Consortium, Mexican American Type 2 Diabetes (MAT2D) Consortium, Type 2 Diabetes Genetic Exploration by Nex-generation sequencing in muylti-Ethnic Samples (T2D-GENES) Consortium, Mahajan A, Go MJ, Zhang W, Below JE, Gaulton KJ, et al. Genome-wide trans-ancestry meta-analysis provides insight into the genetic architecture of type 2 diabetes susceptibility. Nat. Genet. 2014;46:234–44.CrossRef DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) Consortium, Asian Genetic Epidemiology Network Type 2 Diabetes (AGEN-T2D) Consortium, South Asian Type 2 Diabetes (SAT2D) Consortium, Mexican American Type 2 Diabetes (MAT2D) Consortium, Type 2 Diabetes Genetic Exploration by Nex-generation sequencing in muylti-Ethnic Samples (T2D-GENES) Consortium, Mahajan A, Go MJ, Zhang W, Below JE, Gaulton KJ, et al. Genome-wide trans-ancestry meta-analysis provides insight into the genetic architecture of type 2 diabetes susceptibility. Nat. Genet. 2014;46:234–44.CrossRef
8.
go back to reference Chiu KC, Chuang L-M, Chu A, Yoon C, Wang M. Comparison of the impact of the I27L polymorphism of the hepatocyte nuclear factor-1alpha on estimated and measured beta cell indices. Eur. J. Endocrinol. Eur. Fed. Endocr. Soc. 2003b;148:641–7.CrossRef Chiu KC, Chuang L-M, Chu A, Yoon C, Wang M. Comparison of the impact of the I27L polymorphism of the hepatocyte nuclear factor-1alpha on estimated and measured beta cell indices. Eur. J. Endocrinol. Eur. Fed. Endocr. Soc. 2003b;148:641–7.CrossRef
9.
go back to reference Urhammer SA, Fridberg M, Hansen T, Rasmussen SK, Møller AM, Clausen JO, Pedersen O. A prevalent amino acid polymorphism at codon 98 in the hepatocyte nuclear factor-1alpha gene is associated with reduced serum C-peptide and insulin responses to an oral glucose challenge. Diabetes. 1997;46:912–6.CrossRef Urhammer SA, Fridberg M, Hansen T, Rasmussen SK, Møller AM, Clausen JO, Pedersen O. A prevalent amino acid polymorphism at codon 98 in the hepatocyte nuclear factor-1alpha gene is associated with reduced serum C-peptide and insulin responses to an oral glucose challenge. Diabetes. 1997;46:912–6.CrossRef
10.
go back to reference Chiu KC, Chuang L-M, Chu A, Wang M. Transcription factor 1 and beta-cell function in glucose-tolerant subjects. Diabet Med J Br Diabet Assoc. 2003a;20:225–30.CrossRef Chiu KC, Chuang L-M, Chu A, Wang M. Transcription factor 1 and beta-cell function in glucose-tolerant subjects. Diabet Med J Br Diabet Assoc. 2003a;20:225–30.CrossRef
11.
go back to reference Morita K, Saruwatari J, Tanaka T, Oniki K, Kajiwara A, Otake K, Ogata Y, Nakagawa K. Associations between the common HNF1A gene variant p.I27L (rs1169288) and risk of type 2 diabetes mellitus are influenced by weight. Diabetes Metab. 2015;41:91–4.CrossRef Morita K, Saruwatari J, Tanaka T, Oniki K, Kajiwara A, Otake K, Ogata Y, Nakagawa K. Associations between the common HNF1A gene variant p.I27L (rs1169288) and risk of type 2 diabetes mellitus are influenced by weight. Diabetes Metab. 2015;41:91–4.CrossRef
12.
go back to reference Gaulton KJ, Ferreira T, Lee Y, Raimondo A, Mägi R, Reschen ME, Mahajan A, Locke A, Rayner NW, Robertson N, et al. Genetic fine mapping and genomic annotation defines causal mechanisms at type 2 diabetes susceptibility loci. Nat Genet. 2015;47:1415–25.CrossRef Gaulton KJ, Ferreira T, Lee Y, Raimondo A, Mägi R, Reschen ME, Mahajan A, Locke A, Rayner NW, Robertson N, et al. Genetic fine mapping and genomic annotation defines causal mechanisms at type 2 diabetes susceptibility loci. Nat Genet. 2015;47:1415–25.CrossRef
13.
go back to reference Bonnycastle LL, Willer CJ, Conneely KN, Jackson AU, Burrill CP, Watanabe RM, Chines PS, Narisu N, Scott LJ, Enloe ST, et al. Common variants in maturity-onset diabetes of the young genes contribute to risk of type 2 diabetes in Finns. Diabetes. 2006;55:2534–40.CrossRef Bonnycastle LL, Willer CJ, Conneely KN, Jackson AU, Burrill CP, Watanabe RM, Chines PS, Narisu N, Scott LJ, Enloe ST, et al. Common variants in maturity-onset diabetes of the young genes contribute to risk of type 2 diabetes in Finns. Diabetes. 2006;55:2534–40.CrossRef
14.
go back to reference Rissanen J, Wang H, Miettinen R, Kärkkäinen P, Kekäläinen P, Mykkänen L, Kuusisto J, Karhapää P, Niskanen L, Uusitupa M, et al. Variants in the hepatocyte nuclear factor-1alpha and -4alpha genes in Finnish and Chinese subjects with late-onset type 2 diabetes. Diabetes Care. 2000;23:1533–8.CrossRef Rissanen J, Wang H, Miettinen R, Kärkkäinen P, Kekäläinen P, Mykkänen L, Kuusisto J, Karhapää P, Niskanen L, Uusitupa M, et al. Variants in the hepatocyte nuclear factor-1alpha and -4alpha genes in Finnish and Chinese subjects with late-onset type 2 diabetes. Diabetes Care. 2000;23:1533–8.CrossRef
15.
go back to reference Steenkamp DW, Alexanian SM, Sternthal E. Approach to the patient with atypical diabetes. CMAJ Can Med Assoc J J Assoc Medicale Can. 2014;186:678–84.CrossRef Steenkamp DW, Alexanian SM, Sternthal E. Approach to the patient with atypical diabetes. CMAJ Can Med Assoc J J Assoc Medicale Can. 2014;186:678–84.CrossRef
16.
go back to reference Ağladıoğlu SY, Aycan Z, Çetinkaya S, Baş VN, Önder A, Peltek Kendirci HN, Doğan H, Ceylaner S. Maturity onset diabetes of youth (MODY) in Turkish children: sequence analysis of 11 causative genes by next generation sequencing. J Pediatr Endocrinol Metab JPEM. 2016;29:487–96.PubMed Ağladıoğlu SY, Aycan Z, Çetinkaya S, Baş VN, Önder A, Peltek Kendirci HN, Doğan H, Ceylaner S. Maturity onset diabetes of youth (MODY) in Turkish children: sequence analysis of 11 causative genes by next generation sequencing. J Pediatr Endocrinol Metab JPEM. 2016;29:487–96.PubMed
17.
go back to reference Gamboa-Meléndez MA, Huerta-Chagoya A, Moreno-Macías H, Vázquez-Cárdenas P, Ordóñez-Sánchez ML, Rodríguez-Guillén R, Riba L, Rodríguez-Torres M, Guerra-García MT, Guillén-Pineda LE, et al. Contribution of common genetic variation to the risk of type 2 diabetes in the Mexican mestizo population. Diabetes. 2012;61:3314–21.CrossRef Gamboa-Meléndez MA, Huerta-Chagoya A, Moreno-Macías H, Vázquez-Cárdenas P, Ordóñez-Sánchez ML, Rodríguez-Guillén R, Riba L, Rodríguez-Torres M, Guerra-García MT, Guillén-Pineda LE, et al. Contribution of common genetic variation to the risk of type 2 diabetes in the Mexican mestizo population. Diabetes. 2012;61:3314–21.CrossRef
18.
go back to reference Chen T, Cao X, Long Y, Zhang X, Yu H, Xu J, Yu T, Tian H. I27L polymorphism in hepatocyte nuclear factor-1A gene and type 2 diabetes mellitus: a meta-analysis of studies about orient population (Chinese and Japanese). Int J Diabetes Mellit. 2010;2:28–31.CrossRef Chen T, Cao X, Long Y, Zhang X, Yu H, Xu J, Yu T, Tian H. I27L polymorphism in hepatocyte nuclear factor-1A gene and type 2 diabetes mellitus: a meta-analysis of studies about orient population (Chinese and Japanese). Int J Diabetes Mellit. 2010;2:28–31.CrossRef
19.
go back to reference Winckler W, Weedon MN, Graham RR, McCarroll SA, Purcell S, Almgren P, Tuomi T, Gaudet D, Boström KB, Walker M, et al. Evaluation of common variants in the six known maturity-onset diabetes of the young (MODY) genes for association with type 2 diabetes. Diabetes. 2007;56:685–93.CrossRef Winckler W, Weedon MN, Graham RR, McCarroll SA, Purcell S, Almgren P, Tuomi T, Gaudet D, Boström KB, Walker M, et al. Evaluation of common variants in the six known maturity-onset diabetes of the young (MODY) genes for association with type 2 diabetes. Diabetes. 2007;56:685–93.CrossRef
20.
go back to reference Saxena R, Elbers CC, Guo Y, Peter I, Gaunt TR, Mega JL, Lanktree MB, Tare A, Castillo BA, Li YR, et al. Large-scale gene-centric meta-analysis across 39 studies identifies type 2 diabetes loci. Am J Hum Genet. 2012;90:410–25.CrossRef Saxena R, Elbers CC, Guo Y, Peter I, Gaunt TR, Mega JL, Lanktree MB, Tare A, Castillo BA, Li YR, et al. Large-scale gene-centric meta-analysis across 39 studies identifies type 2 diabetes loci. Am J Hum Genet. 2012;90:410–25.CrossRef
21.
go back to reference Cauchi S, Nead KT, Choquet H, Horber F, Potoczna N, Balkau B, Marre M, Charpentier G, Froguel P, Meyre D. The genetic susceptibility to type 2 diabetes may be modulated by obesity status: implications for association studies. BMC Med Genet. 2008;9:45.CrossRef Cauchi S, Nead KT, Choquet H, Horber F, Potoczna N, Balkau B, Marre M, Charpentier G, Froguel P, Meyre D. The genetic susceptibility to type 2 diabetes may be modulated by obesity status: implications for association studies. BMC Med Genet. 2008;9:45.CrossRef
22.
go back to reference Bonatto N, Nogaroto V, Svidnicki PV, Milléo FQ, Grassiolli S, Almeida MC, Vicari MR, Artoni RF. Variants of the HNF1A gene: a molecular approach concerning diabetic patients from southern Brazil. Genet Mol Biol. 2012;35:737–40.CrossRef Bonatto N, Nogaroto V, Svidnicki PV, Milléo FQ, Grassiolli S, Almeida MC, Vicari MR, Artoni RF. Variants of the HNF1A gene: a molecular approach concerning diabetic patients from southern Brazil. Genet Mol Biol. 2012;35:737–40.CrossRef
23.
go back to reference Deobagkar D, Ranade S, Deobagkar D. Identification of I27L polymorphism in the HNF-1Agene in Western Indian population with late-onset of diabetes. Int J Diabetes Dev Ctries. 2010;30:226.CrossRef Deobagkar D, Ranade S, Deobagkar D. Identification of I27L polymorphism in the HNF-1Agene in Western Indian population with late-onset of diabetes. Int J Diabetes Dev Ctries. 2010;30:226.CrossRef
24.
go back to reference Chiu KC, Chuang LM, Ryu JM, Tsai GP, Saad MF. The I27L amino acid polymorphism of hepatic nuclear factor-1alpha is associated with insulin resistance. J Clin Endocrinol Metab. 2000;85:2178–83.PubMed Chiu KC, Chuang LM, Ryu JM, Tsai GP, Saad MF. The I27L amino acid polymorphism of hepatic nuclear factor-1alpha is associated with insulin resistance. J Clin Endocrinol Metab. 2000;85:2178–83.PubMed
25.
go back to reference Bergman BC, Howard D, Schauer IE, Maahs DM, Snell-Bergeon JK, Eckel RH, Perreault L, Rewers M. Features of hepatic and skeletal muscle insulin resistance unique to type 1 diabetes. J Clin Endocrinol Metab. 2012;97:1663–72.CrossRef Bergman BC, Howard D, Schauer IE, Maahs DM, Snell-Bergeon JK, Eckel RH, Perreault L, Rewers M. Features of hepatic and skeletal muscle insulin resistance unique to type 1 diabetes. J Clin Endocrinol Metab. 2012;97:1663–72.CrossRef
26.
go back to reference Lehto M, Wipemo C, Ivarsson SA, Lindgren C, Lipsanen-Nyman M, Weng J, Wibell L, Widén E, Tuomi T, Groop L. High frequency of mutations in MODY and mitochondrial genes in Scandinavian patients with familial early-onset diabetes. Diabetologia. 1999;42:1131–7.CrossRef Lehto M, Wipemo C, Ivarsson SA, Lindgren C, Lipsanen-Nyman M, Weng J, Wibell L, Widén E, Tuomi T, Groop L. High frequency of mutations in MODY and mitochondrial genes in Scandinavian patients with familial early-onset diabetes. Diabetologia. 1999;42:1131–7.CrossRef
27.
go back to reference Anuradha S, Radha V, Deepa R, Hansen T, Carstensen B, Pedersen O, Mohan V. A prevalent amino acid polymorphism at codon 98 (Ala98Val) of the hepatocyte nuclear factor-1alpha is associated with maturity-onset diabetes of the young and younger age at onset of type 2 diabetes in Asian Indians. Diabetes Care. 2005;28:2430–5.CrossRef Anuradha S, Radha V, Deepa R, Hansen T, Carstensen B, Pedersen O, Mohan V. A prevalent amino acid polymorphism at codon 98 (Ala98Val) of the hepatocyte nuclear factor-1alpha is associated with maturity-onset diabetes of the young and younger age at onset of type 2 diabetes in Asian Indians. Diabetes Care. 2005;28:2430–5.CrossRef
28.
go back to reference Yang Y, Zhou T-C, Liu Y-Y, Li X, Wang W-X, Irwin DM, Zhang Y-P. Identification of HNF4A mutation p.T130I and HNF1A mutations p.I27L and p.S487N in a Han Chinese family with early-onset maternally inherited type 2 diabetes. J Diabetes Res. 2016;2016:3582616.PubMedPubMedCentral Yang Y, Zhou T-C, Liu Y-Y, Li X, Wang W-X, Irwin DM, Zhang Y-P. Identification of HNF4A mutation p.T130I and HNF1A mutations p.I27L and p.S487N in a Han Chinese family with early-onset maternally inherited type 2 diabetes. J Diabetes Res. 2016;2016:3582616.PubMedPubMedCentral
29.
go back to reference Yorifuji T, Higuchi S, Kawakita R, Hosokawa Y, Aoyama T, Murakami A, Kawae Y, Hatake K, Nagasaka H, Tamagawa N. Genetic basis of early-onset, maturity-onset diabetes of the young-like diabetes in Japan and features of patients without mutations in the major MODY genes: dominance of maternal inheritance. Pediatr Diabetes. 2018;19:1164–72.CrossRef Yorifuji T, Higuchi S, Kawakita R, Hosokawa Y, Aoyama T, Murakami A, Kawae Y, Hatake K, Nagasaka H, Tamagawa N. Genetic basis of early-onset, maturity-onset diabetes of the young-like diabetes in Japan and features of patients without mutations in the major MODY genes: dominance of maternal inheritance. Pediatr Diabetes. 2018;19:1164–72.CrossRef
30.
go back to reference Locke JM, Saint-Martin C, Laver TW, Patel KA, Wood AR, Sharp SA, Ellard S, Bellanné-Chantelot C, Hattersley AT, Harries LW, et al. The common HNF1A variant I27L is a modifier of age at diabetes diagnosis in individuals with HNF1A-MODY. Diabetes. 2018;67:1903–7.CrossRef Locke JM, Saint-Martin C, Laver TW, Patel KA, Wood AR, Sharp SA, Ellard S, Bellanné-Chantelot C, Hattersley AT, Harries LW, et al. The common HNF1A variant I27L is a modifier of age at diabetes diagnosis in individuals with HNF1A-MODY. Diabetes. 2018;67:1903–7.CrossRef
31.
go back to reference Awa WL, Thon A, Raile K, Grulich-Henn J, Meissner T, Schober E, Holl RW, DPV-Wiss. Study Group. Genetic and clinical characteristics of patients with HNF1A gene variations from the German-Austrian DPV database. Eur J Endocrinol Eur Fed Endocr Soc. 2011;164:513–20.CrossRef Awa WL, Thon A, Raile K, Grulich-Henn J, Meissner T, Schober E, Holl RW, DPV-Wiss. Study Group. Genetic and clinical characteristics of patients with HNF1A gene variations from the German-Austrian DPV database. Eur J Endocrinol Eur Fed Endocr Soc. 2011;164:513–20.CrossRef
Metadata
Title
HNF1A gene p.I27L is associated with early-onset, maturity-onset diabetes of the young-like diabetes in Turkey
Authors
Selvihan Beysel
Nilnur Eyerci
Ferda Alparslan Pinarli
Muhammed Kizilgul
Ozgur Ozcelik
Mustafa Caliskan
Erman Cakal
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2019
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/s12902-019-0375-2

Other articles of this Issue 1/2019

BMC Endocrine Disorders 1/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine