Monogenic Diabetes
Gene: ZMPSTE24
PMID 39993161 reports a Polynesian family (from Wallis) with insulin resistance, nonautoimmune diabetes, obesity, and metabolic syndrome. They identified a heterozygous missense variant in ZMPSTE24 (p.Leu438Phe)(93 hets/1 hom, v4) that segregated with 2 other affected individuals (but not all affected individuals were tested). Functional assays showed a decreased prelamin to lamin A maturation and accelerated cellular senescence.
PMID 27120622 reports an individual from New Caledonia with partial lipodystrophy, early onset
type 2 diabetes, android obesity and dilated cardiomyopathy. They identified the same heterozygous missense variant in ZMPSTE24 (p.Leu438Phe). No segregation performed. The variant was shown to reduce ZMPSTE24 activity drastically and produce an impaired capacity to
process prelamin A maturation both in vitro and in the patient’s cells.Created: 9 Jul 2026, 2:35 p.m. | Last Modified: 9 Jul 2026, 2:35 p.m.
Panel Version: 2.1
Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Phenotypes
Familial partial lipodystrophy, MONDO:0020088; monogenic diabetes, MONDO:0015967
Publications
Established gene disease association with Mandibuloacral dysplasia with type B lipodystrophy. Lipodystrophy associated with clinical features of insulin resistance, impaired glucose tolerance, and diabetes mellitus.Created: 21 May 2024, 11:13 a.m.
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Mandibuloacral dysplasia with type B lipodystrophy, MONDO:0012074
Publications
Severity of disease correlates with residual enzyme activity. Mandibuloacral dysplasia is the milder phenotype and is characterized by skeletal abnormalities including hypoplasia of the mandible and clavicles, acroosteolysis, cutaneous atrophy, and lipodystrophy. Results from one hylomorphic allele in trans with a second hylomorphic or null allele. 10 families reported.
Bi-allelic null alleles are associated with a more severe phenotype, restrictive dermopathy.Created: 8 Apr 2021, 6:55 a.m.
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Mandibuloacral dysplasia with type B lipodystrophy, MIM# 608612; MONDO:0012074
Publications
Gene: zmpste24 has been classified as Green List (High Evidence).
Phenotypes for gene: ZMPSTE24 were changed from Mandibuloacral dysplasia with type B lipodystrophy, 608612 to Mandibuloacral dysplasia with type B lipodystrophy, 608612; Familial partial lipodystrophy, MONDO:0020088; monogenic diabetes, MONDO:0015967
Publications for gene: ZMPSTE24 were set to 12913070; 15317753; 20034068; 16297189; 18435794
Mode of inheritance for gene: ZMPSTE24 was changed from BIALLELIC, autosomal or pseudoautosomal to BOTH monoallelic and biallelic, autosomal or pseudoautosomal
gene: ZMPSTE24 was added gene: ZMPSTE24 was added to Monogenic diabetes. Sources: Expert Review Green Mode of inheritance for gene: ZMPSTE24 was set to BIALLELIC, autosomal or pseudoautosomal Publications for gene: ZMPSTE24 were set to 12913070; 15317753; 20034068; 16297189; 18435794 Phenotypes for gene: ZMPSTE24 were set to Mandibuloacral dysplasia with type B lipodystrophy, 608612