rs202039659

Variant summary

Our verdict is Benign. Variant got -8 ACMG points: 1P and 9B. BA1BP5PP3

This summary comes from the ClinGen Evidence Repository: The c.1541A>G variant in the HNF1 homeobox A gene, HNF1A, causes an amino acid change of histidine to arginine at codon 514 (p.(His514Arg)) of NM_000545.8. This variant is predicted to be deleterious by computational evidence, with a REVEL score of 0.85, which is greater than the MDEP VCEP threshold of 0.70 (PP3). However, this variant has a Grpmax Filtering allele frequency in gnomAD 2.1.1 of 0.0001150, which is greater than the MDEP threshold for BA1 (0.0001) (BA1). Additionally, this variant was identified in a patient with an alternate molecular basis for disease (BP5; internal lab contributors). In summary, c.1541A>G meets the criteria to be classified as benign for monogenic diabetes. ACMG/AMP criteria applied, as specified by the ClinGen MDEP (specification version 2.1.0, approved 08/11/2023): BA1, BP5, PP3. While this variant is benign for HNF1A-monogenic diabetes, there is evidence to suggest that this variant may act as a risk allele for type 2 diabetes (PMID:11692182, 27899486, 36216889, 33046911). LINK:https://erepo.genome.network/evrepo/ui/classification/CA6832103/MONDO:0015967/017

Frequency

Genomes: 𝑓 0.00027 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00023 ( 1 hom. )

Consequence

HNF1A
NM_000545.8 missense

Scores

5
9
4

Clinical Significance

Benign reviewed by expert panel U:9B:3

Conservation

PhyloP100: 3.44
Variant links:
Genes affected
HNF1A (HGNC:11621): (HNF1 homeobox A) The protein encoded by this gene is a transcription factor required for the expression of several liver-specific genes. The encoded protein functions as a homodimer and binds to the inverted palindrome 5'-GTTAATNATTAAC-3'. Defects in this gene are a cause of maturity onset diabetes of the young type 3 (MODY3) and also can result in the appearance of hepatic adenomas. Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Apr 2015]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Benign. Variant got -8 ACMG points.

PP3
For more information check the summary or visit ClinGen Evidence Repository.
BP5
For more information check the summary or visit ClinGen Evidence Repository.
BA1
For more information check the summary or visit ClinGen Evidence Repository.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HNF1ANM_000545.8 linkc.1541A>G p.His514Arg missense_variant Exon 8 of 10 ENST00000257555.11 NP_000536.6 P20823E0YMI7
HNF1ANM_001306179.2 linkc.1541A>G p.His514Arg missense_variant Exon 8 of 10 NP_001293108.2 P20823E0YMI7
HNF1ANM_001406915.1 linkc.1349A>G p.His450Arg missense_variant Exon 7 of 9 NP_001393844.1
HNF1AXM_024449168.2 linkc.1541A>G p.His514Arg missense_variant Exon 8 of 9 XP_024304936.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HNF1AENST00000257555.11 linkc.1541A>G p.His514Arg missense_variant Exon 8 of 10 1 NM_000545.8 ENSP00000257555.5 A0A0A0MQU7

Frequencies

GnomAD3 genomes
AF:
0.000270
AC:
41
AN:
151994
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000327
Gnomad ASJ
AF:
0.00750
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000132
Gnomad OTH
AF:
0.000479
GnomAD3 exomes
AF:
0.000430
AC:
108
AN:
251200
Hom.:
0
AF XY:
0.000420
AC XY:
57
AN XY:
135872
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000231
Gnomad ASJ exome
AF:
0.00814
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000132
Gnomad OTH exome
AF:
0.000489
GnomAD4 exome
AF:
0.000233
AC:
340
AN:
1461718
Hom.:
1
Cov.:
32
AF XY:
0.000226
AC XY:
164
AN XY:
727166
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.000201
Gnomad4 ASJ exome
AF:
0.00830
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000692
Gnomad4 OTH exome
AF:
0.000580
GnomAD4 genome
AF:
0.000270
AC:
41
AN:
152110
Hom.:
0
Cov.:
32
AF XY:
0.000256
AC XY:
19
AN XY:
74352
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.000327
Gnomad4 ASJ
AF:
0.00750
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000132
Gnomad4 OTH
AF:
0.000474
Alfa
AF:
0.000480
Hom.:
0
Bravo
AF:
0.000317
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.00
AC:
0
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000349
AC:
3
ExAC
AF:
0.000288
AC:
35
EpiCase
AF:
0.000164
EpiControl
AF:
0.000296

ClinVar

Significance: Benign
Submissions summary: Uncertain:9Benign:3
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

not specified Uncertain:2Benign:1
Jan 17, 2017
Genetic Services Laboratory, University of Chicago
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Dec 22, 2023
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: HNF1A c.1541A>G (p.His514Arg) results in a non-conservative amino acid change located in the Hepatocyte nuclear factor 1, beta isoform, C-terminal domain (IPR006897) of the encoded protein sequence. Three of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.00024 in 1613828 control chromosomes in the gnomAD database, including 1 homozygotes. The observed variant frequency is approximately 9 fold of the estimated maximal expected allele frequency for a pathogenic variant in HNF1A causing Maturity Onset Diabetes Of The Young 3 phenotype (2.5e-05), strongly suggesting that the variant is benign. c.1541A>G has been reported in the literature in individuals affected with diabetes and individuals from MODY cohort studies without strong evidence of segregation (examples: Behn_1998, Gragnoli_2001,Flannick_2013, Karaca_2017, Yu_2019, Elashi_2022). These report(s) do not provide unequivocal conclusions about association of the variant with Maturity Onset Diabetes Of The Young 3. At least one publication reports experimental evidence that this variant had a reduction in transcriptional activity and abnormal nuclear localization compared to Wild-Type (Najmi_2017). The following publications have been ascertained in the context of this evaluation (PMID: 9604876, 36613572, 24097065, 11692182, 28395978, 27899486, 10333057, 31264968). Nine submitters have cited clinical-significance assessments for this variant to ClinVar after 2014 and classified this variant as VUS (n=8) and Benign (n=1). Based on the evidence outlined above, the variant was classified as VUS-possibly benign. -

Nov 06, 2020
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.His514Arg variant in HNF1A is classified as likely benign because it has been identified in 0.8% (83/10366) of Ashkenazi Jewish chromosomes by gnomAD (http://gnomad.broadinstitute.org). Computational prediction tools and conservation analyses do not provide strong support for or against an impact to the protein. ACMG/AMP Criteria applied: BS1. -

not provided Uncertain:2Benign:1
Jan 29, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Dec 21, 2020
GeneDx
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 32910913, 31264968, 28395978, 27899486, 24097065, 11692182) -

Jun 01, 2018
CeGaT Center for Human Genetics Tuebingen
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Maturity-onset diabetes of the young type 3 Uncertain:2
May 28, 2019
Mendelics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Apr 27, 2017
Illumina Laboratory Services, Illumina
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). No publications were found based on this search. Allele frequency data from public databases did not allow this variant to be ruled in or out of causing disease. Therefore, this variant is classified as a variant of unknown significance. -

Monogenic diabetes Uncertain:1Benign:1
Mar 24, 2017
Personalized Diabetes Medicine Program, University of Maryland School of Medicine
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: research

ACMG Criteria:PP3 (8 predictors), BP4 (2 predictors), PS3 (PMID: 27899486 shows decreased activity and altered localization) -

Feb 20, 2025
ClinGen Monogenic Diabetes Variant Curation Expert Panel
Significance: Benign
Review Status: reviewed by expert panel
Collection Method: curation

The c.1541A>G variant in the HNF1 homeobox A gene, HNF1A, causes an amino acid change of histidine to arginine at codon 514 (p.(His514Arg)) of NM_000545.8. This variant is predicted to be deleterious by computational evidence, with a REVEL score of 0.85, which is greater than the MDEP VCEP threshold of 0.70 (PP3). However, this variant has a Grpmax Filtering allele frequency in gnomAD 2.1.1 of 0.0001150, which is greater than the MDEP threshold for BA1 (0.0001) (BA1). Additionally, this variant was identified in a patient with an alternate molecular basis for disease (BP5; internal lab contributors). In summary, c.1541A>G meets the criteria to be classified as benign for monogenic diabetes. ACMG/AMP criteria applied, as specified by the ClinGen MDEP (specification version 2.1.0, approved 08/11/2023): BA1, BP5, PP3. While this variant is benign for HNF1A-monogenic diabetes, there is evidence to suggest that this variant may act as a risk allele for type 2 diabetes (PMID: 11692182, 27899486, 36216889, 33046911). -

Maturity onset diabetes mellitus in young Uncertain:1
Jan 24, 2018
Ambry Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.H514R variant (also known as c.1541A>G), located in coding exon 8 of the HNF1A gene, results from an A to G substitution at nucleotide position 1541. The histidine at codon 514 is replaced by arginine, an amino acid with highly similar properties. This variant was first reported in a 29-year-old female and her mother, who were both diagnosed with type 2 diabetes (Gragnoli C et al. Diabetologia, 2001 Oct;44:1326-9). In another study, this variant was identified in a sample submitted for maturity-onset diabetes of the young genetic testing; however, specific clinical information was not provided and this variant was reported as a variant of uncertain significance (Bennett JT et al. Mol. Genet. Metab., 2015 Mar;114:451-8). This variant was also identified in a cohort of individuals with diabetes as well as in an 18-year-old female with negative autoantibodies and no family history of diabetes (Flannick J et al. Nat. Genet., 2013 Nov;45:1380-5; Karaca E et al. Diabetes Metab Syndr, 2017 Nov;11 Suppl 1:S491-S496). Functional analyses in HeLa cells demonstrated a reduction of transcriptional activity and nuclear localization compared to wild type, but at higher levels than known mutations in the HNF1A gene (Najmi LA et al. Diabetes, 2017 02;66:335-346). Based on data from gnomAD, the G allele has an overall frequency of approximately 0.039% (109/276936) total alleles studied. The highest observed frequency was 0.807% (82/10150) of Ashkenazi Jewish alleles. This amino acid position is poorly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on available evidence to date, the clinical significance of this alteration remains unclear. -

Diabetes mellitus type 1;C0011860:Type 2 diabetes mellitus;C1838100:Maturity-onset diabetes of the young type 3;C2675866:Type 1 diabetes mellitus 20 Uncertain:1
Oct 26, 2022
New York Genome Center
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The c.1541A>G variant identified in the HNF1A gene has been previously reported in individuals with diabetes in the literature [PMID:31264968, 28395978, 27899486, others], however it has also been reported in individuals without family history of diabetes [PMID: 31264968]. This variant has been reported in ClinVar as both a Variant of Uncertain Significance and as Likely Benign (VarID:435421). The c.1541A>G variant is observed in population databases (gnomADv2.1, gnomADv3.1.2, BRAVO-TOPMed) with highest allele frequency of 3.96e-4-4 (112 heterozygotes, 0 homozygotes, gnomADv2.1). The c.1541A>G variant is located within exon 8 of this 10-exon gene and is predicted to substitute a evolutionarily well conserved Histidine for Arginine at amino acid 514/632 (p.(His514Arg)),outside of predicted domains of HNF1A (UniProtKB:P20823). In silico algorithms predict this variant to have a damaging effect to protein function (REVEL=0.85) and this is supported by in vitro functional studies suggest that the p.His514Arg variant results in a functionally impaired protein with ~50-60% activity, and that this variant may lead to aggregation of HNF1A within the cell [PMID: 27899486]. Additional studies are needed to confirm this in vitro finding and clinical correlation with moderately reduced functional impairment is needed. Based on the available evidence, the c.1541A>G p.(His514Arg) variant identified in the HNF1A gene is reported as a Variant of Uncertain Significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.15
BayesDel_addAF
Pathogenic
0.24
D
BayesDel_noAF
Pathogenic
0.41
CADD
Uncertain
24
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.82
.;D;.;T;.
Eigen
Uncertain
0.47
Eigen_PC
Uncertain
0.44
FATHMM_MKL
Uncertain
0.83
D
LIST_S2
Uncertain
0.88
D;D;D;D;D
M_CAP
Uncertain
0.25
D
MetaRNN
Benign
0.039
T;T;T;T;T
MetaSVM
Pathogenic
0.93
D
PrimateAI
Uncertain
0.70
T
PROVEAN
Uncertain
-2.9
D;.;.;D;D
REVEL
Pathogenic
0.85
Sift
Uncertain
0.016
D;.;.;D;D
Sift4G
Benign
0.17
T;T;T;T;T
Polyphen
1.0
.;.;.;.;D
Vest4
0.62
MVP
0.97
MPC
0.21
ClinPred
0.26
T
GERP RS
4.3
gMVP
0.71

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs202039659; hg19: chr12-121437110; COSMIC: COSV105084529; COSMIC: COSV105084529; API