Genetic Spectrum and Cascade Screening of Familial Hypercholesterolemia in Routine Clinical Setting in Hong Kong

被引:2
|
作者
Yip, Man-Kwan [1 ]
Kwan, Elaine Yin-Wah [2 ]
Leung, Jenny Yin-Yan [3 ]
Lau, Emmy Yuen-Fun [4 ]
Poon, Wing-Tat [1 ]
机构
[1] Pamela Youde Nethersole Eastern Hosp, Dept Clin Pathol, Chai Wan, Hong Kong, Peoples R China
[2] Pamela Youde Nethersole Eastern Hosp, Dept Paediat & Adolescent Med, Chai Wan, Hong Kong, Peoples R China
[3] Ruttonjee Hosp, Dept Med & Geriatr, Wan Chai, Hong Kong, Peoples R China
[4] Pamela Youde Nethersole Eastern Hosp, Dept Med, Chai Wan, Hong Kong, Peoples R China
关键词
familial hypercholesterolemia; genetic spectrum; cascade screening; LDLR gene; LIPOPROTEIN RECEPTOR GENE; MUTATIONS; DIAGNOSIS; CHOLESTEROL; PREVALENCE;
D O I
10.3390/genes14112071
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Familial hypercholesterolemia (FH) is a prevalent but often underdiagnosed monogenic disorder affecting lipoprotein metabolism, and genetic testing for FH has not been widely conducted in Asia in the past. In this cross-sectional study of 31 probands (19 adults and 12 children) and an addition of 15 individuals (12 adults and 3 children), who underwent genetic testing and cascade screening for FH, respectively, during the period between February 2015 and July 2023, we identified a total of 25 distinct LDLR variants in 71.0% unrelated probands. Among the adult proband cohort, a higher proportion of genetically confirmed cases exhibited a positive family history of premature cardiovascular disease. Treatment intensity required to achieve an approximate 50% reduction in pretreatment low-density lipoprotein cholesterol (LDL-C) exhibited potentially better diagnostic performance compared to pretreatment LDL-C levels, Dutch Lipid Clinic Network Diagnostic Criteria (DLCNC) score, and modified DLCNC score. Adult individuals identified through cascade screening demonstrated less severe phenotypes, and fewer of them met previously proposed local criteria for FH genetic testing compared to the probands, indicating that cascade screening played a crucial role in the early detection of new cases that might otherwise have gone undiagnosed. These findings underscore the significance of genetic testing and cascade screening in the accurate identification and management of FH cases.
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页数:14
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