1. Cascade screening and genetic diagnosis of familial hypercholesterolemia in clusters of the Southeastern region from Brazil
- Author
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Karina Braga Gomes, Mauricio Teruo Tada, Júnea Paolucci de Paiva Silvino, Alexandre C. Pereira, Cinthia E. Jannes, Isabella Ramos Lima, and Ieda de Fátima Oliveira Silva
- Subjects
Adult ,Male ,0301 basic medicine ,Apolipoprotein E ,Proband ,Heterozygote ,Adolescent ,Apolipoprotein B ,Mutation, Missense ,Disease ,Familial hypercholesterolemia ,Hyperlipoproteinemia Type II ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Genetics ,medicine ,Cluster Analysis ,Humans ,Mass Screening ,Child ,Molecular Biology ,Gene ,Aged ,biology ,business.industry ,PCSK9 ,High-Throughput Nucleotide Sequencing ,Infant ,Cholesterol, LDL ,Sequence Analysis, DNA ,General Medicine ,Middle Aged ,medicine.disease ,Early Diagnosis ,030104 developmental biology ,Receptors, LDL ,Child, Preschool ,030220 oncology & carcinogenesis ,LDL receptor ,biology.protein ,Female ,lipids (amino acids, peptides, and proteins) ,business ,Brazil - Abstract
Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease characterized by high levels of low-density lipoprotein-cholesterol (LDLc), associated to premature cardiovascular disease. The detection of the variants related to FH is important to improve the early diagnosis in probands / index-cases (ICs) and their relatives. We included ICs with FH and their relatives, living in a small region of Minas Gerais state-Brazil, which were classified according to Dutch Lipid Clinic Network Criteria (DLCNC) and submitted to sequencing of genes related to FH (LDLR, APOB, PCSK9, LDLRAP1, LIPA, STAP1, APOE, ABCG5 e ABCG8). In a total of 143 subjects (32 ICs and 111 relatives), eight variants were identified in 91 individuals. From these variants, five were in LDLR [p.(Asp224Asn), p.(Ser854Gly), p.(Cys34Arg), p.(Asp601His), deletion of exon15 in LDLR)], one in APOB [p.(Met499Val)], one in PCSK9 [p.(Arg237Trp)] and one in APOE [p.(Pro28Leu)] genes. The variants were detected in 100% of those subjects classified as definitive, 87% as probable and 69% as possible FH cases based on DLCNC. The LDLc level was higher in individuals with corneal arch and xanthomas or xanthelasmas, as well as in pathogenic or probably pathogenic variants carriers. This study showed higher frequency of LDLR gene variants compared to other genes related to LDL metabolism in individuals with FH in Minas Gerais - Brazil and the presence of FH in relatives without previous diagnosis. Our data reinforce the importance of molecular and clinical evaluation of FH relatives in order to early diagnosis the FH, as well as cardiovascular diseases prevention. more...
- Published
- 2020
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