Genetic identification of familial hypercholesterolemia within whole genome sequences in 6820 newborns

Clin Genet. 2024 Mar;105(3):308-312. doi: 10.1111/cge.14453. Epub 2023 Nov 29.

Abstract

Familial hypercholesterolemia (FH) is defined as a monogenic disease, characterized by elevated low-density lipoprotein cholesterol (LDL-C) levels. FH remains underdiagnosed and undertreated in Chinese. We whole-genome sequenced 6820 newborns from Qingdao of China to investigate the FH-related gene (LDLR, APOB, PCSK9) mutation types, carrier ratio and genotype-phenotype correlation. In this study, the prevalence of FH in Qingdao of China was 0.47% (95% CI: 0.32%-0.66%). The plasma lipid levels of FH-related gene mutation carriers begin to increase as early as infant. T-CHO and LDL-C of FH infants was higher by 48.1% (p < 0.001) and 42.9% (p < 0.001) relative to non-FH infants. A total of 22 FH infants and their parent participate in further studies. The results indicated that FH infant parent noncarriers have the normal plasma lipid level, while T-CHO and LDL-C increased in FH infants and FH infant parent carriers, but no difference between the groups. This highlights the importance of genetic factors. In conclusion, the spectrum of FH-causing mutations in the newborns of Qingdao, China was described for the first time. These data can serve as a considerable dataset for next-generation sequencing analysis of the Chinese population with FH and potentially helping reform regional policies for early detection and prevention of FH.

Keywords: familial hypercholesterolemia; gene mutation; genetic; newborn; whole-genome sequence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cholesterol, LDL / genetics
  • Humans
  • Hyperlipoproteinemia Type II* / diagnosis
  • Hyperlipoproteinemia Type II* / epidemiology
  • Hyperlipoproteinemia Type II* / genetics
  • Infant, Newborn
  • Mutation
  • Proprotein Convertase 9* / genetics
  • Receptors, LDL / genetics

Substances

  • PCSK9 protein, human
  • Proprotein Convertase 9
  • Cholesterol, LDL
  • Receptors, LDL