在单一的美国医疗保健系统内对家族性高胆固醇血症的基因鉴定
Noura S Abul-Husn1, Kandamurugu Manickam2, Laney K Jones2
1Regeneron Genetics Center, Tarrytown, NY 10591, USA.
概括
家庭高胆固醇血症 (FH) 诊断不足,但基因组查发现冠状动脉疾病风险增加的携带者. 许多FH患者接受治疗不足,这突显了改善诊断和降脂治疗的必要性.
科学领域:
- 遗传学
- 心脏病学
- 公共卫生
背景情况:
- 家庭高胆固醇血症 (FH) 是一种常见的遗传疾病,导致高LDL胆固醇和早发性心血管疾病.
- 尽管进行胆固醇查,但在一般人群中,FH的诊断仍然显著不足.
研究的目的:
- 使用外基因组测序和EHR数据确定FH相关基因组变异的流行率和临床影响.
- 评估已确定的FH变种携带者的诊断缺口和当前的降脂治疗状态.
主要方法:
- 对50726个人的外体序列和电子健康记录 (EHR) 数据分析.
- 在未经选择和通过心脏导管测定的队列中估计FH变异的流行率.
- 在FH携带者中评估冠状动脉疾病 (CAD) 风险和治疗模式.
主要成果:
- 在一般人群中,FH患病率估计为1:256;在心脏导管患者中估计为1:118.
- 冠状动脉疾病的风险显著增加.
- 在基因检测之前,只有24%的携带者符合可能/确定的FH诊断的临床标准.
- 58%的携带者接受了他类药物治疗,其中46%的LDL- C低于100 mg/ dL.
结论:
- 基因组查有效地识别出患有FH的个体,其中许多人未被诊断或未得到最佳治疗.
- 这种方法可以迅速诊断并改善FH患者的治疗,从而降低心血管风险.
相关概念视频
Pharmacogenomics: Identification of New Drug Targets
57
Advances in genomics have profoundly influenced drug discovery by increasing both the speed and accuracy of pharmaceutical development. Pharmacogenomics, which examines how genetic variation influences drug response, facilitates the identification of novel therapeutic targets and enables patient stratification for personalized treatment. These strategies contribute to improved drug efficacy, minimized adverse effects, and more efficient clinical trial design.Mapping genetic differences...
57
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
677
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
677
Cholesterol: Significance and Regulation
1.8K
Although not a source of energy, cholesterol plays a significant role as a foundational structure for bile salts, steroid hormones, and vitamin D, as well as being a crucial component of plasma membranes. Approximately 15% of blood cholesterol is derived from our diet, with the remainder synthesized from acetyl CoA by the liver and intestines. Cholesterol is eliminated from the body through its conversion into bile salts, which are eventually discarded in the feces.
Considering cholesterol and...
Considering cholesterol and...
1.8K
Blood Studies for Cardiovascular System III: Serum Lipid Profile
726
Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
726
Cardiomyopathy III: Hypertrophic Cardiomyopathy
602
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
602
Human Genetics
1.8K
Human genetics provides a profound framework for understanding the interplay between genetic predispositions and human psychology. At the heart of this discipline lies the study of how genes influence physical traits, behaviors, and susceptibility to diseases. Each person carries a unique genetic code that subtly or significantly shapes their psychological and behavioral landscape.
The complex relationship between genetics and psychology is observable through common biological components such...
The complex relationship between genetics and psychology is observable through common biological components such...
1.8K


