中国晚发型庞贝氏症高风险筛查:一项扩大的多中心研究。

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Kexin Jiao, Bochen Zhu, Xueli Chang, Junhong Guo, Jun Fu, Xueqin Song, Xuen Yu, Xiaoge Zhang, Jihong Dong, Wang Yan, Xinghua Luan, Zhiqiang Wang, Hong Han, Lijun Du, Liqiang Yu, Yali Zhang, Jingjing Zhang, Yan Chen, Jing Hu, Zhe Zhao, Juan Kang, Song Tan, Zhiyun Wang, Shanshan Mao, Fangyuan Qian, Ronghua Luo, Changxia Liu, Zhengyu Huang, Gang Li, Xia Li, Lijun Luo, Dong Li, Yuanlin Zhou, Xiafei Hu, Xuefan Yu, Yongguang Shi, Jianming Jiang, Jialong Zhang, Nachuan Cheng, Ningning Wang, Xingyu Xia, Dongyue Yue, Mingshi Gao, Jianying Xi, Sushan Luo, Jiahong Lu, Chongbo Zhao, Qing Ke, Mingming Ma, Wenhua Zhu
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引用次数: 0

摘要

晚发型庞贝氏症(LOPD)是由溶酶体酶酸α-葡萄糖苷酶(GAA)的遗传性缺乏引起的,会导致进行性肢体无力和呼吸障碍。非特异性早期症状起病隐匿,往往无法及时诊断。本研究旨在验证中国人群中 LOPD 的高危筛查标准。研究共纳入 726 名患者,其中包括 96 名 14 岁以下的患者。研究采用干血斑(DBS)和串联质谱法(MS/MS)评估血清 GAA 活性。44 名患者的 GAA 活性降低,其中 16 人(2.2%)通过基因检测确认为 LOPD。此外,还发现了三种以前未报道过的 GAA 突变。中位诊断延迟时间缩短至 3 年,优于之前的回顾性研究。确诊时,大多数患者表现为呼吸功能受损和/或四肢无力。血清肌酸激酶(CK)水平升高多见于16岁以前发病的患者。总之,高危筛查是早期发现 LOPD 患者的可行且有效的方法。对于 16 岁以下的患者,CK 水平超过正常上限的 2 倍应作为附加标准。这一修改后的 LOPD 高危筛查标准需要在更大的中国人群中进一步验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
High-risk screening for late-onset Pompe disease in China: An expanded multicenter study.

Late-onset Pompe disease (LOPD) is caused by a genetic deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA), leading to progressive limb-girdle weakness and respiratory impairment. The insidious onset of non-specific early symptoms often prohibits timely diagnosis. This study aimed to validate the high-risk screening criteria for LOPD in the Chinese population. A total of 726 patients were included, including 96 patients under 14 years of age. Dried blood spots (DBS) and tandem mass spectrometry (MS/MS) were employed to evaluate serum GAA activity. Forty-four patients exhibited a decreased GAA activity, 16 (2.2%) of which were confirmed as LOPD by genetic testing. Three previously unreported GAA mutations were also identified. The median diagnostic delay was shortened to 3 years, which excelled the previous retrospective studies. At diagnosis, most patients exhibited impaired respiratory function and/or limb-girdle weakness. Elevated serum creatine kinase (CK) levels were more frequently observed in patients who manifested before age 16. Overall, high-risk screening is a feasible and efficient method to identify LOPD patients at an early stage. Patients over 1 year of age with either weakness in axial and/or proximal limb muscles, or unexplained respiratory distress shall be subject to GAA enzymatic test, while CK levels above 2 times the upper normal limit shall be an additional criterion for patients under 16. This modified high-risk screening criteria for LOPD requires further validation in larger Chinese cohorts.

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来源期刊
Journal of Inherited Metabolic Disease
Journal of Inherited Metabolic Disease 医学-内分泌学与代谢
CiteScore
9.50
自引率
7.10%
发文量
117
审稿时长
4-8 weeks
期刊介绍: The Journal of Inherited Metabolic Disease (JIMD) is the official journal of the Society for the Study of Inborn Errors of Metabolism (SSIEM). By enhancing communication between workers in the field throughout the world, the JIMD aims to improve the management and understanding of inherited metabolic disorders. It publishes results of original research and new or important observations pertaining to any aspect of inherited metabolic disease in humans and higher animals. This includes clinical (medical, dental and veterinary), biochemical, genetic (including cytogenetic, molecular and population genetic), experimental (including cell biological), methodological, theoretical, epidemiological, ethical and counselling aspects. The JIMD also reviews important new developments or controversial issues relating to metabolic disorders and publishes reviews and short reports arising from the Society''s annual symposia. A distinction is made between peer-reviewed scientific material that is selected because of its significance for other professionals in the field and non-peer- reviewed material that aims to be important, controversial, interesting or entertaining (“Extras”).
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