葡萄糖转运蛋白1缺乏综合征在中国患者中的临床和遗传特征

IF 6.1 2区 医学 Q1 PEDIATRICS
World Journal of Pediatrics Pub Date : 2025-03-01 Epub Date: 2025-03-06 DOI:10.1007/s12519-025-00884-9
Mei-Jiao Zhang, Shi-Min Zhang, Qing-Ping Zhang, Yong-Xin Wen, Jia-Ping Wang, Yu-Wu Jiang, Xin-Hua Bao
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引用次数: 0

摘要

背景:SLC2A1基因突变导致葡萄糖转运蛋白1型缺乏综合征(Glut1DS)。本研究旨在探讨中国Glut1DS患者的临床和分子遗传学特征。方法:回顾性分析Glut1DS患者的临床资料。SLC2A1突变分析采用Sanger测序或下一代测序(NGS)。阴性患者行多重结扎依赖探针扩增(MLPA)。结果:90例患者确诊为Glut1DS,其中经典型63例(70%),非经典型27例(30%)。69例(77%)患者出现癫痫发作,58例(68%)患者出现运动障碍,17例(19%)患者出现眼头运动。73例(81%)患者的脑脊液(CSF)葡萄糖水平为1.0至2.6 mmol/L(中位1.9 mmol/L), 90%(66/73)患者的血糖水平低于2.2 mmol/L。此外,71例(79%)患者的csf -血糖比值在0.20 - 0.63(中位0.37)之间,87%(62/71)患者的比值低于0.45。遗传分析确定了SLC2A1基因的69个变体,其中包括39个先前报道的变体和30个未报道的变体。两个最常见的变异是c.997C > T (p.a g333trp)和c.988C >t (p.a g330*)。在生酮饮食治疗后,57例患者中有47例(82%)癫痫发作得到控制,47例患者中有18例(38%)运动障碍得到缓解,47例患者中有26例(55%)改善。结论:Glut1DS的临床表现主要包括癫痫发作、运动障碍和发育迟缓。大多数患儿脑脊液葡萄糖水平低于2.2 mmol/L,脑脊液与血糖比值低于0.45。在我们的队列中发现了两种最常见的SLC2A1变异。生酮饮食疗法在控制癫痫发作、改善运动障碍方面有效,且耐受性良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and genetic characteristics of glucose transporter 1 deficiency syndrome in a large cohort of Chinese patients.

Background: Mutations in the SLC2A1 gene cause glucose transporter type 1 deficiency syndrome (Glut1DS). This study aimed to investigate the clinical and molecular genetics characteristics of Chinese patients with Glut1DS.

Methods: The clinical data of patients with Glut1DS were analyzed retrospectively. SLC2A1 mutation analysis was performed using Sanger sequencing or next-generation sequencing (NGS). Multiplex ligation-dependent probe amplification (MLPA) was conducted in patients with negative results.

Results: A total of 90 patients were diagnosed with Glut1DS, including 63 (70%) classic type and 27 (30%) non-classic type. Seizures occurred in 69 patients (77%), movement disorders were observed in 58 (68%), and episodic eye-head movements were noted in 17 (19%). Cerebrospinal fluid (CSF) glucose levels were available for 73 patients (81%), ranging from 1.0 to 2.6 mmol/L (median 1.9 mmol/L), with 90% (66/73) of patients showing levels below 2.2 mmol/L. Additionally, CSF-to-blood glucose ratios measured in 71 patients (79%) ranged from 0.20 to 0.63 (median 0.37), with 87% (62/71) of patients having ratios below 0.45. Genetic analysis identified 69 variants of the SLC2A1 gene including 39 previously reported and 30 unreported variants. The two most common variants were c.997C > T (p.Arg333Trp) and c.988C > T (p.Arg330*). Following ketogenic diet therapy, seizures were controlled in 47 of 57 patients (82%), movement disorders resolved in 18 of 47 patients (38%), and improved in 26 of 47 patients (55%).

Conclusions: The clinical manifestations of Glut1DS primarily include seizures, movement disorders, and developmental delay. Most affected children had CSF glucose levels below 2.2 mmol/L, with CSF-to-blood glucose ratios under 0.45. Two of the most common SLC2A1 variants were identified in our cohort. Ketogenic diet therapy was effective in controlling seizures, improving movement disorders, and was well tolerated.

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来源期刊
World Journal of Pediatrics
World Journal of Pediatrics 医学-小儿科
CiteScore
10.50
自引率
1.10%
发文量
592
审稿时长
2.5 months
期刊介绍: The World Journal of Pediatrics, a monthly publication, is dedicated to disseminating peer-reviewed original papers, reviews, and special reports focusing on clinical practice and research in pediatrics. We welcome contributions from pediatricians worldwide on new developments across all areas of pediatrics, including pediatric surgery, preventive healthcare, pharmacology, stomatology, and biomedicine. The journal also covers basic sciences and experimental work, serving as a comprehensive academic platform for the international exchange of medical findings.
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