ISSN 1671-5411 CN 11-5329/R
Xu WANG, Long JIANG, Li-Yuan SUN, Yue WU, Wen-Hui WEN, Xi-Fu WANG, Wei LIU, Yu-Jie ZHOU, Lu-Ya WANG. Genetically confirmed familial hypercholesterolemia in outpatients with hypercholesterolemia. J Geriatr Cardiol 2018; 15(6): 434-440. doi: 10.11909/j.issn.1671-5411.2018.06.006
Citation: Xu WANG, Long JIANG, Li-Yuan SUN, Yue WU, Wen-Hui WEN, Xi-Fu WANG, Wei LIU, Yu-Jie ZHOU, Lu-Ya WANG. Genetically confirmed familial hypercholesterolemia in outpatients with hypercholesterolemia. J Geriatr Cardiol 2018; 15(6): 434-440. doi: 10.11909/j.issn.1671-5411.2018.06.006

Genetically confirmed familial hypercholesterolemia in outpatients with hypercholesterolemia

doi: 10.11909/j.issn.1671-5411.2018.06.006
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This work was supported by grants from the National Natural Science Foundation of China (No. 30470722, 30771982 and 30772356) and the Beijing Natural Science Foundation (No. 7032012, 7052021 and No. 7062010).

  • Received Date: 2017-10-16
  • Rev Recd Date: 2018-02-04
  • Publish Date: 2018-06-28
  • Background Familial hypercholesterolemia (FH) is an autosomal dominant disorder of lipoprotein metabolism which can lead to premature coronary heart disease (pCHD). There are about 3.8 million potential FH patients in China, whereas the clinical and genetic data of FH are limited. Methods Dutch Lipid Clinic Network (DLCN) criteria was used to diagnose FH in outpatients with hypercholesterolemia. Resequencing chip analysis combined with Sanger sequencing validation were used to identify mutations in the definite FH patients according to DLCN criteria. In silico analysis was conducted in mutations with previously unknown pathogenicity. Then, the novel mutant receptors were transfected into human embryo kidney 293 (HEK-293) cells. The binding and the internalization activities of the mutant receptors were analyzed by flow cytometry. Results The prevalence of definite FH in outpatients with hypercholesterolemia in this study is 3.2%. Using genetic testing, one homozygous FH (HoFH), one heterozygous FH (HeFH) and three compound heterozygous FH patients were confirmed. Eight mutations in low-density lipoprotein receptor (LDLR) gene were identified, in which c.357delG was a novel mutation and co-segregated with the FH phenotype. Bioinformatic analysis confirmed that c.357delG was a pathogenic mutation. Furthermore, when compared with the wild-type LDLRs by flow cytometry analysis, the binding and internalization activities of c.357delG mutant LDLRs were reduced by 35% and 49%, respectively. Conclusions This study identified eight LDLR gene mutations in five patients with definite FH, in which c.357delG is a novel pathogenic mutation. These findings increase our understanding of the genetic spectrum of FH in China.
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