Department of Internal Medicine, Division of Hepatology, Hacettepe University Medical Faculty, Ankara, Turkey.
J Clin Lab Anal. 2011;25(4):296-9. doi: 10.1002/jcla.20472.
Alpha 1 antitrypsin (AT) deficiency is a hereditary disorder leading to the defective defence system against neutrophil elastasis in lung and accumulation of insoluble heterodimer AT molecules in hepatocytes. Knowledge of the prevalence of AT deficiency in each country is important to organize the public health policy. The aim of this study is to determine the prevalence of AT deficiency in Turkish population and to define the cutoff value of AT level in serum to detect heterozygous AT deficient subjects.
Serum samples from 1,203 healthy blood donors were used, attending the Blood Bank of Hacettepe Medical Faculty. Isoelectric focusing method for determining PIM, PIS, and PIZ alleles and rate immune nephelometry for measuring the level of AT in serum were used.
Out of 1,203 healthy blood donors enrolled, 1,164 (%96.8) had normal variant PI MM allelee, 9 (%0.7) PI MZ, 7 (%0.6) PI MS, 6 (%0.5) MF, and 17 (%1.4) PI M? (unidentified variants with existing standards). Most individuals (89.6%) with low AT level (cutoff <100 mg/dl) in serum were positive for PI MM allele. The cutoff value to investigate PI MZ was 100.5 mg/dl, which had PPV and NPV of 5.0 and 99.9%, respectively. AT deficiency is a rare hereditary disorder in asymptomatic healthy Turkish blood donors. Although the cutoff value of 100.5 mg/dl for AT level in serum was able to detect heterozygous AT deficiency in the healthy population, this finding should be conformed to case-control studies.
α1 抗胰蛋白酶(AT)缺乏症是一种遗传性疾病,导致肺中中性粒细胞弹性蛋白酶防御系统缺陷和不溶性杂合二聚体 AT 分子在肝细胞中积聚。了解每个国家 AT 缺乏症的患病率对于组织公共卫生政策很重要。本研究旨在确定土耳其人群中 AT 缺乏症的患病率,并确定血清中 AT 水平的截止值以检测杂合子 AT 缺乏的受试者。
使用来自参加哈塞特佩医科大学血库的 1203 名健康献血者的血清样本。使用等电聚焦法测定 PIM、PIS 和 PIZ 等位基因,速率免疫比浊法测定血清 AT 水平。
在纳入的 1203 名健康献血者中,1164 名(96.8%)具有正常变异 PI MM 等位基因,9 名(0.7%)PI MZ,7 名(0.6%)PI MS,6 名(0.5%)MF 和 17 名(1.4%)PI M?(现有标准下的未识别变异体)。大多数血清中 AT 水平较低(<100mg/dl 的截止值)的个体(89.6%)为 PI MM 等位基因阳性。PI MZ 的检测截止值为 100.5mg/dl,其阳性预测值和阴性预测值分别为 5.0%和 99.9%。AT 缺乏症是无症状健康土耳其献血者中罕见的遗传性疾病。虽然血清中 AT 水平的 100.5mg/dl 截止值可以检测健康人群中的杂合子 AT 缺乏症,但这一发现应与病例对照研究相吻合。