Chien Yin-Hsiu, Lee Ni-Chung, Chao Mei-Chyn, Chen Li-Chu, Chen Li-Hsin, Chien Chun-Ching, Ho Hui-Chen, Suen Jeng-Hung, Hwu Wuh-Liang
Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
JIMD Rep. 2013;11:165-72. doi: 10.1007/8904_2013_236. Epub 2013 May 23.
Fatty acid oxidation (FAO) disorders are a heterogeneous group of inborn errors in the transportation and oxidation of fatty acids. FAO disorders were thought to be very rare in the Chinese population. Newborn screening for FAO disorders beginning in 2002 in Taiwan may have increased the diagnosis of this group of diseases.
Till 2012, the National Taiwan University Hospital Newborn Screening Center screened more than 800,000 newborns for FAO disorders. Both patients diagnosed through screening and patients detected after clinical manifestations were included in this study.
A total of 48 patients with FAO disorders were identified during the study period. The disorders included carnitine palmitoyltransferase I deficiency, carnitine acylcarnitine translocase deficiency, carnitine palmitoyltransferase II deficiency, very long-chain acyl-CoA dehydrogenase deficiency, medium-chain acyl-CoA dehydrogenase deficiency, multiple acyl-CoA dehydrogenase deficiency, short-chain defects, and carnitine uptake defect. Thirty-nine patients were diagnosed through newborn screening. Five false-negative newborn screening cases were noted during this period, and four patients who were not screened were diagnosed based on clinical manifestations. The ages of all patients ranged from 6 months to 22.9 years (mean age 6.6 years). Except for one case of postmortem diagnosis, there were no other mortalities.
The combined incidence of FAO disorders estimated by newborn screening in the Chinese population in Taiwan is 1 in 20,271 live births. Newborn screening also increases the awareness of FAO disorders and triggers clinical diagnoses of these diseases.
脂肪酸氧化(FAO)障碍是一组脂肪酸转运和氧化方面的先天性遗传缺陷疾病。FAO障碍在中国人群中曾被认为非常罕见。台湾自2002年开始的新生儿FAO障碍筛查可能增加了这组疾病的诊断率。
截至2012年,台湾大学医院新生儿筛查中心对超过800,000例新生儿进行了FAO障碍筛查。本研究纳入了通过筛查确诊的患者以及出现临床表现后被检测出的患者。
研究期间共确诊48例FAO障碍患者。这些疾病包括肉碱棕榈酰转移酶I缺乏症、肉碱/脂酰肉碱转位酶缺乏症、肉碱棕榈酰转移酶II缺乏症、极长链酰基辅酶A脱氢酶缺乏症、中链酰基辅酶A脱氢酶缺乏症、多种酰基辅酶A脱氢酶缺乏症、短链缺陷以及肉碱摄取缺陷。39例患者通过新生儿筛查确诊。在此期间发现5例假阴性新生儿筛查病例,4例未接受筛查的患者根据临床表现确诊。所有患者年龄在6个月至22.9岁之间(平均年龄6.6岁)。除1例尸检诊断外,无其他死亡病例。
台湾中国人群中通过新生儿筛查估计的FAO障碍合并发病率为每20,271例活产中有1例。新生儿筛查还提高了对FAO障碍的认识并引发了这些疾病的临床诊断。