Park Kyoung-Jin, Park Hyun-Kyung, Kim Young-Jin, Lee Kyoung-Ryul, Park Jong-Ho, Park June-Hee, Park Hyung-Doo, Lee Soo-Youn, Kim Jong-Won
Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.
Department of Laboratory Medicine, Seoul Clinical Laboratories, Seoul Medical Science Institute, Seoul, Korea.
Ann Lab Med. 2016 Mar;36(2):145-53. doi: 10.3343/alm.2016.36.2.145.
Most cases with congenital hypothyroidism (CH) are usually sporadic, while about 20% of the cases are caused by genetic defects. Little information is available regarding the mutation incidence and genetic heterogeneity of CH in Koreans. We aimed to determine the mutation incidence of CH in newborn screenings (NBS) and to evaluate the frequency and spectrum of mutations underlying CH.
A total of 112 newborns with thyroid dysfunction were enrolled from 256,624 consecutive NBS. Furthermore, 58 outpatients with primary CH were added from an endocrine clinic. All coding exons of TSHR, PAX8, TPO, DUOX2, DUOXA2, and SCL5A5 were sequenced.
The mutation incidence of CH was estimated to be 1 in 6,580 newborns. A total of 36 different mutations were identified in 53 cases. The overall mutation positive rate was 31%. The DUOX2 mutations were the most prevalent in both newborns and outpatients. Seven different recurrent mutations [p.G488R (n=13), p.A649E (n=3), p.R885Q (n=3), p.I1080T (n=2), and p.A1206T (n=2) in DUOX2; p.Y138X (n=9) in DUOXA2; and p.R450H (n=5) in TSHR) were identified as the mutations underlying CH.
The mutation incidence of CH was considerably higher than expected in the Korean newborn population. This study revealed seven different recurrent mutations underlying CH. We conclude that DUOX2 mutations are a frequent cause of CH in the Korean population.
大多数先天性甲状腺功能减退症(CH)病例通常为散发性,而约20%的病例由遗传缺陷引起。关于韩国人群中CH的突变发生率和遗传异质性的信息很少。我们旨在确定新生儿筛查(NBS)中CH的突变发生率,并评估CH潜在突变的频率和谱。
从256,624例连续的NBS中招募了112例甲状腺功能障碍的新生儿。此外,从内分泌诊所增加了58例原发性CH门诊患者。对TSHR、PAX8、TPO、DUOX2、DUOXA2和SCL5A5的所有编码外显子进行测序。
估计CH在新生儿中的突变发生率为1/6580。在53例病例中总共鉴定出36种不同的突变。总体突变阳性率为31%。DUOX2突变在新生儿和门诊患者中最为普遍。七种不同的复发性突变[DUOX2中的p.G488R(n = 13)、p.A649E(n = 3)、p.R885Q(n = 3)、p.I1080T(n = 2)和p.A1206T(n = 2);DUOXA2中的p.Y138X(n = 9);TSHR中的p.R450H(n = 5)]被鉴定为CH的潜在突变。
韩国新生儿人群中CH的突变发生率明显高于预期。本研究揭示了CH的七种不同的复发性突变。我们得出结论,DUOX2突变是韩国人群中CH的常见原因。