Neocleous Vassos, Fanis Pavlos, Toumba Meropi, Phedonos Alexia A P, Picolos Michalis, Andreou Elena, Kyriakides Tassos C, Tanteles George A, Shammas Christos, Phylactou Leonidas A, Skordis Nicos
Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus.
Pediatric Endocrine Clinic, IASIS Hospital, Paphos, Cyprus.
Int J Endocrinol. 2017;2017:8984365. doi: 10.1155/2017/8984365. Epub 2017 Apr 12.
Heterozygosity for mutations in females is possibly related to increased risk of developing clinical hyperandrogenism. The present study was designed to seek evidence on the phenotype-genotype correlation in female children, adolescents, and women with mutations and variants in the 3'UTR region of the gene. Sixty-six patients out of the 169 were identified as carriers of mutations. Higher values of stimulated 17 hydroxyprogesterone (17-OHP) levels were found in the carriers of the p.Val281Leu mutation compared to the carriers of other mutations (mean: 24.7 nmol/l versus 15.6 nmol/l). The haplotype of the 52C>T, 440C>T, and 443T>C in the 3'UTR was identical in all heterozygous patients with p.Val281Leu and the haplotype of the 12C>T and 52C>T was identical in all heterozygous patients with the p.Gln318. In conclusion, hyperandrogenaemic females are likely to bear heterozygous mutations. Carriers of the mild p.Val281Leu mutation are at higher risk of developing hyperandrogenism than the carriers of more severe mutations. The identification of variants in the 3'UTR of in combination with the heterozygous mutation may be associated with the mild form of nonclassic congenital adrenal hyperplasia and reveal the importance of analyzing the untranslated regions for the appropriate management of this category of patients.
女性中突变的杂合性可能与临床高雄激素血症发生风险增加有关。本研究旨在寻找在基因3'UTR区域存在突变和变异的女童、青少年及女性中表型 - 基因型相关性的证据。169名患者中有66名被鉴定为突变携带者。与其他突变携带者相比,p.Val281Leu突变携带者的刺激后17羟孕酮(17 - OHP)水平更高(平均值:24.7 nmol/l对15.6 nmol/l)。在所有携带p.Val281Leu的杂合患者中,3'UTR区域的52C>T、440C>T和443T>C单倍型相同,在所有携带p.Gln318的杂合患者中,12C>T和52C>T单倍型相同。总之,高雄激素血症女性可能携带杂合突变。轻度p.Val281Leu突变携带者比更严重突变携带者发生高雄激素血症的风险更高。基因3'UTR区域变异与杂合突变的联合鉴定可能与非经典型先天性肾上腺皮质增生的轻度形式相关,并揭示分析该基因非翻译区域对于这类患者适当管理的重要性。