a Dipartimento di Medicina Clinica e Sperimentale , University of Sassari , Sassari , Italy.
b Sardinia Longevity Blue Zone Observatory , Ogliastra, Italy.
Ann Med. 2018 Feb;50(1):68-73. doi: 10.1080/07853890.2017.1390247. Epub 2017 Oct 16.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited disorder common in Sardinia. In this study, the frequency variation of G6PD-deficiency across age groups and birth cohorts was investigated using Age-Period-Cohort analysis.
Data were collected from the clinical records of 11,252 patients (6975 women, age range 17-94 years) who underwent endoscopy between 2000 and 2016 at a teaching hospital (University of Sassari), Italy. G6PD status was assessed by enzymatic assay based on G6PD/6GPD ratio. A Poisson log-linear regression model was used to identify age and time trend in G6PD deficiency.
Enzyme deficiency was detected in 11.4% of the entire cohort (men: 7.9%; women: 13.6%). Age-Period-Cohort analysis showed no inflection points across age groups, especially after age 80. The effects of time period and birth cohorts on G6PD deficiency were negligible (frequencies before and after 1950 were 11.0% and 11.8%, respectively).
These findings indicate that the frequency of G6PD deficiency does not vary significantly in oldest subjects. The lack of evidence for selection across the malaria eradication time may be explained by other factors, including somatic cell selection or misclassification of heterozygotes women as G6PD normal in the older birth cohorts. Additional molecular studies may help clarify these issues. Key message The frequency of glucose-6-phosphate dehydrogenase deficiency is stable across age groups and does not vary in generations born before or after malaria eradication.
葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症是撒丁岛常见的遗传性疾病。在这项研究中,我们使用年龄-时期-队列分析研究了 G6PD 缺乏症在不同年龄组和出生队列中的频率变化。
从意大利萨萨里大学教学医院(University of Sassari) 2000 年至 2016 年间接受内镜检查的 11252 名患者(6975 名女性,年龄 17-94 岁)的临床记录中收集数据。G6PD 状态通过基于 G6PD/6GPD 比值的酶测定法进行评估。使用泊松对数线性回归模型来确定 G6PD 缺乏症的年龄和时间趋势。
整个队列中发现酶缺乏症的比例为 11.4%(男性:7.9%;女性:13.6%)。年龄-时期-队列分析未显示各年龄组存在拐点,尤其是 80 岁以上年龄组。时期和出生队列对 G6PD 缺乏症的影响可以忽略不计(1950 年前和之后的频率分别为 11.0%和 11.8%)。
这些发现表明,G6PD 缺乏症的频率在最年长的受试者中没有明显变化。在消除疟疾的时间内没有证据表明选择作用可能是由其他因素引起的,包括体细胞选择或在年龄较大的出生队列中将杂合子女性错误分类为 G6PD 正常。进一步的分子研究可能有助于阐明这些问题。主要结论葡萄糖-6-磷酸脱氢酶缺乏症的频率在各年龄组之间保持稳定,并且在疟疾消除之前或之后出生的各代中没有变化。