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新生儿筛查和遗传性代谢缺陷病诊断:中国东部地区的一项为期 5 年的研究。

Newborn screening and diagnosis of inborn errors of metabolism: A 5-year study in an eastern Chinese population.

机构信息

Center of Neonatal Disease Screening, Maternal and Child Health Care Hospital, 12 Gongxiao Road, Jining, Shandong Province, China.

Hangzhou Genuine Clinical Laboratory Co., Ltd., 859 Shixiang West Road, Hangzhou, Zhejiang Province, China.

出版信息

Clin Chim Acta. 2020 Mar;502:133-138. doi: 10.1016/j.cca.2019.12.022. Epub 2019 Dec 29.

Abstract

Inborn errors of metabolism (IEMs) can cause intellectual disability or even death in children. To evaluate the disease spectrum and genetic characteristics of IEMs in Jining City of Shandong Province in East China, we used tandem mass spectrometry (MS/MS) technology for IEMs screening combined with genetic analysis. Newborns were screened from July 14, 2014, to December 31, 2018. Amino acid and carnitine contents were detected by MS/MS. According to the results for normal newborns, the reference range of our laboratory was established with the percentile method. The suspected positive newborns were further diagnosed using next-generation sequencing. A total of 514,234 newborns were screened, and 265 were diagnosed with IEMs, with a detection rate of 1:1941. Of the 265 patients, 130 (49.06%) had organic acid disorders, 83 (31.32%) had amino acid disorders, 34 (12.83%) had fatty acid oxidation disorders, and 18 (6.79%) had urea circulatory disorders. PAHD and MMA were the two most common disorders. IEMs-associated genes were identified in 233 patients. Our data indicated that IEMs are never uncommon in Jining, and the disease spectrum and genetic background were clearly elucidated, contributing to the treatment and prenatal genetic counseling of these disorders in the region.

摘要

先天性代谢缺陷(IEMs)可导致儿童智力残疾甚至死亡。为了评估中国东部山东省济宁市的 IEM 疾病谱和遗传特征,我们采用串联质谱(MS/MS)技术进行 IEM 筛查,并结合遗传分析。从 2014 年 7 月 14 日至 2018 年 12 月 31 日,对新生儿进行了筛查。采用 MS/MS 检测氨基酸和肉碱含量。根据正常新生儿的结果,我们采用百分位法建立了实验室的参考范围。对疑似阳性的新生儿进行下一代测序进一步诊断。共筛查了 514234 名新生儿,诊断出 265 例 IEM,检出率为 1:1941。在 265 例患者中,130 例(49.06%)为有机酸代谢障碍,83 例(31.32%)为氨基酸代谢障碍,34 例(12.83%)为脂肪酸氧化障碍,18 例(6.79%)为尿素循环障碍。PAHD 和 MMA 是两种最常见的疾病。在 233 例患者中鉴定出与 IEM 相关的基因。我们的数据表明,IEM 在济宁并不罕见,并且明确阐明了疾病谱和遗传背景,有助于该地区这些疾病的治疗和产前遗传咨询。

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