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[广州新生儿葡萄糖-6-磷酸脱氢酶基因型与酶活性的相关性分析]

[Correlation analysis of genotypes and the enzymatic activities of glucose-6-phosphate dehydrogenase in neonates in Guangzhou].

作者信息

Tang F, Tang C F, Jiang X, Jia X F, Liu S C, Chen Q Y, Huang Y L

机构信息

Guangzhou Newborn Screening Center, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Nov 6;54(11):1275-1282. doi: 10.3760/cma.j.cn112150-20200611-00864.

Abstract

To reveal the relationship between G6PD genotypes and the G6PD enzyme activities in dried blood spots of newborn screening. Simple random sampling procedure was used in this study. The fluorescence PCR melting curve analysis was performed to classify G6PD gene variants in 635 neonates coming from Guangzhou Newborn Screening Center during October 1 to 20, 2016, including 15 reported variants. Those samples consisted of 377 cases with screening positive results (261 from males and 116 from females) and 258 cases with screening negative results (32 from males and 226 from females). The cut-off value of G6PD was less than 2.6 U/g Hb in dry blood spots. Sanger sequencing for G6PD gene was used in 7 cases with screening negative results under simple random sampling. One-way ANOVA and least significant difference method (LSD) test were performed to compare the difference of G6PD activity among genotypes. The top 6 frequency of G6PD gene variants were c.1388G>A(35.07%), c.1376G>T(32.13%), c.95A>G(12.72%), c.871G>A(8.32%), c.1024C>T(4.08%) and c.392G>T(2.28%), accounting for 94.62% of all variant alleles (580/613). A total of 253 males positive for enzyme activity were detected to have gene mutations. The positive rate of G6PD enzyme activity was 98.06%(253/258). The mean values of G6PD activities for c.1376G>T,c.95A>G and c.1388G>A were 0.85, 1.10 and 1.28 U/g Hb, respectively. There were significant differences among the three groups (=28.7, <0.01). A total of 105 females positive for enzyme activity were detected to have gene mutations. The positive rate of G6PD enzyme activity was 90.52%(105/116). The positive rate of G6PD enzyme activity was 26.95% among 256 females with one point mutation while it was 83.72% in females with multi-allele variants. The G6PD activity of heterozygous females was (2.9±0.8) U/g Hb, which was significant higher than that of females with multi-allele variants (1.5±1.0) U/g Hb (=8.6,<0.01). G6PD activities in dried blood spots were related to G6PD genotypes in males. They were also associated with the numbers of allele variants in females. Newborn screening for G6PD deficiency can be used to detect most of G6PD-deficient hemizygotes and female patients with multi-allele variants, which is helpful for preventing neonatal jaundice and medicine application.

摘要

揭示新生儿筛查干血斑中葡萄糖-6-磷酸脱氢酶(G6PD)基因型与G6PD酶活性之间的关系。本研究采用简单随机抽样程序。对2016年10月1日至20日来自广州新生儿筛查中心的635例新生儿进行荧光PCR熔解曲线分析,以分类G6PD基因变异,其中包括15种已报道的变异。这些样本包括377例筛查阳性结果的病例(男性261例,女性116例)和258例筛查阴性结果的病例(男性32例,女性226例)。干血斑中G6PD的临界值低于2.6 U/g Hb。对7例简单随机抽样筛查阴性结果的病例进行G6PD基因的桑格测序。采用单因素方差分析和最小显著差法(LSD)检验比较各基因型间G6PD活性的差异。G6PD基因变异的前6位频率分别为c.1388G>A(35.07%)、c.1376G>T(32.13%)、c.95A>G(12.72%)、c.871G>A(8.32%)、c.1024C>T(4.08%)和c.392G>T(2.28%),占所有变异等位基因的94.62%(580/613)。共检测到253例酶活性阳性的男性有基因突变。G6PD酶活性阳性率为98.06%(253/258)。c.1376G>T、c.95A>G和c.1388G>A基因型的G6PD活性平均值分别为0.85、1.10和1.28 U/g Hb。三组间差异有统计学意义(=28.7,<0.01)。共检测到105例酶活性阳性的女性有基因突变。G6PD酶活性阳性率为90.52%(105/116)。256例单点突变女性中G6PD酶活性阳性率为26.95%,而多等位基因变异女性中为83.72%。杂合子女性的G6PD活性为(2.9±0.8)U/g Hb,显著高于多等位基因变异女性(1.5±1.0)U/g Hb(=8.6,<0.01)。干血斑中的G6PD活性与男性的G6PD基因型有关。它们也与女性等位基因变异的数量有关。G6PD缺乏症的新生儿筛查可用于检测大多数G6PD缺乏的半合子和多等位基因变异的女性患者,这有助于预防新生儿黄疸和药物应用。

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