Xi Lei, Zhang Hao, Zhang Zhen-Lin
Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Front Genet. 2021 Jul 16;12:622078. doi: 10.3389/fgene.2021.622078. eCollection 2021.
Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility and abnormal connective tissue. Ninety percent of OI patients are caused by two mutations of and , and more investigation was needed to better understand the rare types of OI. We followed up 29 patients with rare types of OI for an average of 5.4 years, and genotype, height, bone mineral density (BMD), blood biochemical indexes, misdiagnosis, and fracture were recorded. gene mutation was found in 18 patients (62.1%), which represents the most common pathogenic gene of rare types of OI in Chinese population. Thirteen cases had once been misdiagnosed, and the initial misdiagnosis rate was 44.8% (13/29). The higher misdiagnosis rate should be paid attention to by clinicians and healthcare providers, and we also give corresponding suggestions. Compared with the non-bisphosphonate treatment group, patients treated with bisphosphonates had higher lumbar spine BMD, fewer fractures, and lower levels of β-CTX and osteocalcin. However, there was no significant difference between OI type V patients and non-type V patients. Our study enriched the knowledge of genotype and phenotype characteristics of OI patients with rare types and bisphosphonate therapy.
成骨不全症(OI)是一种罕见的遗传性疾病,其特征为骨骼脆弱和结缔组织异常。90%的OI患者由 和 的两种突变引起,需要更多研究以更好地了解罕见类型的OI。我们对29例罕见类型的OI患者进行了平均5.4年的随访,并记录了基因型、身高、骨密度(BMD)、血液生化指标、误诊情况和骨折情况。在18例患者(62.1%)中发现了 基因突变,这是中国人群中罕见类型OI最常见的致病基因。13例曾被误诊,初始误诊率为44.8%(13/29)。较高的误诊率应引起临床医生和医疗服务提供者的重视,我们也给出了相应建议。与非双膦酸盐治疗组相比,接受双膦酸盐治疗的患者腰椎BMD更高、骨折更少,且β-CTX和骨钙素水平更低。然而,V型OI患者与非V型患者之间无显著差异。我们的研究丰富了罕见类型OI患者的基因型和表型特征以及双膦酸盐治疗的相关知识。