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中国 244 个甲基丙二酸血症家系的基因型分析与产前遗传诊断。

The genotype analysis and prenatal genetic diagnosis among 244 pedigrees with methylmalonic aciduria in China.

机构信息

The First Affiliated Hospital of Zhengzhou University, Genetic and Prenatal Diagnosis Center, No.1 Jianshe East Road, Zhengzhou, Henan, CN 450052, China.

出版信息

Taiwan J Obstet Gynecol. 2022 Mar;61(2):290-298. doi: 10.1016/j.tjog.2022.02.017.

Abstract

OBJECTIVES

To investigate the phenotypes, biochemical features and genotypes for 244 pedigrees with methylmalonic aciduria (MMA) in China, and to perform the prenatal genetic diagnosis by chorionic villus for these pedigrees.

MATERIALS AND METHODS

Gene analyses were performed for 244 pedigrees. There are 130 pedigrees, chorionic villus sampling was performed on the pregnant women to conduct the prenatal diagnosis.

RESULTS

Among 244 patients, 168 (68.9%) cases were combined methylmalonic aciduria and homocystinuria, 76 (31.1%) cases were isolated methylmalonic aciduria. All the patients were diagnosed with MMA by their clinical manifestation, elevated blood propionylcarnitine, propionylcarnitine to acetylcarnitine ratio, and/or urine/blood methylmalonic acid with or without homocysteine. MMACHC, MMUT, SUCLG1 and LMBRD1 gene variants were found in 236 (96.7%) pedigrees included 6 probands with only one heterozygous variant out of 244 cases. For the 130 pedigrees who received a prenatal diagnosis, 22 fetuses were normal, 69 foetuses were carriers of heterozygous variants, and the remaining 39 foetuses harboured compound heterozygous variants or homozygous variants. The follow-up results were consistent with the prenatal diagnosis.

CONCLUSION

The present study indicates genetic heterogeneity in MMA patients. Genetic analysis is a convenient method for prenatal diagnosis that will aid in avoiding the delivery of MMA patients.

摘要

目的

对中国 244 个甲基丙二酸血症(MMA)家系进行表型、生化特征和基因型分析,并对这些家系进行产前绒毛活检的遗传诊断。

材料与方法

对 244 个家系进行基因分析。对 130 个家系的孕妇进行绒毛取样,进行产前诊断。

结果

244 例患者中,168 例(68.9%)为甲基丙二酸血症合并同型半胱氨酸血症,76 例(31.1%)为单纯甲基丙二酸血症。所有患者均根据临床表现、血丙酰肉碱升高、丙酰肉碱与乙酰肉碱比值升高及/或尿/血甲基丙二酸升高伴或不伴同型半胱氨酸升高诊断为 MMA。236 个家系(96.7%)发现 MMACHC、MMUT、SUCLG1 和 LMBRD1 基因突变,244 例患者中有 6 例仅发现 1 种杂合变异。对 130 个接受产前诊断的家系,22 例胎儿正常,69 例胎儿为杂合变异携带者,其余 39 例胎儿为复合杂合变异或纯合变异。随访结果与产前诊断一致。

结论

本研究表明 MMA 患者存在遗传异质性。基因分析是一种方便的产前诊断方法,有助于避免 MMA 患儿的出生。

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