Recall by genotype and cascade screening for familial hypercholesterolemia in a population-based biobank from Estonia.


Journal

Genetics in medicine : official journal of the American College of Medical Genetics
ISSN: 1530-0366
Titre abrégé: Genet Med
Pays: United States
ID NLM: 9815831

Informations de publication

Date de publication:
05 2019
Historique:
received: 22 06 2018
accepted: 06 09 2018
pubmed: 3 10 2018
medline: 14 2 2020
entrez: 2 10 2018
Statut: ppublish

Résumé

Large-scale, population-based biobanks integrating health records and genomic profiles may provide a platform to identify individuals with disease-predisposing genetic variants. Here, we recall probands carrying familial hypercholesterolemia (FH)-associated variants, perform cascade screening of family members, and describe health outcomes affected by such a strategy. The Estonian Biobank of Estonian Genome Center, University of Tartu, comprises 52,274 individuals. Among 4776 participants with exome or genome sequences, we identified 27 individuals who carried FH-associated variants in the LDLR, APOB, or PCSK9 genes. Cascade screening of 64 family members identified an additional 20 carriers of FH-associated variants. Via genetic counseling and clinical management of carriers, we were able to reclassify 51% of the study participants from having previously established nonspecific hypercholesterolemia to having FH and identify 32% who were completely unaware of harboring a high-risk disease-associated genetic variant. Imaging-based risk stratification targeted 86% of the variant carriers for statin treatment recommendations. Genotype-guided recall of probands and subsequent cascade screening for familial hypercholesterolemia is feasible within a population-based biobank and may facilitate more appropriate clinical management.

Identifiants

pubmed: 30270359
doi: 10.1038/s41436-018-0311-2
pii: S1098-3600(21)01484-2
pmc: PMC6443485
mid: NIHMS994784
doi:

Substances chimiques

APOB protein, human 0
Apolipoprotein B-100 0
LDLR protein, human 0
Receptors, LDL 0
PCSK9 protein, human EC 3.4.21.-
Proprotein Convertase 9 EC 3.4.21.-

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1173-1180

Subventions

Organisme : NHLBI NIH HHS
ID : K08 HL140203
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK075787
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL142711
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM007205
Pays : United States

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Auteurs

Maris Alver (M)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.
Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia.

Marili Palover (M)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.
Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia.

Aet Saar (A)

Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Cardiology Centre, North Estonia Medical Centre, Tallinn, Estonia.

Kristi Läll (K)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.
Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia.

Seyedeh Maryam Zekavat (SM)

Broad Institute of Harvard and MIT, Cambridge, MA, USA.
Yale School of Medicine, New Haven, CT, USA.

Neeme Tõnisson (N)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.
Department of Clinical Genetics in Tallinn, United Laboratories, Tartu University Hospital, Tartu, Estonia.

Liis Leitsalu (L)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.

Anu Reigo (A)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.

Tiit Nikopensius (T)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.

Tiia Ainla (T)

Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Cardiology Centre, North Estonia Medical Centre, Tallinn, Estonia.

Mart Kals (M)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.
Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia.

Reedik Mägi (R)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.

Stacey B Gabriel (SB)

Broad Institute of Harvard and MIT, Cambridge, MA, USA.

Jaan Eha (J)

Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Heart Clinic, Tartu University Hospital, Tartu, Estonia.

Eric S Lander (ES)

Broad Institute of Harvard and MIT, Cambridge, MA, USA.

Alar Irs (A)

Heart Clinic, Tartu University Hospital, Tartu, Estonia.

Anthony Philippakis (A)

Broad Institute of Harvard and MIT, Cambridge, MA, USA.

Toomas Marandi (T)

Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Cardiology Centre, North Estonia Medical Centre, Tallinn, Estonia.

Pradeep Natarajan (P)

Broad Institute of Harvard and MIT, Cambridge, MA, USA.
Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
Department of Medicine, Harvard Medical School, Boston, MA, USA.

Andres Metspalu (A)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.
Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia.

Sekar Kathiresan (S)

Broad Institute of Harvard and MIT, Cambridge, MA, USA.
Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
Department of Medicine, Harvard Medical School, Boston, MA, USA.

Tõnu Esko (T)

Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia. tesko@broadinstitute.org.
Broad Institute of Harvard and MIT, Cambridge, MA, USA. tesko@broadinstitute.org.

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