Clinical expression in heterozygotes of two frequent low density lipoprotein receptor gene mutations in the French Canadian population
- Clinical Research Institute of Montreal, Quebec (Canada)
Five mutations in the low density lipoprotein (LDL) receptor (R) gene account for approximately 83% of cases of heterozygous familial hypercholesterolemia (hFH) in French Canadians in Quebec. The two most prevalent mutations are a >10kb deletion (10kb) of the promoter region resulting in a null allele (60.5% of cases) and a trp{sub 66}{r_arrow}gly missense mutation in exon 3 (ex3) resulting in a binding-defective R (11.7%). We have compared the phenotypic expression of these two mutations in 427 10kb hFH patients, 239 women (age 37.5 {plus_minus} 14.2 years) and 188 men (33.7 {plus_minus} 11.7) and 69 ex3 hFH patients, 42 women (40.6 {plus_minus} 14.3) and 27 men (36.8 {plus_minus}13.2). All data were analyzed separately for women and men. Tendon xanthomas were more prevalent in the 10kb (women 63%, men 68%) than in the ex3 patients (48%,48%). Total and LDL cholesterol were significantly higher in the 10kb patients with than without xanthomas but similar in ex3 patients. There were no significant differences in plasma lipoprotein concentrations between 10kb and ex3 patients with coronary artery disease (CAD) or between 10kb and ex3 patients without CAD. Among men with CAD, those with 10kb were significantly younger than those with ex3 (39.6 {plus_minus} 9.8, n=93 and 46.4 {plus_minus} 7.0, n=9, respectively). In both sexes, high plasma lipoprotein concentrations conferred an increased risk of CAD in 10kb but not in ex3 patients. Thus, as in homozygotes (previous study), the >10kb deletion is associated with more severe expression of FH than is the exon 3 mutation, although the plasma lipoprotein concentrations are not significantly different between the 10kb and ex3 heterozygotes. Since in homozygotes plasma cholesterol levels in 10kb are 60% higher than in ex3 patients, these observations suggest that the expression of the normal LDL-R allele compensates for the lack of a second allele in 10kb heterozygotes.
- OSTI ID:
- 133631
- Report Number(s):
- CONF-941009--
- Journal Information:
- American Journal of Human Genetics, Journal Name: American Journal of Human Genetics Journal Issue: Suppl.3 Vol. 55; ISSN AJHGAG; ISSN 0002-9297
- Country of Publication:
- United States
- Language:
- English
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