A systematic review of LDLR, PCSK9, and APOB variants in Asia

Abstract

Background and aimsGenetic identification is a public health care concern for management of familial hypercholesterolemia (FH) associated cardiovascular morbidity and mortality. This study presents the spectrum and distribution of LDLR, APOB, PCSK9 gene mutations in Asia. MethodsDatabases were searched for English papers from 1950 to 2019. The spectrum of the variants was investigated in 8994 FH families in 48 Asian countries. We determined the frequency of variants, zygosity, and clinical features. ResultsTwenty countries have studied LDLR variants. A total of 629 mutations were reported and twenty variants were accounted as common variants in different populations. China, Japan, India and Taiwan constituted 68% of published articles. The most frequent mutation was reported in Japan but was not common in other countries. Other missense variants accounted for 50% of the mutations, frameshifts 19%, and nonsense 11%. The pooled frequency of variation was estimated in 1867 individuals. Approximately 67% of Iranian families were homozygous.,The common variant was p.Ser130Ter. p.Arg3527Trp in APOB was common among 184 heterozygous patients; the common variant of PCSK9 was p.Glu32Lys. ConclusionsThis is the first systematic review of LDLR, APOB, PCSK9 mutations in FH patients in Asia. These findings underscore the need to fill in the gap of studies on different populations in Asia. It also underlies the importance of early detection and management to decrease atherosclerosis and cardiovascular risk in different ethnicities.