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      Gene spectrum analysis of thalassemia for people residing in northern China

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          Abstract

          Background

          Southern China provinces have high incidence of thalassemia, however, sporadic cases can be found in northern China as well.

          Methods

          People resided in north China who were suspected to have thalassemia were detected mutations by gap-polymerase chain reaction (Gap-PCR) and reverse dot blot (RDB) analyses. Those with positive findings from 2012 to 2017 were further analyzed for basic clinical data and ancestral information either by medical records or by telephone follow-up or both.

          Results

          Most people enrolled in our study had no or mild symptoms. For those with positive gene findings, people originated from the north had higher percentage of β-thalassemia gene mutations compared with those originated from the south (72.8% vs. 62.4%, χ 2 = 9.92, P = 0.001). Analysis of the individual gene distribution of people from south and north areas did not show significant difference either in α- thalassemia ( P = 0.221) or β-thalassemia ( P = 0.979). No significant difference was found in the frequency of α mutation in people living in different altitudes. However, for β-thalassemia, the frequency of the 6 most common mutations was significantly different in people living in different provinces with altitude below 500 m, 500–1000 m, and above 1000 m (χ 2 test, P < 0.05).

          Conclusion

          Most of people in north China with thalassemia mutation gene were thalassemia carriers. People originated from the north had higher frequency of β mutation than those originated from the south, but the north people had similar individual gene mutation profile compared with south people both for α and β mutations. People lived in different altitudes had different spectrum of β mutations.

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          Most cited references21

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          The prevalence of thalassemia in mainland China: evidence from epidemiological surveys

          Comprehensive data regarding the epidemiology and prevalence of thalassemia in mainland China are lacking. To assess the prevalence of thalassemia, we performed a meta-analysis including 16 articles published from 1981 to 2015. The overall prevalence of α-thalassemia, β-thalassemia and α + β-thalassemia was 7.88%, 2.21% and 0.48%, respectively. Trends in thalassemia prevalence in mainland China were not steady; a prevalence map based on a geographic information system (GIS) showed that the geographic distribution of thalassemia was highest in the south of China and decreased from south to north. Additionally, the most common α- and β-globin gene mutation was --SEA and CD41/42, respectively. The current study provides valuable information regarding epidemiology and intervention and supports the planning, implementation and management of prevention programmes for public health.
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            Molecular Epidemiological Characterization and Health Burden of Thalassemia in Jiangxi Province, P. R. China

            Background Thalassemia is the most common inherited disease in southern China. However, this disorder is usually ignored by Jiangxi provincial health system and government due to lack of epidemiological data. Materials and Methods A total of 9489 samples from Hakka Han and Gan-speaking Han in three geographical areas of Jiangxi Province were analyzed for both complete blood cell (CBC) count and reverse dot blot (RDB) gene chip for thalassemia. Results 1182 cases of suspected thalassemia carriers with microcytosis (MCV<82 fL) were found by CBC count, and were tested by RDB gene chip to reveal a total of 594 mutant chromosomes, including 433 α-thalassemia mutant chromosomes and 172 β-thalassemia mutant chromosomes. Our results indicated a higher prevalence of thalassemia with the heterozygote frequency of 9.49% in southern Jiangxi province, whereas the low frequency was found in middle (3.90%) and northern Jiangxi (2.63%). Conclusions Based on the epidemiological data, the estimated numbers of pregnancies in Jiangxi province in which the fetus is at risk for β-thalassemia major or intermedia, Bart's hydrops fetalis and Hb H disease are 34 (95% CI, 16 to 58), 79 (95% CI, 50 to 114) and 39 (95% CI, 27 to 58) per year, respectively. We suggested that prevention network of thalassemia should be established, especially in high prevalent southern Jiangxi (Hakka Han), including establishment of thalassemia database collection, hematological analysis laboratories, genetic counselling clinics, prenatal diagnosis centers and neonatal screening centers.
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              New trend in the epidemiology of thalassaemia

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                Author and article information

                Contributors
                yangzhuopumch@163.com
                zhouwz13@163.com
                lilly-love-jenny@163.com
                lingqiubj@aliyun.com
                hanbing_li@sina.com
                Journal
                BMC Med Genet
                BMC Med. Genet
                BMC Medical Genetics
                BioMed Central (London )
                1471-2350
                22 May 2019
                22 May 2019
                2019
                : 20
                : 86
                Affiliations
                [1 ]ISNI 0000 0001 0662 3178, GRID grid.12527.33, Department of clinical laboratory, Peking Union Medical College Hospital, , Chinese Academy of Medical Science, ; Beijing, China
                [2 ]ISNI 0000 0001 0662 3178, GRID grid.12527.33, Department of hematology, Peking Union Medical College Hospital, , Chinese Academy of Medical Science, ; Beijing, China
                [3 ]ISNI 0000 0001 0662 3178, GRID grid.12527.33, Peking Union Medical College, Chinese Academy of Medical Science, ; Beijing, China
                Author information
                http://orcid.org/0000-0003-3844-2608
                Article
                818
                10.1186/s12881-019-0818-7
                6530100
                31113390
                3f22114d-dd4f-4f89-9a46-fb6f304288fd
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 October 2018
                : 30 April 2019
                Funding
                Funded by: Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences and Peking Union Medical College (CN)
                Award ID: No. 2016-I2M-3-004
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Genetics
                thalassemia,gene mutation,spectrum,altitude,china
                Genetics
                thalassemia, gene mutation, spectrum, altitude, china

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