The Prevalence of Different Genotypic Forms of Familial Hypercholesterolemia in Relation to Race and Ethnicity

Makhabbat Bekbossynova 1 * , Tatyana Ivanova-Razumova 1, Aknur Kali 1, Aliya Sailybayeva 1, Sadyk Khamitov 1, Zhansaya Oralbekova 1
More Detail
1 “University Medical Center” Corporate Fund, National Cardiac Surgery Center, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 4, pp. 38-45. https://doi.org/10.23950/jcmk/14974
OPEN ACCESS 261 Views 116 Downloads
Download Full Text (PDF)
Author Contributions: Conceptualization, M.B.; methodology, A.K.; validation, A.S.; formal analysis, Z.O.; investigation, S.K.; resources, Z.O.; data curation, Z.O.; writing – original draft preparation, M.B.; writing – review and editing, A.S.; visualization, A.K.; supervision, M.B.; project administration, A.S.; funding acquisition, S.K. All authors have read and agreed to the published version of the manuscript.

ABSTRACT

In the present study, a systematic literature review was conducted to examine the prevalence of homo- and heterozygous forms of Familial hypercholesterolemia among different racial and ethnic groups. Familial hypercholesterolemia (FH) is an inherited disorder characterised by elevated blood levels of cholesterol and low-density lipoprotein (LDL), which increases the risk of cardiovascular disease. Databases PubMed, Web of Science, and Elsiever were searched and only peer-reviewed articles with a large number of contributors and sufficient prevalence and ethnicity data were included. Diagnosis of FH was based on genetic testing or clinical criteria. The results of the study indicate inadequate and untimely diagnosis of FH, resulting in inadequate treatment. To date, only 9% of countries have statistical data on the prevalence of FH in the general population. In order to develop effective prevention strategies for cardiovascular diseases associated with FH, further research is needed to obtain accurate epidemiological data, including the race and ethnicity of patients. This will allow optimisation of strategies to reduce the burden of preventable cardiovascular disease associated with FH.
 

CITATION

Bekbossynova M, Ivanova-Razumova T, Kali A, Sailybayeva A, Khamitov S, Oralbekova Z. The Prevalence of Different Genotypic Forms of Familial Hypercholesterolemia in Relation to Race and Ethnicity. J CLIN MED KAZ. 2024;21(4):38-45. https://doi.org/10.23950/jcmk/14974

REFERENCES

  • de Ferranti, S. D., Rodday, A. M., Mendelson, M. M., Wong, J. B., Leslie, L. K., and Sheldrick, R. C. (2016). Prevalence of Familial Hypercholesterolemia in the 1999 to 2012 United States National Health and Nutrition Examination Surveys (NHANES). Circulation 133, 1067–1072. doi:10.1161/circulationaha.115.018791
  • Harada, P. H., Miname, M. H., Benseñor, I. M., Santos, R. D., and Lotufo, P. A. (2018). Familial Hypercholesterolemia Prevalence in an Admixed Racial Society: Sex and Race Matter. The ELSA-Brasil. Atherosclerosis 277, 273–277. doi:10.1016/j.atherosclerosis.2018.08.021;
  • Chua, Y.-A., Razman, A. Z., Ramli, A. S., Mohd Kasim, N. A., and Nawawi, H.(2021). Familial Hypercholesterolaemia in the Malaysian Community:Prevalence, Under-detection and Under-treatment. Jat 28, 1095–1107.doi:10.5551/jat.57026
  • Firth, J. C., and Marais, A. D. (2008). Familial Hypercholesterolaemia: The Cape Town Experience. S Afr. Med. J. 98, 99–104. doi:10.7196/samj.423
  • Singh A, Gupta A, Collins BL, Qamar A, Monda KL, Biery D, Lopez JAG, de Ferranti SD, Plutzky J, Cannon CP, Januzzi JL, Di Carli MF, Nasir K, Bhatt DL, Blankstein R. Familial Hypercholesterolemia Among Young Adults With Myocardial Infarction. Journal of the American College of Cardiology. 2019; 73 (19): 2439-2450. https://doi.org/10.1016/j.jacc.2019.02.059.
  • Familial Hypercholesterolemia Among Young Adults with Myocardial Infarction. J. Am. Coll. Cardiol. 73, 2439–2450. doi:10.1016/j.jacc.2019.02.059
  • Familial Hypercholesterolemia Prevalence Among Ethnicities—Systematic Review and Meta-Analysis, Frida Toft-Nielsen1,2, Frida Emanuelsson1 and Marianne Benn1,2*. Frontiers in Genetics,Volume 13.
  • Parihar RK, Razaq M, Saini G. Homozygous familial hypercholesterolemia. Indian J Endocrinol Metab. 2012 Jul;16(4):643–5. pmid:22837934;
  • Béliard S, Rabès JP, Cariou B, Farnier M, Krempf M, Ferrières J. Familial hypercholesterolemia: an under-diagnosed and under-treated disease. Survey of 495 physicians]. Presse Med. 2018 Sep;47(9):e159–67. pmid:30060905;
  • Alnouri F, Al-Allaf FA, Athar M, Abduljaleel Z, Alabdullah M, Alammari D. Xanthomas Can Be Misdiagnosed and Mistreated in Homozygous Familial Hypercholesterolemia Patients: A Call for Increased Awareness Among Dermatologists and Health Care Practitioners. Glob Heart. 2020 Feb;15(1):19. pmid:32489792;
  • Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide prevalence of familial hypercholesterolemia: meta-analyses of 11 million subjects. J Am Coll Cardiol. 2020 May;75(20):2553–66. pmid:32439005;
  • Gidding SS, Champagne MA, de Ferranti SD, Defesche J, Ito MK, Knowles JW, McCrindle B, Raal F, Rader D, Santos RD, et al; American Heart Association Atherosclerosis, Hypertension, and Obesity in Young Committee of Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and Council on Lifestyle and Cardiometabolic Health. The agenda for familial hypercholesterolemia: a scientific statement from the American Heart Association. Circulation. 2015;132:2167–2192. doi: 10.1161/CIR.0000000000000297;
  • Fahed AC, Safa RM, Haddad FF, Bitar FF et al; Homozygous familial hypercholesterolemia in Lebanon: A genotype/phenotype correlation. Molecular Genetics and Metabolism. February 2011; 102:181-188. doi:10.1016/j.ymgme.2010.11.006
  • Chater R, Aït Chihab K, Rabès J.P, Varret M, Chabraoui L, El Jahiri Y, Adlouni A et al; Mutational heterogeneity in low-density lipoprotein receptor gene related to familial hypercholesterolemia in Morocco. Clinica Chimica Acta. November 2006; 373: 62-69. doi: 10.1016/j.cca.2006.05.007
  • Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide Prevalence of Familial Hypercholesterolemia: Meta-Analyses of 11 Million Subjects. Journal of the American College of Cardiology. May 2020. 26;75(20):2553-2566. doi: 10.1016/j.jacc.2020.03.057.
  • Harada-Shiba M, Arai H, Oikawa S, et al. Guidelines for the management of familial hypercholesterolemia. J Atheroscler Thromb 2012;19:1043–60.
  • Zhou M, Zhao D. Familial hypercholesterolemia in Asian populations. J Atheroscler Thromb 2016;23:539–49.
  • A reassessment of the Japanese clinical diagnostic criteria of familial hypercholesterolemia in a hospital-based cohort using comprehensive genetic analysis. Hayato Tada a,*, Hirofumi Okada a, Akihiro Nomura a, Atsushi Nohara b, Soichiro Usui a, Kenji Sakata a, Masayuki Takamura a, Masa-aki Kawashiri./ Practical Laboratory Medicine 22 (2020) e00180.
  • Belay B, Racine AD, Belamarich PF. Underrepresentation of non-White children in trials of statins in children with heterozygous familial hypercholesterolemia. Ethn Dis. 2009;19:166–171.
  • Ahmad Z, Adams-Huet B, Chen C, Garg A. Low prevalence of mutations in known loci for autosomal dominant hypercholesterolemia in a multiethnic patient cohort. Circ Cardiovasc Genet. 2012;5:666–675. doi:10.1161/CIRCGENETICS.112.963587
  • Brown et al Homozygous Familial Hypercholesterolemia in Canada./ JACC: Advances, Vol. 2, No. 3, 2023.
  • M. Benn, G.F. Watts, A. Tybjaerg-Hansen, B.G. Nordestgaard, Familial hypercholesterolemia in the Danish general population, prevalence, coronary artery diseases, and cholesterol-lowering medication, J. Clin. Endocrinol. Metab. 97 (11) (2012) 3956-3964.
  • Resident population and its recentual distribution, according to race/ethnicity and age - Brasil, 1995 to 2015. Applied Economic research Institute from Statistic and Geography Brazilian Institute.
  • P.R.S. Silva, C.E. Jannes, T.G.M. Oliviera, et al. Evaluation of clinical and laboratory parameters used in the identification of index cases for genetic screening of Familial hypercholesterolemia in Brasil, Atherosclerosis 263 (2017) 257-262;
  • P.J. Talmud, S. Shah, R. Whittal, et al., Use of low-density lipoprotein cholesterol gene score to distinguish patients with polygenic and monogenic familial hypercholesterolemia: a case-control study, Lancet 381 (9874) (2013) 1293 - 1301.
  • el-Hazmi MA, al-Swailem AR, Warsy AS et.al., Consanguinity among the Saudi Arabian Population. J Med. Genetics, 1995; 32(8):623-6;
  • Warsy AS, Al-Jaser MH, Albdass A, Al-Daihan S, Alanazi M. Is consanguinity prevalence decreasing in Saudis?: a study in two generations. Afr Health Sci. 2014;14(2):314-21;
  • Al-Alaf FA, Alashwal A, et al., Identification of the recurrent frameshift mutation at the LDLR exon 14 (c.2027delG, p.(G676afs*33)) causing familial hypercholesterolemia in Saudi Arab homozygous children. Genomics 2016;107 (1):24-32;
  • Iacocca MA, Chora JR, Carrie A., Freiberger T et al., ClinGen FH Variant Curation Expert Panel. ClinVar database of global familial hypercholesterolemia-associated DNA variants. Hum Mutat. 2018;39:1631-1640.
  • Steyn K, Goldberg YP, Kotze MJ, Steyn M, Swanepoel AS, Fourie JM, Coetzee GA, Van der Westhuyzen DR. Estimation of the prevalence of familial hypercholesterolaemia in a rural Afrikaner community by direct screening for three Afrikaner founder low density lipoprotein receptor gene mutations.Hum Genet. 1996; 98:479–484. doi:
  • Frederick J. Raal, El Mustapha Bahassi, Belinda Stevens, Traci A. Turner and Evan A. Stein, Cascade Screening for Familial Hypercholesterolemia in South Africa The Wits FIND-FH Program, Arterioscler Thromb Vasc Biol. 2020 Nov;40(11):2747-2755.
  • Hu, P., Dharmayat, K. I., Stevens, C. A. T., Sharabiani, M. T. A., Jones, R. S., Watts, G. F., et al. (2020). Prevalence of Familial Hypercholesterolemia Among the General Population and Patients with Atherosclerotic Cardiovascular Disease. Circulation 141, 1742–1759. doi:10.1161/circulationaha.119.044795;
  • L.E. Akioyamen, J. Genest, S.D. Shan, R.L. Reel, J.M. Albaum, A. Chu, J.V. Tu, Estimating the prevalence of heterozygous familial hypercholesterolaemia: a systematic review and meta-analysis, BMJ Open 7 (9) (2017), e016461, https://doi.org/10.1136/bmjopen-2017-016461.
  • Provine, W. B. (2004). "Ernst Mayr: Genetics and speciation". Genetics. 167 (3): 1041–6;
  • M. Benn, G.F. Watts, A. Tybjaerg-Hansen, B.G. Nordestgaard, Mutation causative of familial hypercholesterolemia: screening of 98098 individuals from the Copenhagen General Population Study estimated prevalence of 1:217, Eur. Heart J. 37 (17) 2016 1384 - 1394;
  • A. Pajak, K. Szafraniec, M. Polak, W. Drygas, W. Piotrowski, T. Zdrojewski, P. Jankowski, Prevalence of familial hypercholesterolemia: a meta-analysis ofsix large, observational, population-based studies in Poland, Arch. Med. Sci. 12 (4) (2016) 687e696;
  • B. Sjouke, D.M. Kusters, I. Kindt, J. Besseling, J.C. Defesche, E.J. Sijbrands, J.E. Roeters van Lennep, A.F. Stalenhoef, A. Wiegman, J. de Graaf, S.W. Fouchier, J.J. Kastelein, G.K. Hovingh, Homozygous autosomal dominant hypercholesterolaemia in The Netherlands: prevalence, genotype-phenotype relationship, and clinical outcome, Eur. Heart J. 36 (9) (2015) 560e565;
  • N. Schmidt, B. Schmidt, A. Dressel, I. Gergei, J. Klotsche, L. Pieper, H. Scharnagl, M.E. Kleber, W. Ma€rz, H. Lehnert, D. Pittrow, G. Stalla, H.U. Wittchen, T.B. Grammer, Familial hypercholesterolemia in primary care in Germany. Diabetes and cardiovascular risk evaluation: targets and Essential Data for Commitment of Treatment (DETECT) study, Atherosclerosis 266 (2017) 24e30;
  • V. Guglielmi, A. Bellia, S. Pecchioli, G. Medea, D. Parretti, D. Lauro, P. Sbraccia, M. Federici, I. Cricelli, C. Cricelli, F. Lapi, What is the actual epidemiology of familial hypercholesterolemia in Italy? Evidence from a National Primary Care Database, Int. J. Cardiol. 223 (2016) 701e705.
  • F. Farzadfar, M.M. Finucane, G. Danaei, P.M. Pelizzari, M.J. Cowan, C.J. Paciorek, G.M. Singh, J.K. Lin, G.A. Stevens, L.M. Riley, M. Ezzati, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Cholesterol). National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3$0 million participants, Lancet 377 (9765) (2011) 578e586,
  • B. Zafrir, A. Jubran, G. Lavie, D.A. Halon, M.Y. Flugelman, C. Shapira, Clinical determinants and treatment gaps in familial hypercholesterolemia: data from a multi-ethnic regional health service, Eur J Prev Cardiol 24 (8) (2017) 867e875;
  • Z. Shi, B. Yuan, D. Zhao, A.W. Taylor, J. Lin, G.F. Watts, Familial hypercholes- terolemia in China: prevalence and evidence of underdetection and under- treatment in a community population, Int. J. Cardiol. 174 (3) (2014) 834e836;
  • Frida Toft-Nielsen1,2, Frida Emanuelsson1 and Marianne Benn, Familial Hypercholesterolemia Prevalence Among Ethnicities—Systematic Review and Meta-Analysis, Frontiers in genetic, 03 February 2022
  • Basulaiman M, EI Bcheraoui C, Tuffaha M, et. al Hypercholesterolemia and its associated risk factors - Kingdo of Saudi Arabia, 2013. Ann Epidemiol. 2014; 24 (11): 801-8;
  • Al-Rasadi K, Al-Zakwani I, Alsheikh - Ali AA, et al., Prevalence, management and outcomes of Familial Hypercholesterolemia in patients with acute coronary syndromes in Arabian Gulf. J Clin Lipidol. 2018; 12 (3): 685 - 92. e2.
  • M. Cuchel, E. Bruckert, H.N. Ginsberg, F.J. Raal, R.D. Santos, R.A. Hegele, J.A. Kuivenhoven, B.G. Nordestgaard, O.S. Descamps, E. Steinhagen-Thiessen, A. Tybjærg-Hansen, G.F. Watts, M. Averna, C. Boileau, J. Boren, A.L. Catapano, J.C. Defesche, G.K. Hovingh, S.E. Humphries, P.T. Kovanen, L. Masana, P. Pajukanta, K.G. Parhofer, K.K. Ray, A.F. Stalenhoef, E. Stroes, M.R. Taskinen, A. Wiegman, O. Wiklund, M.J. Chapman, European atherosclerosis society consensus panel on familial hypercholesterolaemia. Homozygous familial hypercholesterolaemia: new insights and guidance for clinicians to improve detection and clinical management. A position paper from the consensus panel on familial hypercholesterolaemia of the european atherosclerosis so- ciety, Eur. Heart J. 35 (32) (2014) 2146e2157,
  • R.M. Sanchez-Hernandez, F. Civeira, M. Stef, S. Perez-Calahorra, F. Almagro, N. Plana, F.J. Novoa, P. Saenz-Aranzubía, D. Mosquera, C. Soler, F.J. Fuentes, Y. Brito-Casillas, J.T. Real, F. Blanco-Vaca, J.F. Ascaso, Pocovi M.Homozygous familial hypercholesterolemia in Spain: prevalence and phenotype-genotype relationship, Circ Cardiovasc Genet 9 (6) (2016) 504e510,
  • S. Walzer, K. Travers, S. Rieder, E. Erazo-Fischer, D. Matusiewicz, Homozygous familial hypercholesterolemia (HoFH) in Germany: an epidemiological survey, Clinicoecon Outcomes Res 5 (2013) 189e192;
  • H. Mabuchi, A. Nohara, T. Noguchi, J. Kobayashi, M.A. Kawashiri, H. Tada, C. Nakanishi, M. Mori, M. Yamagishi, A. Inazu, J. Koizumi, Hokuriku FH Study Group. Molecular genetic epidemiology of homozygous familial hypercho- lesterolemia in the Hokuriku district of Japan, Atherosclerosis 214 (2) (2011);
  • A. Wiegman, S.S. Gidding, G.F. Watts, M.J. Chapman, H.N. Ginsberg, M. Cuchel, L. Ose, M. Averna, C. Boileau, J. Boren, E. Bruckert, A.L. Catapano, J.C. Defesche, O.S. Descamps, R.A. Hegele, G.K. Hovingh, S.E. Humphries, P.T. Kovanen, J.A. Kuivenhoven, L. Masana, B.G. Nordestgaard, P. Pajukanta, K.G. Parhofer, F.J. Raal, K.K. Ray, R.D. Santos, A.F. Stalenhoef, E. Steinhagen-Thiessen, E.S. Stroes, M.R. Taskinen, A. Tybjærg-Hansen, O. Wiklund, European Atherosclerosis Society Consensus Panel. Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment, Eur. Heart J. 36 (36) (2015 Sep 21) 2425e2437;
  • The World Factbook 2018, Central Intelligence Agency, Washington, DC, 2018. (Accessed 13 April 2018).
  • Clark LT, Watkins L, Piña IL, Elmer M, Akinboboye O, Gorham M, Jamerson B, McCullough C, Pierre C, Polis AB, et al. Increasing diversity in clinical trials: overcoming critical barriers. Curr Probl Cardiol. 2019;44:148–172. doi: 10.1016/j.cpcardiol.2018.11.002