Diagnosis of familial hypercholesterolemia in general practice using clinical diagnostic criteria or genetic testing as part of cascade genetic screening.

Diagnosis of familial hypercholesterolemia in general practice using clinical diagnostic criteria or genetic testing as part of cascade genetic screening. Research Abstract Details 

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Diagnosis of familial hypercholesterolemia in general practice using clinical diagnostic criteria or genetic testing as part of cascade genetic screening. Abstract Text:

Trond P Leren,Tora Himle Finborud,Turid E Manshaus,Leiv Ose,Knut Erik Berge,Trond P Leren,Tora Himle Finborud,Turid E Manshaus,Leiv Ose,Knut Erik Berge,Trond P Leren,Tora Himle Finborud,Turid E Manshaus,Leiv Ose,Knut Erik Berge,

Background: Too few familial hypercholesterolemia (FH) patients are diagnosed. The most cost-effective strategy to diagnose FH is to examine first-degree relatives of already diagnosed patients. This is referred to as cascade genetic screening. Methods and Results: One thousand eight hundred and five first-degree relatives of index patients with molecularly defined FH consented to cascade genetic screening by the use of molecular genetic testing. Of these, 44.8% were mutation carriers and 55.2% were noncarriers. Only 44.2% of the mutation carriers were on lipid-lowering drugs at the time of genetic testing. Of these, only 9.4% had a value for total serum cholesterol below 5 mM. Among adult mutation carriers who were not on lipid-lowering treatment at the time of genetic testing, reductions in total serum cholesterol and low-density lipoprotein cholesterol of 18.4% (p < 0.0001) and 25.3% (p < 0.0001), respectively, were observed 6 months after genetic testing. It is assumed that this improvement in the lipid profile is due to a definite diagnosis obtained by molecular genetic testing. By using the results of genetic testing as the gold standard for diagnosis of FH, data from a questionnaire filled out by the relatives showed that the use of clinical criteria to diagnose FH in general practice had a sensitivity of 46.2% and a specificity of 88.0%. Conclusions: The use of clinical diagnostic criteria to diagnose FH in general practice identifies only approximately 50% of FH patients. Molecular genetic testing as part of cascade genetic screening is an efficient tool to diagnose patients, leading to significant improvement in the lipid profile. It should therefore be implemented in clinical medicine. Copyright (c) 2008 S. Karger AG, Basel.

Diagnosis of familial hypercholesterolemia in general practice using clinical diagnostic criteria or genetic testing as part of cascade genetic screening. Publishing Authors By Initials

TP Leren,TH Finborud,TE Manshaus,L Ose,KE Berge,TP Leren,TH Finborud,TE Manshaus,L Ose,KE Berge,TP Leren,TH Finborud,TE Manshaus,L Ose,KE Berge,

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Diagnosis of familial hypercholesterolemia in general practice using clinical diagnostic criteria or genetic testing as part of cascade genetic screening. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Community genetics

VOLUME: 11

Page Numbers: 26-35

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ISSN: 1422-2833

DAY: 15

MONTH: 01

YEAR: 2008

Diagnosis of familial hypercholesterolemia in general practice using clinical diagnostic criteria or genetic testing as part of cascade genetic screening. Information

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LANGUAGE: eng

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AFFILIATION: Medical Genetics Laboratory, Department of Medical Genetics, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.

Country: Switzerland

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MEDLINETA: Community Genet

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