Molecular epidemiological characteristics, variant spectrum and genotype-phenotype correlation of glucose-6-phosphate dehydrogenase deficiency in China: A population-based multicenter study using newborn screening

PLoS One. 2024 Oct 22;19(10):e0310517. doi: 10.1371/journal.pone.0310517. eCollection 2024.

Abstract

Background and aims: Newborn screening (NBS) for glucose-6-phosphate dehydrogenase (G6PD) deficiency by biochemical tests is being used worldwide, however, the outcomes arising from combined genetic and biochemical tests have not been evaluated. This research aimed to evaluate the outcomes of application of combined genetic and biochemical NBS for G6PD deficiency and to investigate the molecular epidemiological characteristics, variant spectrum, and genotype-phenotype correlation of G6PD deficiency in China.

Methods: A population-based cohort of 29,601 newborns were prospectively recruited from eight NBS centers in China between February 21 and December 30, 2021. Biochemical and genetic NBS was conducted simultaneously.

Results: The overall prevalence of G6PD deficiency was 1.12% (1.86% for male, and 0.33% for female; 1.94% for South China and 0.08% for North China). Genetic NBS identified 10 male patients undetected by biochemical NBS. The overall positive predictive values (PPVs) of biochemical and genetic NBS were 79.95% and 47.57%, respectively. A total of 15 variants were identified, with the six most common variants being c.1388G > A, c.1376G > T, c.95A > G, c.871G > A, c.1024C > T and c.392G > T (94.2%). The activity of G6PD was correlated with the type and WHO classification of variants.

Conclusion: This study highlighted that combined screening could enhance the efficiency of current NBS for diagnosing G6PD deficiency. The prevalence, variant spectrum and allele frequency of G6PD deficiency vary across different regions. Our data provide valuable references for clinical practice and optimization of future screening strategies for G6PD deficiency.

Publication types

  • Multicenter Study

MeSH terms

  • China / epidemiology
  • Female
  • Genetic Association Studies
  • Genotype
  • Glucosephosphate Dehydrogenase Deficiency* / diagnosis
  • Glucosephosphate Dehydrogenase Deficiency* / epidemiology
  • Glucosephosphate Dehydrogenase Deficiency* / genetics
  • Glucosephosphate Dehydrogenase* / genetics
  • Humans
  • Infant, Newborn
  • Male
  • Molecular Epidemiology
  • Neonatal Screening* / methods
  • Prevalence
  • Prospective Studies

Substances

  • Glucosephosphate Dehydrogenase

Grants and funding

This study was supported by Science and Technology Projects in Guangzhou [grant number 202201020618], Scientific research Project plan of Shanghai Municipal Health Commission [grant number 202140346], Application Technology Research and Development Project of Inner Mongolia Autonomous Region [grant number 2020GG0119], Open Fund of Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases [grant number 2020ZDKFKT001], and Open Fund of Reproductive Obstetrics and Gynecology Clinical Center of Yunnan Province [grant number 2022LCZXKF-SZ02].