Yasmin Bylstra1,2, Jyn Ling Kuan1,3, Weng Khong Lim1,4, Jaydutt Digambar Bhalshankar5, Jing Xian Teo1, Sonia Davila1,6, Bin Tean Teh1,4,7, Steve Rozen1,4, Ene-Choo Tan3, Wendy Kein Meng Liew3,8, Khung Keong Yeo5, Patrick Tan1,4,9, Seang Mei Saw10,11,12,13, Ching-Yu Cheng11,13, Stuart Cook1,5,6, Roger Foo12,14, Saumya Shekhar Jamuar15,16,17. 1. SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore. 2. Inherited Cardiac Clinic, National University Hospital, Singapore, Singapore. 3. Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore. 4. Cancer and Stem Biology, Duke-NUS Medical School, Singapore, Singapore. 5. Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore. 6. Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore, Singapore. 7. Division of Medical Sciences, National Cancer Centre, Singapore, Singapore. 8. Paediatrics ACP, Duke-NUS Medical School, Singapore, Singapore. 9. Biomedical Research Council, Agency for Science, Technology and Research, Singapore, Singapore. 10. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. 11. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. 12. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 13. Eye ACP, Duke-NUS Medical School, Singapore, Singapore. 14. Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore. 15. SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore. Saumya.s.jamuar@singhealth.com.sg. 16. Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore. Saumya.s.jamuar@singhealth.com.sg. 17. Paediatrics ACP, Duke-NUS Medical School, Singapore, Singapore. Saumya.s.jamuar@singhealth.com.sg.
Abstract
PURPOSE: Genomic studies have demonstrated the necessity of ethnicity-specific population data to ascertain variant pathogenicity for disease diagnosis and treatment. This study examined the carrier prevalence of treatable inherited disorders (TIDs), where early diagnosis of at-risk offspring can significantly improve clinical outcomes. METHODS: Existing exome/ genome sequencing data of 831 Singaporeans were aggregated and examined for disease causing variants in 104 genes associated with 80 TIDs. RESULTS: Among the 831 Singaporean participants, genomic variant filtering and analysis identified 1 in 18 individuals (6%) to be carriers amongst one of 13 TIDs. Citrin deficiency and Wilson disease had the highest carrier frequency of 1 in 41, and 1 in 103 individuals, respectively. The pathogenic variants associated with citrin deficiency were 24 times more prevalent in our local cohorts when compared to Western cohorts. CONCLUSION: This study demonstrates the value of a population specific genomic database to determine true disease prevalence and has enabled the discovery of carrier frequencies of treatable genetic conditions specific to South East Asian populations, which are currently underestimated in existing data sources. This study framework can be adapted to other population groups and expanded to multiple genetic conditions to inform health policies directing precision medicine.
PURPOSE: Genomic studies have demonstrated the necessity of ethnicity-specific population data to ascertain variant pathogenicity for disease diagnosis and treatment. This study examined the carrier prevalence of treatable inherited disorders (TIDs), where early diagnosis of at-risk offspring can significantly improve clinical outcomes. METHODS: Existing exome/ genome sequencing data of 831 Singaporeans were aggregated and examined for disease causing variants in 104 genes associated with 80 TIDs. RESULTS: Among the 831 Singaporean participants, genomic variant filtering and analysis identified 1 in 18 individuals (6%) to be carriers amongst one of 13 TIDs. Citrin deficiency and Wilson disease had the highest carrier frequency of 1 in 41, and 1 in 103 individuals, respectively. The pathogenic variants associated with citrin deficiency were 24 times more prevalent in our local cohorts when compared to Western cohorts. CONCLUSION: This study demonstrates the value of a population specific genomic database to determine true disease prevalence and has enabled the discovery of carrier frequencies of treatable genetic conditions specific to South East Asian populations, which are currently underestimated in existing data sources. This study framework can be adapted to other population groups and expanded to multiple genetic conditions to inform health policies directing precision medicine.
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