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• 研究报告 •    

基于大规模新生儿靶向基因筛查的中国罕见病发病率预测研究

胡旭昀1,2,郭若兰1,2,齐展1,郝婵娟1,2,3,李巍1,2,3   

  1. 1. 国家儿童医学中心,首都医科大学附属北京儿童医院,遗传与出生缺陷防治中心;北京市儿科研究所,出生缺陷遗传学研究北京市重点实验室;儿科重大疾病研究教育部重点实验室,北京 100045

    2. 河南省儿童医院郑州儿童医院,郑州大学附属儿童医院,河南省儿童遗传与发育疾病重点实验室,郑州 450053

    3. 河南省医学科学院儿童医学研究所,郑州 451162

  • 收稿日期:2026-05-27 修回日期:2026-07-13 发布日期:2026-08-18
  • 基金资助:

    国家重点研发计划项目(编号:2025YFC2708600,北京市科委国际(港澳台)科技合作项目(编号:Z251100007125041),北京市科委首都临床特色诊疗技术研究及转化应用(编号:Z221100007422017)资助[Supported by the National Key Research and Development Program of China (No. 2025YFC2708600)the International (Hong Kong, Macao, and Taiwan) Science and Technology Cooperation Project of Beijing Municipal Science and Technology Commission (No. Z251100007125041), and the Capital Clinical Characteristic Diagnosis and Treatment Technology Research and Translational Application Project of Beijing Municipal Science and Technology Commission (No. Z221100007422017)]

Prediction of rare disease incidence in China based on large-Scale targeted genetic screening in newborns

Xuyun Hu1, 2, Ruolan Guo1, 2, Zhan Qi1, Chanjuan Hao1, 2, 3, Wei Li1, 2, 3   

  1. 1 Beijing Children's Hospital, Capital Medical University; Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute; MOE Key Laboratory of Major Diseases in Children; Center of Genetics and Birth Defects Control, National Center for Children's Health, Beijing 100045, China

    2 Henan Key Laboratory of Genetic and Developmental Disorders, Pediatric Research Institute, Henan Children’s Hospital of Zhengzhou University, Zhengzhou 450053, China

    3 Institute of Children’s Health, Henan Academy of Medical Sciences, Zhengzhou 451162, China

  • Received:2026-05-27 Revised:2026-07-13 Online:2026-08-18

摘要:

罕见病由于单病种发病率低,长期缺乏大规模人群水平的流行病学数据。本研究基于大规模新生儿人群的靶向基因测序数据,预测《罕见病目录》中本研究覆盖的42种罕见病发病率。研究选取了来自中国14个省份的33,894名新生儿作为研究对象,采用定制的465个致病基因靶向二代测序,依据美国医学遗传学与基因组学学会(ACMG)标准判定致病/可能致病变异。通过中国《第一批罕见病目录》及《第二批罕见病目录》筛选出本研究中基因完全覆盖的疾病,并根据不同遗传模式计算疾病的预测发病率。在207种罕见病目录中,本研究共涉及82种,其中42种罕见病的致病基因被完全覆盖,共涉及62个致病基因。在33,894名新生儿中,62个基因中有57个检测到4,657个致病/可能致病变异,平均每人携带变异0.137个。发病率较高的疾病包括苯丙酮尿症(1/5,060)、肝豆状核变性(1/12,200)、原发性肉碱缺乏症(1/17,700)、瓜氨酸血症(1/29,600)以及糖原累积病(Ⅰ型、Ⅱ型,1/63,600)等。本研究基于大规模中国新生儿人群数据,系统预测了42种致病基因完全覆盖的罕见病发病率。靶向基因筛查可作为现有新生儿筛查体系的一线联合方案,为罕见病的早期干预和公共卫生策略制定提供了重要的循证数据。

关键词: 罕见病, 发病率, 靶向测序, 新生儿筛查, 基因携带率

Abstract:

Rare diseases are characterized by the extremely low prevalence of individual conditions, and large-scale population-based epidemiological data remain limited. In this study, we aimed to predict the incidence of 42 rare diseases included in the Chinese Rare Disease Catalog based on large-scale newborn targeted genetic screening data. A total of 33,894 newborns from 14 provinces in China were enrolled. Targeted next-generation sequencing of 465 disease-causing genes was performed, and pathogenic/likely pathogenic (P/LP) variants were classified according to the American College of Medical Genetics and Genomics (ACMG)guidelines. Diseases with complete gene coverage were screened from China’s First and Second Lists of Rare Diseases, and predicted incidence was calculated according to different inheritance patterns. Among the listed 207 rare diseases, 82 were covered in this study, of which 42 had complete gene coverage involving 62 pathogenic genes. In 33,894 newborns, 4,657 P/LP variants were detected across 57 genes, with an average of 0.137 variants per individual. Diseases with higher predicted incidence included phenylketonuria (1/5,060), Wilson disease (1/12,200), primary carnitine deficiency (1/17,700), citrullinemia (1/29,600), and glycogen storage disease (types I and II, 1/63,600). This study systematically predicted the incidence of 42 rare diseases with fully covered genes based on large-scale Chinese newborn genomic data. Targeted genetic screening can serve as an effective first-tier combined strategy within the existing newborn screening and provides important evidence-based data for early intervention and public health policies for rare diseases.

Key words: rare diseases, incidence, targeted sequencing, newborn screening, carrier rate