Ann Rheum Dis:多基因风险评分对强直性脊柱炎具有很高的诊断价值

2021-08-25 xiangting MedSci原创

多基因风险评分(PRS)可以用来评估个体患某种疾病的风险,如冠状动脉疾病、乳腺癌或糖尿病等。

多基因风险评分(PRS)可以用来评估个体患某种疾病的风险,如冠状动脉疾病、乳腺癌或糖尿病等。这项研究对PRS可以很好地区分强直性脊柱炎 (AS) 患者与健康人和慢性背痛患者的假设进行了检验。

                   

研究使用来自 15 585 例 AS 患者和 20 452 例对照(欧洲和东亚人种)的全基因组关联研究数据,开发和验证了 PRS。并将 PRS 的区分能力与其他广泛使用的诊断方法进行了比较,其中包括 C 反应蛋白 (CRP)、HLA-B27和骶髂关节 MRI。

在欧洲人群中,PRS 具有很高的区分能力,受试者工作特征曲线下面积 (AUC) 为 0.924。这明显优于HLA-B27 (AUC=0.869)、MRI (AUC=0.885) 或 C 反应蛋白 (AUC=0.700)。在东亚人种中开发和验证的 PRS 表现相似(AUC=0.948)。假设 AS 的先验概率为 10%,对于45 岁以下的慢性背痛患者,与仅检测HLA-B27相比,35%的患者使用PRS的阳性值更高,而67.5% 的患者为阴性预测值。 在欧洲血统的人群中,PRS最大阳性预测值为 78.2%,阴性预测值为 100%,而HLA-B27分别为 51.9% 和 97.9%。

                                      多基因风险评分的受试者工作特征曲线

总之,与仅检查CRP、骶髂 MRI 或HLA-B27相比,PRS 对 AS 的鉴别能力更强。为获得最佳性能,应建立适合特定种族群体的PRS。

 

原始出处:

Zhixiu Li.Polygenic Risk Scores have high diagnostic capacity in ankylosing spondylitis. Ann Rheum Dis. September 2021.

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    2022-05-22 zywlvao
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