Sex Chromosome Aberrations

性染色体畸变
  • 文章类型: Journal Article
    背景:男性不育已成为全球性的健康问题,遗传因素是其中一个重要原因。Y染色体微缺失是导致男性不育的主要遗传因素。本研究的目的是探讨海南男性不育与Y染色体微缺失的相关性。中国唯一的热带岛屿省。
    方法:本研究对海南897名不育男性进行精液分析。根据世界卫生组织标准,生殖医学部的专业人员对精液分析进行了测量,海南医科大学第一附属医院,在那里收集样本。通过在外周血DNA上进行多重聚合酶链反应检测六个STS标记,证实了Y染色体AZF微缺失。生殖激素的水平,包括FSH,LH,PRL,T,和E2,使用酶联免疫吸附测定(ELISA)进行定量。
    结果:海南不育男性Y染色体微缺失发生率为7.13%。少精子症组Y染色体微缺失发生率为6.69%(34/508),无精子症组Y染色体微缺失发生率为7.71%(30/389)。在无精子症组中观察到AZF亚区各种类型的缺失,而在少精子症组没有检测到AZFb缺失。在所有微缺失患者中,AZFc区的缺失率为68.75%(64个中的44个),其次是AZFa区的缺失率为6.25%(64个中的4个),AZFb区的缺失率为4.69%(64个中的3个)。无精子症患者的AZFa区域缺失率明显高于少精子症患者(0.51%vs.0.39%,p<0.001)。相比之下,在少精子症患者中,AZFc区的缺失率明显更高(3.08%vs.6.30%,p<0.001)。此外,在所有患者中,AZFb+c次区域关联缺失的比例最高(0.89%,8/897),其次是AZFa+b+c缺失(0.56%,5/897),并且仅发生在无精子症患者中。激素分析显示FSH(21.63±2.01U/Lvs.10.15±0.96U/L,p=0.001),LH(8.96±0.90U/Lvs.4.58±0.42U/L,p<0.001)和PRL(263.45±21.84mIU/Lvs.170.76±17.10mIU/L,p=0.002)在无精子症患者中微缺失显着增加。尽管如此,P、E2水平两组间差异无统计学意义。
    结论:海南省男性不育患者AZF微缺失发生率可达7.13%,AZFc亚区的缺失最高。虽然Y染色体微缺失率在不同的区域或群体中是不同的,Y染色体的上述区域可能在调节精子发生中起着不可或缺的作用。Y染色体微缺失分析在男性不育的临床评估和诊断中起着至关重要的作用。
    BACKGROUND: Male infertility has become a global health problem, and genetic factors are one of the essential causes. Y chromosome microdeletion is the leading genetic factor cause of male infertility. The objective of this study is to investigate the correlation between male infertility and Y chromosome microdeletions in Hainan, the sole tropical island province of China.
    METHODS: We analyzed the semen of 897 infertile men from Hainan in this study. Semen analysis was measured according to WHO criteria by professionals at the Department of Reproductive Medicine, the First Affiliated Hospital of Hainan Medical University, where samples were collected. Y chromosome AZF microdeletions were confirmed by detecting six STS markers using multiple polymerase chain reactions on peripheral blood DNA. The levels of reproductive hormones, including FSH, LH, PRL, T, and E2, were quantified using the enzyme-linked immunosorbent assay (ELISA).
    RESULTS: The incidence of Y chromosome microdeletion in Hainan infertile men was 7.13%. The occurrence rate of Y chromosome microdeletion was 6.69% (34/508) in the oligozoospermia group and 7.71% (30/389) in the azoospermia group. The deletion of various types in the AZF subregion was observed in the group with azoospermia, whereas no AZFb deletion was detected in the oligozoospermia group. Among all patients with microdeletions, the deletion rate of the AZFc region was the higher at 68.75% (44 out of 64), followed by a deletion rate of 6.25% (4 out of 64) for the AZFa region and a deletion rate of 4.69% (3 out of 64) for the AZFb region. The deletion rate of the AZFa region was significantly higher in patients with azoospermia than in patients with oligozoospermia (0.51% vs. 0.39%, p < 0.001). In comparison, the deletion rate of the AZFc region was significantly higher in patients with oligozoospermia (3.08% vs. 6.30%, p < 0.001). Additionally, the AZFb + c subregion association deletion was observed in the highest proportion among all patients (0.89%, 8/897), followed by AZFa + b + c deletion (0.56%, 5/897), and exclusively occurred in patients with azoospermia. Hormone analysis revealed FSH (21.63 ± 2.01 U/L vs. 10.15 ± 0.96 U/L, p = 0.001), LH (8.96 ± 0.90 U/L vs. 4.58 ± 0.42 U/L, p < 0.001) and PRL (263.45 ± 21.84 mIU/L vs. 170.76 ± 17.10 mIU/L, p = 0.002) were significantly increased in azoospermia patients with microdeletions. Still, P and E2 levels were not significantly different between the two groups.
    CONCLUSIONS: The incidence of AZF microdeletion can reach 7.13% in infertile men in Hainan province, and the deletion of the AZFc subregion is the highest. Although the Y chromosome microdeletion rate is distinct in different regions or populations, the regions mentioned above of the Y chromosome may serve an indispensable role in regulating spermatogenesis. The analysis of Y chromosome microdeletion plays a crucial role in the clinical assessment and diagnosis of male infertility.
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  • 文章类型: Journal Article
    背景:染色体异常在马群体中以约2%的比率发生。使用分子细胞遗传学技术可以更准确地识别染色体异常,尤其是那些异常中期比率低的人,证明在马群中的实际发病率较高。
    目的:从不同品种的幼马群体中估计样本中核型异常携带者的数量,使用分子细胞遗传学技术。
    方法:横断面。
    方法:从代表5个品种的500匹幼马中收集静脉血样(纯种阿拉伯,Hucul,波兰原始马[Konik],Maswopolska,冷血,西里西亚)。从血液淋巴细胞中获得染色体和DNA,并通过荧光原位杂交(FISH)和PCR进行评估,使用性染色体的探针和标记并选择常染色体。
    结果:19匹马,18匹母马和1匹种马,被诊断为不同的染色体异常:17例性染色体非整倍体的镶嵌形式,发病率非常低(0.6%-4.7%),一例SRY阴性64,XY性别逆转母马,还有一匹X-autosome易位的母马.在整个人群中,性别染色体畸变的百分比确定为3.8%,女性为6.08%,男性为0.49%。
    结论:样本量有限,仅限于来自波兰的马。
    结论:我们发现的性染色体异常率几乎是以前使用经典染色体染色技术的人群研究报告的两倍。FISH允许检测发生率非常低的非整倍体细胞系。FISH技术是一种更快速、更精确的核型检查方法;然而,它通常只关注一个或两个染色体,而条带核型分析包括整个染色体组。
    BACKGROUND: Chromosomal abnormalities occur in the equine population at a rate of approximately 2%. The use of molecular cytogenetic techniques allows a more accurate identification of chromosomal abnormalities, especially those with a low rate of abnormal metaphases, demonstrating that the actual incidence in equine populations is higher.
    OBJECTIVE: Estimation of the number of carriers of karyotypic abnormalities in a sample from a population of young horses of various breeds, using molecular cytogenetic techniques.
    METHODS: Cross-sectional.
    METHODS: Venous blood samples were collected from 500 young horses representing 5 breeds (Purebred Arabian, Hucul, Polish primitive horse [Konik], Małopolska, Coldblood, Silesian). Chromosomes and DNA were obtained from blood lymphocytes and evaluated by fluorescence in situ hybridisation (FISH) and PCR, using probes and markers for the sex chromosomes and select autosomes.
    RESULTS: Nineteen horses, 18 mares and 1 stallion, were diagnosed with different chromosomal abnormalities: 17 cases of mosaic forms of sex chromosome aneuploidies with a very low incidence (0.6%-4.7%), one case of a SRY-negative 64,XY sex reversal mare, and one mare with X-autosome translocation. The percentage of sex chromosomal aberrations was established as 3.8% in the whole population, 6.08% in females and 0.49% in males.
    CONCLUSIONS: Limited sample size, confined to horses from Poland.
    CONCLUSIONS: The rate of sex chromosomal abnormalities we identified was almost double that reported in previous population studies that used classical chromosome staining techniques. FISH allowed the detection of aneuploid cell lines which had a very low incidence. The FISH technique is a faster and more precise method for karyotype examination; however, it is usually focused on only one or two chromosomes while banding karyotyping includes the entire chromosome set.
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  • 文章类型: Journal Article
    背景:描述并总结X染色体异常患者的体外受精(IVF)结果。
    方法:进行回顾性病例系列研究。根据正常X的数量,患者被分为两组:A组(仅X正常的患者,而其他X具有任何类型的异常)和B组(患者具有两个或多个正常X染色体)。临床数据,包括基本信息,生育信息,和IVF结果,被收集。
    结果:纳入14例X染色体异常患者,其中13例患者共接受了29个周期。B组患者有5例成功怀孕和3例活产,而A组没有患者有临床妊娠。此外,A组的囊胚形成率和妊娠发生率显着降低(Z=-3.135,p=.002;Z=-2.946,p=.003)。当受控协变量时,一个正常X的核型也是囊胚形成率和成功妊娠的危险因素(β=.820,95%置信区间[CI]=0.458-1.116,β=.333,95%CI=0.017-0.494).
    结论:我们的结果显示,只有一个正常X的女性可能会遭受更差的IVF结局。主要是囊胚形成率,与那些有两个或两个以上正常X的人相比,包括马赛克特纳综合征和47,XXX。
    BACKGROUND: To describe and conclude the in vitro fertilization (IVF) results of patients with X chromosome abnormality.
    METHODS: A retrospective case series was conducted. According to the number of normal X, patients were allocated into two groups: Group A (patients with only a normal X, while other X has any types of abnormalities) and Group B (patients have two or more normal X chromosomes). Clinical data, including basic information, fertility information, and IVF outcomes, were collected.
    RESULTS: Fourteen patients with X chromosome abnormality were included, among which 13 patients underwent a total of 29 cycles. Patients in Group B had five successful pregnancies and three live births, while no patient in Group A had a clinical pregnancy. Furthermore, the blastocyst formation rate and incidence of pregnancy were significantly lower in Group A (Z = -3.135, p = .002; Z = -2.946, p = .003, respectively). When controlled covariates, the karyotype of one normal X was also a risk factor for both blastocyst formation rate and success pregnancy (β = .820, 95% confidence interval [CI] = 0.458-1.116, β = .333, 95% CI = 0.017-0.494, respectively).
    CONCLUSIONS: Our results revealed that women with only one normal X might suffer from worse IVF outcomes, mainly blastocyst formation rate, compared with those who had two or more normal X, including mosaic Turner syndrome and 47,XXX.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    造血细胞的性染色体丢失现象是生物衰老的新兴指标。虽然已经开发了许多检测这种损失的方法,加强领域,这些现有的方法往往是劳动密集型的,贵,不够敏感。为了弥合这个差距,开发了一种新颖且更有效的技术,命名为SinChro试验。该方法采用多重单细胞液滴PCR,旨在以单细胞分辨率检测性染色体丢失的细胞。通过SinChro检测,成功定位了男性血液中Y染色体缺失的年龄依赖性增加。还确定了女性血液中X染色体的年龄依赖性丢失,这一发现对现有方法一直具有挑战性。SinChro测定法的出现标志着与年龄相关的性别镶嵌性研究的重大突破。它的效用超出了血液分析,适用于各种组织,它有可能加深对生物衰老和相关疾病的理解。
    The phenomenon of sex chromosome loss from hematopoietic cells is an emerging indicator of biological aging. While many methods to detect this loss have been developed, enhancing the field, these existing methods often suffer from being labor-intensive, expensive, and not sufficiently sensitive. To bridge this gap, a novel and more efficient technique is developed, named the SinChro assay. This method employs multiplexed single-cell droplet PCR, designed to detect cells with sex chromosome loss at single-cell resolution. Through the SinChro assay, the age-dependent increase in Y chromosome loss in male blood is successfully mapped. The age-dependent loss of the X chromosome in female blood is also identified, a finding that has been challenging with existing methods. The advent of the SinChro assay marks a significant breakthrough in the study of age-related sex mosaicism. Its utility extends beyond blood analysis, applicable to a variety of tissues, and it holds the potential to deepen the understanding of biological aging and related diseases.
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  • 文章类型: Journal Article
    目的:探讨性发育障碍(DSD)患者的遗传基础。
    方法:选择2022年4月6日因原发性闭经到临沂市人民医院就诊的女性患者作为研究对象。常规染色体核型分析,荧光原位杂交(FISH),染色体微阵列分析(CMA),对患者进行荧光定量PCR和Sanger测序。
    结果:患者,一个14岁的女性,有短雕像,多个痣,和原发性闭经.她的核型为46,X,idic(Y)(p11.3)[59]/45,X[39]/47,X,idic(Y)(p11.3)×2[2]。FISH检测结果为46,X,der(Y)。ishidic(Y)(p11.3)(SRY+)[59]/45,X[39]/47,X,der(Y)×2。ishidic(Y)(p11.3)(SRY+)[2]。CMA的参数为arr[GRCh37](X)×1,(Y)×0-1,arr[GRCh37]Yp11.32(118552_472090)×1。患者Y染色体AZF区无缺失,SRY基因变异体阴性。结合以上结果,她的分子核型被确定为mos46,X,idic(Y)(p11.32)[59]/45,X[39]/47,X,idic(Y)(p11.32)×2[2]。ish46,X,idic(Y)(p11.32)(DXZ1+,DYZ1++,DYZ3++,SRY+)[59]/45,X(DXZ1+,DYZ1-,DYZ3-,SRY-)[39]/47,X,der(Y)×2。ishidic(Y)(p11.32)(DXZ1+,DYZ1++,DYZ3++,SRY+)[2]。arr[GRCh37](X)×1,(Y)×0-1,arr[GRCh37]Yp11.32(118552_472090)×1。患者被诊断为镶嵌性DSD与idic(Y)(p11.32)。
    结论:异常镶嵌核型可能是该患者DSD的基础。
    OBJECTIVE: To explore the genetic basis for a patient with Disorders of sex development (DSD).
    METHODS: A female patient who had presented at the Linyi People\'s Hospital due to primary amenorrhea on April 6, 2022 was selected as the study subject. Conventional chromosomal karyotyping, fluorescence in situ hybridization (FISH), chromosomal microarray analysis (CMA), fluorescence quantitative PCR and Sanger sequencing were carried out for the patient.
    RESULTS: The patient, a 14-year-old female, had featured short statue, multiple nevi, and primary amenorrhea. She was found to have a karyotype of 46,X,idic(Y)(p11.3)[59]/45,X[39]/47,X,idic(Y)(p11.3)×2[2]. The result of FISH assay was 46,X,der(Y).ish idic(Y)(p11.3)(SRY+)[59]/45,X[39]/47,X,der(Y)×2.ish idic(Y)(p11.3)(SRY+)[2]. That of CMA was arr[GRCh37](X)×1,(Y)×0-1,arr[GRCh37]Yp11.32(118552_472090)×1. The patient had no deletion in the AZF region of Y chromosome, and was negative for variant of SRY gene. Combining the above results, her molecular karyotype was determined as mos 46,X,idic(Y)(p11.32)[59]/45,X[39]/47,X,idic(Y)(p11.32)×2[2].ish 46,X,idic(Y)(p11.32)(DXZ1+,DYZ1++,DYZ3++,SRY+)[59]/45,X(DXZ1+,DYZ1-,DYZ3-,SRY-)[39]/47,X,der(Y)×2.ish idic(Y)(p11.32)(DXZ1+,DYZ1++,DYZ3++,SRY+)[2].arr[GRCh37](X)×1, (Y)×0-1,arr[GRCh37]Yp11.32(118552_472090)×1. The patient was diagnosed with mosaicism DSD with idic(Y)(p11.32).
    CONCLUSIONS: The abnormal mosaicism karyotype probably underlay the DSD in this patient.
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  • 文章类型: English Abstract
    目的:了解中国西南地区男性不育患者Y染色体AZF微缺失和核型异常的频率和特征。
    方法:选取2018年9月至2023年7月四川大学华西第二医院收治的4278例男性不育患者作为研究对象。回顾了Y染色体微缺失检测和G带核型分析的结果。
    结果:收集患者的临床资料,其中包括2048例无精子症患者,1536例少精子症,310例轻度至中度少精子症,和384名不育但精子浓度正常的患者。在2421例接受核型分析的患者中,有213例(8.80%)发现核型异常。Y染色体微缺失的发生率为9.86%(422/4278),发生在10.4%,13.28%,无精子症的病例分别为0.97%和0.52%,严重的少精子症,轻度至中度少精子症,和精子浓度正常的不育,分别。
    结论:Y染色体微缺失检测和核型分析对于评估男性不育的原因至关重要。早期诊断可以促进生殖方法的选择。
    OBJECTIVE: To determine the frequency and characteristics of AZF microdeletions of Y chromosome and karyotypic abnormalities among infertile male patients from southwest China.
    METHODS: 4 278 infertile male patients treated at West China Second University Hospital of Sichuan University from September 2018 to July 2023 were selected as the study subjects. Results of Y chromosome microdeletion detection and G-banded karyotyping analysis were retrospectively reviewed.
    RESULTS: Clinical data of the patients were collected, which have included 2 048 patients with azoospermia, 1 536 patients with oligozoospermia, 310 patients with mild to moderate oligozoospermia, and 384 patients with infertility but normal sperm concentration. An abnormal karyotype was found in 213 (8.80%) of 2 421 patients who had undergone karyotyping analysis. The frequency of Y chromosome microdeletions was 9.86% (422/4 278), which had occurred in 10.4%, 13.28%, 0.97% and 0.52% of the cases with azoospermia, severe oligozoospermia, mild to moderate oligozoospermia, and infertility with normal sperm concentration, respectively.
    CONCLUSIONS: Y chromosome microdeletion detection and karyotyping analysis are crucial for assessing the cause of male infertility. Early diagnosis can facilitate the selection of reproductive methods.
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  • 文章类型: Journal Article
    背景:在儿科实践中实施基因检测后,多余X和Y染色体变异的诊断有所增加。经验证据表明,诊断的交付对受影响的个人及其父母如何感知和适应诊断具有持久的影响。这篇综述的目的是综合文献,以基于越来越多的关于患者经验的定量和定性文献,为提供性染色体多体(SCM)的儿科诊断提供有用的建议。
    方法:我们使用PubMed进行了综合文献综述,科学网和CINAHL采用关键词“基因诊断交付”,基因诊断披露,性染色体非整倍性,\"\"Klinefelter综合征\"或\"\"47,XXY,\"\"雅各布综合征\"或\"47,XYY,\"\"三体X,\"\"三X\"或\"47,XXX,“和”48XXYY从2000年1月1日至2023年10月31日。
    结果:文献支持患者和父母重视提供最新信息和与支持资源的联系。讨论下一步的护理,包括相关的转介,防止对提供者放弃和承诺持续支持的看法。积极解决特殊问题,例如向孩子披露诊断结果,家庭,社区也是有益的。提供了有用的信息资源,可能需要支持患者的医学专业,以及常见的误解会干扰有关诊断的准确信息。
    结论:患者经验表明,应加强对诊断交付的关注,关于SCM诊断的更广泛的道德和社会影响。我们提出了在儿童早期和晚期最佳披露SCM诊断的建议,青春期,和年轻的成年。
    BACKGROUND: The diagnosis of supernumerary X & Y chromosome variations has increased following the implementation of genetic testing in pediatric practice. Empirical evidence suggests that the delivery of the diagnosis has a lasting impact on how affected individuals and their parents perceive and adapt to the diagnosis. The purpose of this review is to synthesize the literature to obtain useful recommendations for delivering a pediatric diagnosis of a sex chromosome multisomy (SCM) based upon a growing body of quantitative and qualitative literature on patient experiences.
    METHODS: We conducted an integrative literature review using PubMed, Web of Science and CINAHL employing keywords \"genetic diagnosis delivery,\" \"genetic diagnosis disclosure,\" \"sex chromosome aneuploidy,\" \"Klinefelter syndrome\" or \"\"47, XXY,\" \"Jacob syndrome\" or \"47, XYY,\" \"Trisomy X,\" \"Triple X\" or \"47, XXX,\" and \"48 XXYY from January 1, 2000, to October 31, 2023.
    RESULTS: Literature supports that patients and parents value the provision of up-to-date information and connection with supportive resources. Discussion of next steps of care, including relevant referrals, prevents perceptions of provider abandonment and commitment to ongoing support. Proactively addressing special concerns such as disclosing the diagnosis to their child, family, and community is also beneficial. Tables are provided for useful information resources, medical specialties that may be required to support patients, and common misconceptions that interfere with accurate information about the diagnosis.
    CONCLUSIONS: Patient experiences suggest there should be heightened attention to diagnosis delivery, in reference to the broader ethical and social impacts of a SCM diagnosis. We present recommendations for optimal disclosure of a SCM diagnosis in early and late childhood, adolescence, and young adulthood.
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    文章类型: English Abstract
    目的:比较六序列标记位点(STS)与八STS方案在Y染色体微缺失检测中的作用。
    方法:使用实时定量PCR,我们比较了6-STS(sY84,sY86,sY127,sY134,sY254,sY255)方案与8-STS(sY84,sY86,sY127,sY134,sY254,sY255,sY145,sY152)方案检测Y染色体微缺失的结果。
    结果:六-STS和八-STS方法对无精子症因子(AZF)区域缺失的检出率差异无统计学意义(9.34%[575/6177]vs8.85%[542/6122],P>0.05)。
    结论:尽管八STS方案增加了AZFd的检测,其对AZF区缺失的检出率与六-STS方法无显著差异。从实验操作的角度来看,经济成本和临床策略指导,在检测Y染色体微缺失方面,6-STS方案优于8-STS方案。
    OBJECTIVE: To compare the six-sequence-tagged site (STS) with the eight-STS scheme in the detection of Y chromosome microdeletions.
    METHODS: Using real-time quantitative PCR, we compared the results of the six-STS (sY84, sY86, sY127, sY134, sY254, sY255) scheme with those of the eight-STS (sY84, sY86, sY127, sY134, sY254, sY255, sY145, sY152) scheme in detecting Y chromosome microdeletions.
    RESULTS: No statistically significant difference was found in the detection rate of the deletion of the azoospermia factor (AZF) regions between the six-STS and eight-STS methods (9.34% [575/6177] vs 8.85% [542/6122], P > 0.05).
    CONCLUSIONS: Though the eight-STS scheme increased the detection of AZFd, its detection rate of the AZF region deletion was not significantly different from that of the six-STS method. From the perspectives of experimental operation, economic cost and clinical strategy guidance, the six-STS is better than the eight-STS scheme for the detection of Y chromosome microdeletions.
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  • 文章类型: Journal Article
    据报道,患有47,XXY和47,XYY综合征的男性表型包括身材高大,多系统合并症,与健康相关的生活质量(HRQOL)较差。然而,关于这些性染色体非整倍性(SCA)疾病的知识来自对不到15%的临床诊断患者的研究,这些患者在年龄和遗传血统方面也缺乏多样性.
    确定参加百万退伍军人计划(MVP)的男性中临床诊断和未诊断的X或Y染色体非整倍体的患病率;描述有SCA的男性的军事服务指标;并比较有和没有临床诊断的SCA男性与匹配对照的发病率和死亡率结果。
    这项横断面研究使用了病例对照招募设计,以选择2011年至2022年在美国退伍军人管理局医疗保健系统的MVP生物库注册的生物男性。病例为47,XXY综合征或47,XYY综合征的参与者,将1:5与基于性别的对照相匹配,年龄,和遗传祖先。数据从2022年1月至2023年12月进行了分析。
    附加X或Y染色体的基因组鉴定。
    感兴趣的结果包括基因组分析中SCA男性的患病率;临床SCA诊断;Charlson合并症指数;门诊率,住院,和每年的紧急情况;自我报告的健康结果;和标准化死亡率。
    在MVP中的595612个基因分型的男性中,862有一个额外的X染色体(47,XXY)和747有一个额外的Y染色体(47,XYY),在东亚(47,XXY:7313名参与者中的10名;47,XYY:7313名参与者中的14名)和欧洲(47,XXY:427143名参与者中的725名;47,XYY:427143名参与者中的625名)男性中患病率最高。评估时的平均(SD)年龄为61(12)岁,在这一点上636退伍军人(74。X%)47、XXY和745名退伍军人(99%)47、XYY仍未诊断。47、XXY和47、XYY的个人有相似的服兵役历史,全因标准化死亡率,和死亡年龄与匹配的对照组相比。有SCA的个人,与对照组相比,Charlson合并症指数得分较高(47,XXY:平均值[SD],4.30[2.72]与对照:平均值[SD],3.90[2.47];47,XYY:平均值[SD],4.45[2.90]与对照:平均值[SD],3.82[2.50])和医疗保健利用率(例如,每年门诊病人的中位数:47,XXY,22.6[11.8-37.8]与对照,16.8[9.4-28];47,XYY:21.4[12.4-33.8]vs对照:17.0[9.4-28.2]),而HRQOL的几项衡量标准较低(例如,平均[SD]自我报告的身体功能:47,XXY:34.2[12]vs对照平均[SD]37.8[12.8];47,XYY:36.3[11.6]vs对照37.9[12.8])。临床诊断为47,XXY的男性,与没有临床诊断的个体相比,具有较高的医疗保健利用率(例如,每年遇到的中位数[IQR]:26.6[14.9-43.2]vs22.2[11.3-36.0]),但Charlson合并症指数得分较低(平均值[SD]:3.7[2.7]vs4.5[4.1])。
    在这项对47,XXY和47,XYY综合征男性的病例对照研究中,SCA的患病率与一般人群的估计值相当.虽然这些人在军队中成功服役,随着年龄的增长,他们的发病率较高,HRQOL较差.该样本的长期纵向随访将为临床和患者报告的结果提供信息。祖先的角色,死亡率统计。
    UNASSIGNED: The reported phenotypes of men with 47,XXY and 47,XYY syndromes include tall stature, multisystem comorbidities, and poor health-related quality of life (HRQOL). However, knowledge about these sex chromosome aneuploidy (SCA) conditions has been derived from studies in the less than 15% of patients who are clinically diagnosed and also lack diversity in age and genetic ancestry.
    UNASSIGNED: To determine the prevalence of clinically diagnosed and undiagnosed X or Y chromosome aneuploidy among men enrolled in the Million Veteran Program (MVP); to describe military service metrics of men with SCAs; and to compare morbidity and mortality outcomes between men with SCA with and without a clinical diagnosis vs matched controls.
    UNASSIGNED: This cross-sectional study used a case-control recruitment design to select biological males enrolled in the MVP biobank in the US Veterans Administration health care system from 2011 to 2022. Cases were participants with 47,XXY syndrome or 47,XYY syndrome, matched 1:5 with controls based on sex, age, and genetic ancestry. Data were analyzed from January 2022 to December 2023.
    UNASSIGNED: Genomic identification of an additional X or Y chromosome.
    UNASSIGNED: Outcomes of interest included prevalence of men with SCAs from genomic analysis; clinical SCA diagnosis; Charlson Comorbidity Index; rates of outpatient, inpatient, and emergency encounters per year; self-reported health outcomes; and standardized mortality ratio.
    UNASSIGNED: Of 595 612 genotyped males in the MVP, 862 had an additional X chromosome (47,XXY) and 747 had an extra Y chromosome (47,XYY), with the highest prevalence among men with East Asian (47,XXY: 10 of 7313 participants; 47,XYY: 14 of 7313 participants) and European (47,XXY: 725 of 427 143 participants; 47,XYY: 625 of 427 143 participants) ancestry. Mean (SD) age at assessment was 61 (12) years, at which point 636 veterans (74.X%) with 47,XXY and 745 veterans (99%) with 47,XYY remained undiagnosed. Individuals with 47,XXY and 47,XYY had similar military service history, all-cause standardized mortality ratio, and age of death compared with matched controls. Individuals with SCA, compared with controls, had higher Charlson Comorbidity Index scores (47,XXY: mean [SD], 4.30 [2.72] vs controls: mean [SD], 3.90 [2.47]; 47,XYY: mean [SD], 4.45 [2.90] vs controls: mean [SD], 3.82 [2.50]) and health care utilization (eg, median [IQR] outpatient encounters per year: 47,XXY, 22.6 [11.8-37.8] vs controls, 16.8 [9.4-28]; 47,XYY: 21.4 [12.4-33.8] vs controls: 17.0 [9.4-28.2]), while several measures of HRQOL were lower (eg, mean [SD] self-reported physical function: 47,XXY: 34.2 [12] vs control mean [SD] 37.8 [12.8]; 47,XYY: 36.3 [11.6] vs control 37.9 [12.8]). Men with a clinical diagnosis of 47,XXY, compared with individuals without a clinical diagnosis, had higher health care utilization (eg, median [IQR] encounters per year: 26.6 [14.9-43.2] vs 22.2 [11.3-36.0]) but lower Charlson Comorbidity Index scores (mean [SD]: 3.7 [2.7] vs 4.5 [4.1]).
    UNASSIGNED: In this case-control study of men with 47,XXY and 47,XYY syndromes, prevalence of SCA was comparable with estimates in the general population. While these men had successfully served in the military, they had higher morbidity and reported poorer HRQOL with aging. Longer longitudinal follow-up of this sample will be informative for clinical and patient-reported outcomes, the role of ancestry, and mortality statistics.
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