NM_000527.5(LDLR):c.1976C>A (p.Thr659Asn) AND Hypercholesterolemia, familial, 1

Germline classification:: Uncertain significance (4 submissions)
Last evaluated:: Mar 20, 2023
Review status:: 3 stars out of maximum of 4 stars
reviewed by expert panel

Somatic classification of clinical impact:: None
Review status:: (0/4) 0 stars out of maximum of 4 stars
no assertion criteria provided

Somatic classification of oncogenicity:: None
Review status:: (0/4) 0 stars out of maximum of 4 stars
no assertion criteria provided

Record status:: current
Accession:: RCV000237463.6

Allele description [Variation Report for NM_000527.5(LDLR):c.1976C>A (p.Thr659Asn)]

NM_000527.5(LDLR):c.1976C>A (p.Thr659Asn)

Gene:

LDLR:low density lipoprotein receptor [Gene - OMIM - HGNC]

Variant type:

single nucleotide variant

Cytogenetic location:

19p13.2

Genomic location:

Preferred name:

NM_000527.5(LDLR):c.1976C>A (p.Thr659Asn)

Other names:

NM_000527.5(LDLR):c.1976C>A; p.Thr659Asn

HGVS:

NC_000019.10:g.11120222C>A
NG_009060.1:g.35842C>A
NM_000527.5:c.1976C>AMANE SELECT
NM_001195798.2:c.1976C>A
NM_001195799.2:c.1853C>A
NM_001195800.2:c.1472C>A
NM_001195803.2:c.1595C>A
NP_000518.1:p.Thr659Asn
NP_000518.1:p.Thr659Asn
NP_001182727.1:p.Thr659Asn
NP_001182728.1:p.Thr618Asn
NP_001182729.1:p.Thr491Asn
NP_001182732.1:p.Thr532Asn
LRG_274t1:c.1976C>A
LRG_274:g.35842C>A
LRG_274p1:p.Thr659Asn
NC_000019.9:g.11230898C>A
NM_000527.4:c.1976C>A
c.1976C>A

Protein change:

T491N

Links:

LDLR-LOVD, British Heart Foundation: LDLR_001572; dbSNP: rs879255094

Molecular consequence:

NM_000527.5:c.1976C>A - missense variant - [Sequence Ontology: SO:0001583]
NM_001195798.2:c.1976C>A - missense variant - [Sequence Ontology: SO:0001583]
NM_001195799.2:c.1853C>A - missense variant - [Sequence Ontology: SO:0001583]
NM_001195800.2:c.1472C>A - missense variant - [Sequence Ontology: SO:0001583]
NM_001195803.2:c.1595C>A - missense variant - [Sequence Ontology: SO:0001583]

Observations:

Condition(s)

Name:: Hypercholesterolemia, familial, 1
Synonyms:: LDL RECEPTOR DISORDER; Hyperlipoproteinemia Type IIa; HYPER-LOW-DENSITY-LIPOPROTEINEMIA; See all synonyms [MedGen]
Identifiers:: MONDO: MONDO:0007750; MedGen: C0745103; Orphanet: 391665; OMIM: 143890

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Submission Accession	Submitter	Review Status (Assertion method)	Clinical Significance (Last evaluated)	Origin	Method	Citations
SCV000295787	LDLR-LOVD, British Heart Foundation	criteria provided, single submitter (ACGS Guidelines, 2013)	Likely benign (Mar 25, 2016)	germline	literature only	PubMed (1) [See all records that cite this PMID] Citation Link,
SCV000606565	Laboratorium voor Moleculaire Diagnostiek Experimentele Vasculaire Geneeskunde, Academisch Medisch Centrum	no assertion criteria provided	Pathogenic	germline	research
SCV004022387	ClinGen Familial Hypercholesterolemia Variant Curation Expert Panel	reviewed by expert panel (ClinGen FH ACMG Specifications v1-2)	Uncertain significance (Mar 20, 2023)	germline	curation	Citation Link,
SCV004835509	All of Us Research Program, National Institutes of Health	criteria provided, single submitter (ACMG Guidelines, 2015)	Uncertain Significance (Mar 5, 2024)	germline	clinical testing	PubMed (4) [See all records that cite these PMIDs] 15199436, 23833242, 32015373, 25741868

Help

Summary from all submissions

Ethnicity	Origin	Affected	Individuals	Families	Chromosomes tested	Number Tested	Family history	Method
not provided	germline	unknown	2	not provided	not provided	143475	not provided	clinical testing, research, curation
not provided	germline	yes	1	not provided	not provided	1	not provided	literature only

Citations

PubMed

Application of molecular genetics for diagnosing familial hypercholesterolemia in Norway: results from a family-based screening program.

Leren TP, Manshaus T, Skovholt U, Skodje T, Nossen IE, Teie C, Sørensen S, Bakken KS.

Semin Vasc Med. 2004 Feb;4(1):75-85. Review.

PubMed [citation]

PMID:: 15199436

Inheritance pattern of familial hypercholesterolemia and markers of cardiovascular risk.

Kusters DM, Avis HJ, Braamskamp MJ, Huijgen R, Wijburg FA, Kastelein JJ, Wiegman A, Hutten BA.

J Lipid Res. 2013 Sep;54(9):2543-9. doi: 10.1194/jlr.M034538. Epub 2013 Jul 5.

PubMed [citation]

PMID:: 23833242
PMCID:: PMC3735950

See all PubMed Citations (4)

Details of each submission

From LDLR-LOVD, British Heart Foundation, SCV000295787.2

#	Ethnicity	Individuals	Chromosomes Tested	Family History	Method	Citations
1	not provided	1	not provided	not provided	literature only	PubMed (1)

#	Sample				Method		Observation
#	Origin	Affected	Number tested	Tissue	Purpose	Method	Individuals	Allele frequency	Families	Co-occurrences
1	germline	yes	1	not provided	not provided		1	not provided	not provided	not provided

From Laboratorium voor Moleculaire Diagnostiek Experimentele Vasculaire Geneeskunde, Academisch Medisch Centrum, SCV000606565.1

#	Ethnicity	Individuals	Chromosomes Tested	Family History	Method	Citations
1	not provided	not provided	not provided	not provided	research	not provided

#	Sample				Method		Observation
#	Origin	Affected	Number tested	Tissue	Purpose	Method	Individuals	Allele frequency	Families	Co-occurrences
1	germline	unknown	not provided	not provided	not provided		not provided	not provided	not provided	not provided

From ClinGen Familial Hypercholesterolemia Variant Curation Expert Panel, SCV004022387.1

#	Ethnicity	Individuals	Chromosomes Tested	Family History	Method	Citations
1	not provided	not provided	not provided	not provided	curation	not provided

Description

The NM_000527.5(LDLR):c.1976C>A (p.Thr659Asn) variant is classified as Uncertain significance - insufficient evidence for Familial Hypercholesterolemia by applying evidence codes (PM2, BS3) as defined by the ClinGen Familial Hypercholesterolemia Expert Panel LDLR-specific variant curation guidelines (https://doi.org/10.1101/2021.03.17.21252755). The supporting evidence is as follows: PM2 - PopMax MAF = 0.00002413 (0.002413%) in African/African American genomes (gnomAD v3.1.2). BS3 - Level 1 assays: PMID 32015373: Heterologous cells, FACS assays - result - 96% cell surface LDLR, 99% LDL-LDLR binding and 97% uptake. ---- functional study is consistent with no damaging effect.

#	Sample				Method		Observation
#	Origin	Affected	Number tested	Tissue	Purpose	Method	Individuals	Allele frequency	Families	Co-occurrences
1	germline	unknown	not provided	not provided	not provided		not provided	not provided	not provided	not provided

From All of Us Research Program, National Institutes of Health, SCV004835509.2

#	Ethnicity	Individuals	Chromosomes Tested	Family History	Method	Citations
1	not provided	2	not provided	not provided	clinical testing	PubMed (4)

Description

This missense variant (also known as p.Thr638Asn in the mature protein) replaces threonine with asparagine at codon 659 of the LDLR protein. Computational prediction suggests that this variant may have a deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). An experimental functional study using LDLR-deficient CHO-ldlA7 cells has shown that this variant does not cause a significant impact on LDLR expression (PMID: 32015373). This variant has been reported in individuals affected with familial hypercholesterolemia (PMID: 15199436, 23833242). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance.

#	Sample				Method		Observation
#	Origin	Affected	Number tested	Tissue	Purpose	Method	Individuals	Allele frequency	Families	Co-occurrences
1	germline	unknown	143475	not provided	not provided		2	not provided	not provided	not provided

Last Updated: Sep 27, 2025

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