LDLR p.Arg237Cys
c.709C>T · rs879254657 · VCV251421
ClinGen expert panel — Familial Hypercholesterolemia VCEP
Uncertain Significance for hypercholesterolemia, familial. Applied ACMG criteria (verbatim):
PM2 PS4_Supporting PP4
Curation rationale (ClinGen, verbatim)
NM_000527.5(LDLR):c.709C>T (p.Arg237Cys) variant is classified as Uncertain significance - insufficient evidence for Familial Hypercholesterolemia by applying evidence code PM2, PS4_Moderate and PP4 as defined by the ClinGen Familial Hypercholesterolemia Expert Panel LDLR-specific variant curation guidelines (https://doi.org/10.1016/j.gim.2021.09.012). The supporting evidence is as follows: PM2 - PopMax MAF = 0.00009799 (0.01%) in South Asian exomes (gnomAD v2.1.1). PS4_Supporting - Variant meets PM2 and is reported in 3 unrelated index cases, two with possible SB criteria (PMID 20236128 and Molecular Genetics Laboratory (Centre for Cardiovascular Surgery and Transplantation)), one with DLCN >= 6 criteria (PMID 30293936). PP4 - Variant meets PM2 and is reported in 3 unrelated index cases, two with possible SB criteria (PMID 20236128 and Molecular Genetics Laboratory (Centre for Cardiovascular Surgery and Transplantation)), one with DLCN >= 6 criteria (PMID 30293936).
ClinGen Evidence Repository → · reported verbatim, not re-tallied by Sugi Variant.
Computational evidence
| Protein change | ||
| AlphaMissense | 0.7917 | likely pathogenic |
|---|---|---|
| REVEL | 0.743 | pathogenic-leaning |
| SaProt | LLR -12.06 | damaging |
| ⇒ AlphaMissense, REVEL and SaProt all call this damaging. | ||
| Splicing | ||
| SpliceAI | — | not assessed · no allele here is in the release |
| Constraint at this position | ||
| Conservation | phyloP 4.9 | GERP -0.51, phastCons 1 |
| Regional constraint | o/e 1.00 | unconstrained · MANE · 42 kb · p 0.91 · regional, not allelic |
| Overall | ||
| CADD | 27.0 | PHRED · no single calibrated threshold — expert panels disagree |
ClinVar classifies this uncertain; the computational predictors unanimously lean damaging — a triage signal, not a reclassification
AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.
Population frequency
| Ancestry group | Frequency | 1 in |
|---|---|---|
| Middle Easterngrpmax | 0.0164% | 6,084 |
| South Asian | 0.00439% | 22,772 |
| Finnishnot grpmax-eligible | 0.00156% | 64,038 |
| African / African-American | 0.00133% | 74,942 |
| European (non-Finnish) | 0.000678% | 147,504 |
Rarity supports pathogenicity (ACMG PM2); frequency above a disease-specific BA1/BS1 threshold argues against it. A variant frequent in one ancestry group can be near-absent in others, so a single global figure can mislead.
Variant & gene context
- Gene
- LDLR
- Protein
- p.Arg237Cys
- Coding
- c.709C>T
- MANE Select
- NM_000527
- dbSNP
- rs879254657
- Type
- single nucleotide variant
- Location
- chr19:11106579 (GRCh38)
- Gene constraint
- LOEUF 1.091 · pLI <0.01 · ClinGen HI 3/3 (gnomAD)
- Structure
- AlphaFold pLDDT 75.81 · 36 PDB
- Residue 237
- the ldl-receptor class a 6 domain
Similar variants
- LDLR p.Arg237His Uncertain significance ★★★ ⚠ same residue
- LDLR p.Arg237= Likely benign ★★ same residue
- LDLR p.Arg237fs Pathogenic ★ same residue
- LDLR c.1186+5G>A Likely pathogenic ★★★ same condition
- LDLR c.1359-1G>A Pathogenic ★★★ same condition
- LDLR c.1359-5C>G Likely pathogenic ★★★ same condition
- LDLR c.1705+2T>C Likely pathogenic ★★★ same condition
- LDLR c.190+4A>T Likely pathogenic ★★★ same condition
Built on 18 open, versioned datasets — ClinVar, gnomAD, AlphaMissense, REVEL, ClinGen & more — plus Sugi Variant's own cross-source analysis. Source data 2026-01–2026-10, ClinVar 2026-10. Full sources & versions →
Cite Sugi Variant
Gür T. Sugi Variant: A Deterministic Per-Variant Germline Reference from a Knowledge Graph for Humans and AI Agents. 2026. doi:10.5281/zenodo.21509445. This variant: https://sugi.bio/variant/ldlr-p-arg237cys (accessed [today's date]).
Preprint & method: sugi.bio/variant/method Machine-readable: this page as Markdown