Familial aggregation of attention-deficit/hyperactivity disorder
Familial aggregation of attention-deficit/hyperactivity disorder
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DOI：
10.1111/jcpp.12616
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发表时间：
2017-03-01
影响因子：
7.6
通讯作者：
Larsson, Henrik
中科院分区：
文献类型：
--
作者：
Chen, Qi;Brikell, Isabell;Larsson, Henrik
注意力缺陷多动障碍（ADHD）具有家族聚集性。到目前为止，家庭聚集的强度，模式和特点还没有得到彻底的评估，在以人口为基础的家庭sample.MethodsIn这个队列研究，我们确定了相对双胞胎，全和半兄弟姐妹，全和半表兄弟从1,656,943独特的个人出生在瑞典1985年和2006年之间。指标人员的亲属从他们的第三个生日到2009年12月31日进行ADHD诊断。出生年份调整后的危险比（HR），即ADHD受影响的指数的人的亲属与ADHD的未受影响的指数的人的亲属的比率相比，ADHD的比率，估计在不同类型的亲属使用考克斯比例风险model.ResultsDuring随访，31,865个人被诊断为ADHD（男性与女性的比例为3.7）。出生年份调整后的HR如下：同卵双胞胎70.45;异卵双胞胎8.44;全兄弟姐妹8.27;母亲半兄弟姐妹2.86;父亲半兄弟姐妹2.31;全堂兄弟姐妹2.24;半堂兄弟姐妹1.47。母亲的半同胞有显着较高的HR比父亲的半同胞。HR似乎不受索引人性别的影响。在18岁或18岁以上的ADHD诊断指数的人的全兄弟姐妹有较高的比率ADHD（HR：11.49）比全兄弟姐妹的ADHD诊断指数的人只有在18岁之前（HR：4.68）。家族聚集性不仅受遗传因素的驱动，还受少量共享环境因素的驱动。ADHD持续到成年期表明ADHD的家族聚集性更强。
BackgroundAttention-deficit/hyperactivity disorder (ADHD) aggregates in families. To date, the strength, pattern, and characteristics of the familial aggregation have not been thoroughly assessed in a population-based family sample.MethodsIn this cohort study, we identified relative pairs of twins, full and half-siblings, and full and half cousins from 1,656,943 unique individuals born in Sweden between 1985 and 2006. The relatives of index persons were followed from their third birthday to 31 December 2009 for ADHD diagnosis. Birth year adjusted hazard ratio (HR), that is, the rate of ADHD in relatives of ADHD-affected index persons compared with the rate of ADHD in relatives of unaffected index persons, was estimated in the different types of relatives using Cox proportional hazards model.ResultsDuring the follow-up, 31,865 individuals were diagnosed with ADHD (male to female ratio was 3.7). The birth year adjusted HRs were as follows: 70.45 for monozygotic twins; 8.44 for dizygotic twins; 8.27 for full siblings; 2.86 for maternal half-siblings; 2.31 for paternal half-siblings; 2.24 for full cousins; 1.47 for half cousins. Maternal half-siblings had significantly higher HR than in paternal half-siblings. The HR did not seem to be affected by index person's sex. Full siblings of index persons with ADHD diagnosis present at age 18 or older had a higher rate of ADHD (HR: 11.49) than full siblings of index persons with ADHD diagnosis only before age 18 (HR: 4.68).ConclusionsFamilial aggregation of ADHD increases with increasing genetic relatedness. The familial aggregation is driven by not only genetic factors but also a small amount of shared environmental factors. Persistence of ADHD into adulthood indexes stronger familial aggregation of ADHD.