Wohl M, Gorwood P
INSERM U675, 16 rue Henri Huchard 75018 Paris, France.
Eur Psychiatry. 2007 Jan;22(1):22-6. doi: 10.1016/j.eurpsy.2006.08.007. Epub 2006 Dec 4.
A link between older age of fatherhood and an increased risk of schizophrenia was detected in 1958. Since then, 10 studies attempted to replicate this result with different methods, on samples with different origins, using different age classes. Defining a cut-off at which the risk is significantly increased in the offspring could have an important impact on public health.
A meta-analysis (Meta Win) was performed, assessing the mean effect size for each age class, taking into account the difference in age class references, and the study design.
An increased risk is detected when paternal age is below 20 (compared to 20-24), over 35 (compared to below 35), 39 (compared to less than 30), and 54 years old (compared to less than 25). Interestingly, 35 years appears nevertheless to be the lowest cut-off where the OR is always above 1, whatever the age class reference, and the smallest value where offspring of fathers below or above this age have a significantly different risk of schizophrenia.
No threshold can be precisely defined, but convergent elements indicate ages below or above 35 years. Using homogeneous age ranges in future studies could help to clarify a precise threshold.
1958年发现父亲生育年龄较大与精神分裂症风险增加之间存在关联。从那时起，有10项研究试图采用不同方法、针对不同来源样本、使用不同年龄组来重复这一结果。确定一个后代风险显著增加的临界值可能会对公共卫生产生重要影响。
进行了一项荟萃分析（Meta Win），评估每个年龄组的平均效应大小，同时考虑年龄组参考值的差异以及研究设计。
当父亲年龄低于20岁（与20 - 24岁相比）、超过35岁（与低于35岁相比）、39岁（与小于30岁相比）以及54岁（与小于25岁相比）时，风险增加。有趣的是，无论年龄组参考值如何，35岁似乎仍是最低临界值，此时比值比（OR）始终高于1，并且是父亲年龄低于或高于此年龄的后代患精神分裂症风险有显著差异的最小值。
无法精确界定一个阈值，但趋同的因素表明年龄低于或高于35岁。未来研究中使用统一的年龄范围可能有助于明确一个精确的阈值。
