Hemminki Kari, Li Xinjun, Sundquist Kristina
Division of Molecular Genetic Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 580, D-69120 Heidelberg, Germany.
J Epidemiol Community Health. 2007 Jan;61(1):80-4. doi: 10.1136/jech.2006.046615.
Nerve, nerve root and plexus disorders are common diseases, but little is known about familial clustering in these diseases. This is, to our knowledge, the first systematic family study carried out on these diseases.
Familial risks for siblings who were hospitalised for nerve, nerve root and plexus disorders in Sweden were defined. A nationwide database for neurological diseases was constructed by linking the Multigeneration Register on 0-69-year-old siblings to the Hospital Discharge Register covering the years 1987-2001. Standardised risk ratios (SIRs) were calculated for affected sibling pairs by comparing them with those whose siblings had no neurological disease.
29,686 patients, 43% men and 57% women, were diagnosed at a mean age of 37.5 years. 191 siblings were hospitalised for these disorders, giving an overall SIR of 2.59 (95% CI 1.58 to 4.22), with no sex difference. Plantar nerve mononeuritis and carpal tunnel syndrome showed the highest familial risks: 4.82 (1.08 to 16.04) and 4.08 (2.07 to 7.84), respectively. Lateral poplitean and plantar nerve neuritis preferentially affected women, with SIRs of >8; disorders of the other cranial nerves affected only men, with an SIR of >10. Concordant trigeminal neuralgia, Bell's palsy and carpal tunnel syndrome showed familial risks, but, with the exception of Bell's palsy, they also showed correlation between spouses, implying environmental sharing of risk factors.
The results cannot distinguish between inheritable or shared environmental factors, or their interactions, but they clearly show familial clustering, suggestive of multifactorial aetiology and inviting for aetiological research.
神经、神经根和神经丛疾病是常见疾病,但对于这些疾病的家族聚集性知之甚少。据我们所知,这是首次针对这些疾病开展的系统性家族研究。
确定了在瑞典因神经、神经根和神经丛疾病住院的兄弟姐妹的家族风险。通过将0至69岁兄弟姐妹的多代登记册与涵盖1987年至2001年的医院出院登记册相链接,构建了一个全国性的神经疾病数据库。通过将患病兄弟姐妹对与那些兄弟姐妹无神经疾病的人进行比较,计算出标准化风险比(SIR)。
共诊断出29,686名患者,男性占43%,女性占57%,平均年龄为37.5岁。191名兄弟姐妹因这些疾病住院,总体SIR为2.59(95%可信区间1.58至4.22),无性别差异。足底神经单神经炎和腕管综合征显示出最高的家族风险:分别为4.82(1.08至16.04)和4.08(2.07至7.84)。腘外侧和足底神经炎优先影响女性,SIR>8;其他颅神经疾病仅影响男性,SIR>10。一致的三叉神经痛、贝尔麻痹和腕管综合征显示出家族风险,但除贝尔麻痹外,它们在配偶之间也显示出相关性,这意味着风险因素存在环境共享。
结果无法区分遗传因素或共享环境因素,或它们之间的相互作用,但它们清楚地显示出家族聚集性,提示多因素病因,并引发病因学研究。