De Luca Vincenzo, Strauss John, Kennedy James L
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, ON, Canada.
Prog Neuropsychopharmacol Biol Psychiatry. 2008 Jan 1;32(1):197-203. doi: 10.1016/j.pnpbp.2007.08.008. Epub 2007 Aug 19.
Suicidality is a major health concern worldwide particularly in affective disorder patients. Attempted suicide is familial. There is strong neurobiological evidence showing that serotonergic and noradrenergic dysfunction is implicated in suicidal behaviours. We will apply now a new family based association strategy aimed to explain the genetic influence in suicidal behaviour by power based association test statistics (PBAT) in 336 bipolar patients assessed for suicidality within nuclear families.
By use of conditional power calculations, the approach screens all possible null hypotheses without biasing the nominal significance level, and it identifies the subset of phenotypes that has optimal power when tested for association by either univariate or multivariate family based association test (FBAT). Using this statistical approach (PBAT) we investigated polymorphisms in serotonergic and noradrenergic genes, considering suicidal behaviour severity instead of the dichotomous phenotype (presence of suicide attempt).
COMT Val/Met polymorphism was not associated with suicide with high confidence (power=91%). On the other hand, the analysis of the other 12 markers in the adrenergic and serotonergic genes revealed that the TH allele tended towards association with higher severity of suicidal behaviour (p=0.060) but the power obtained was very low.
The marginal finding of association between TH and severe suicidal behaviour are convergent with previous reports. On the other hand, our sample has enough power to exclude the other polymorphisms investigated as major candidate for suicidality in bipolar disorder.
自杀倾向是全球主要的健康问题,在情感障碍患者中尤为突出。自杀未遂具有家族性。有强有力的神经生物学证据表明,血清素能和去甲肾上腺素能功能障碍与自杀行为有关。我们现在将应用一种新的基于家系的关联策略,旨在通过基于效能的关联检验统计量(PBAT)来解释自杀行为中的遗传影响,该研究纳入了336名在核心家庭中接受自杀倾向评估的双相情感障碍患者。
通过条件效能计算,该方法筛选所有可能的无效假设而不影响名义显著性水平,并识别出在通过单变量或多变量基于家系的关联检验(FBAT)进行关联测试时具有最佳效能的表型子集。使用这种统计方法(PBAT),我们研究了血清素能和去甲肾上腺素能基因的多态性,考虑的是自杀行为的严重程度而非二分法表型(自杀未遂的存在)。
COMT Val/Met多态性与自杀的关联不具有高置信度(效能=91%)。另一方面,对肾上腺素能和血清素能基因中的其他12个标记物的分析显示,TH等位基因倾向于与更高严重程度的自杀行为相关(p=0.060),但获得的效能非常低。
TH与严重自杀行为之间的边缘性关联发现与先前的报告一致。另一方面,我们的样本有足够的效能排除所研究的其他多态性作为双相情感障碍自杀倾向的主要候选因素。