Larsson Emma, Granath Fredrik, Swedenborg Jesper, Hultgren Rebecka
Department of Molecular Medicine and Surgery, Stockholm, Sweden.
J Vasc Surg. 2009 Jan;49(1):47-50; discussion 51. doi: 10.1016/j.jvs.2008.08.012. Epub 2008 Nov 22.
Several studies have reported a familial clustering of abdominal aortic aneurysm (AAA) supporting that AAA is an inheritable disease, but few population-based studies can be found. Possible gender differences regarding hereditary patterns have been reported.
The aim of this study was to investigate the risk of developing an AAA for first-degree relatives of patients with AAA in Sweden and compare them with matched controls and their relatives.
All persons (3183) born after 1932, diagnosed with AAA between 2001 and 2005, and a random selection of 15,943 age-, gender-, and region-matched controls were included. First-degree relatives of cases and controls were identified via the Multigeneration Register. Family history of AAA for cases and controls was assessed by linking the relatives to the Hospital Discharge Register and Cause of Death Register. The data were analyzed by conditional logistic regression.
The overall relative risk of AAA associated with family history compared to no family history was 1.9 (95% confidence interval [CI] 1.6-2.2). Comorbidities were more common among the cases than the controls (P < .0001) but the relative risks remained unchanged after adjustment for comorbidities. Stratification for absence or presence of comorbidities showed no significant difference between the two groups (P = .29). The relative risk of AAA for first-degree relatives was similar for women and men (P = .22 for gender differences), ie, the relative risk of AAA was not dependent on the gender of the index person.
In this nationwide survey, the relative risk of developing AAA for first-degree relatives to persons diagnosed with AAA was approximately doubled compared to persons with no family history. Neither the gender of the index person nor the first-degree relative influenced the risk of AAA.
多项研究报告了腹主动脉瘤（AAA）的家族聚集性，支持AAA是一种可遗传疾病，但基于人群的研究较少。已有报道称遗传模式可能存在性别差异。
本研究旨在调查瑞典AAA患者的一级亲属发生AAA的风险，并将他们与匹配的对照组及其亲属进行比较。
纳入所有1932年后出生、在2001年至2005年间被诊断为AAA的患者（3183人），以及随机选取的15943名年龄、性别和地区匹配的对照组。通过多代登记册确定病例和对照组的一级亲属。通过将亲属与医院出院登记册和死亡原因登记册相链接，评估病例和对照组的AAA家族史。采用条件逻辑回归分析数据。
与无家族史相比，有家族史的AAA总体相对风险为1.9（95%置信区间[CI] 1.6 - 2.2）。病例组的合并症比对照组更常见（P <.0001），但在调整合并症后相对风险保持不变。按有无合并症分层显示两组之间无显著差异（P =.29）。AAA患者一级亲属的AAA相对风险在女性和男性中相似（性别差异P =.22），即AAA的相对风险不取决于索引人物的性别。
在这项全国性调查中，与无家族史的人相比，被诊断为AAA的人的一级亲属发生AAA的相对风险大约增加了一倍。索引人物的性别和一级亲属均不影响AAA的风险。
