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脆性 X 智力低下 1 号基因(FMR1)前突变等位基因携带者中的共病诊断。

Co-occurring diagnoses among FMR1 premutation allele carriers.

机构信息

Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA.

出版信息

Clin Genet. 2010 Apr;77(4):374-81. doi: 10.1111/j.1399-0004.2009.01317.x. Epub 2010 Jan 6.

Abstract

Following the discovery of two disorders associated with premutation alleles of the fragile X mental retardation gene (FMR1), primary ovarian insufficiency [fragile X-associated primary ovarian insufficiency (FXPOI)] and a tremor/ataxia syndrome [fragile X-associated tremor/ataxia disorder (FXTAS)], numerous studies have examined other potential co-morbid conditions, including neuropsychological deficits. Here, the frequency of self-reported diagnoses obtained through medical history interviews from FMR1 premutation carriers and non-carriers aged 18-50 were analyzed. Study subjects included 537 women, 334 of whom carry the premutation and 151 men, 37 of whom carry the premutation. Men with the premutation did not report any medical conditions at higher rates compared with non-carriers, controlling for age, ethnicity/race, and household income. Women with the premutation reported mental health disorders [i.e. attention deficit hyperactivity disorder (ADHD), anxiety, depression] significantly more often than non-carriers. However, after adjusting for covariates, these increased rates were not statistically significant. Additional follow-up analyses examined the consequence of ovarian dysfunction as a cause of co-occurring conditions. Women with an indication of ovarian insufficiency (i.e. irregular cycles) reported higher rates of thyroid problems and depression/anxiety. Because only women, not men, reported these conditions more often, the relationship between FXPOI and hormone irregularities in women should be explored for a potential link with the increase in the reported medical conditions.

摘要

在发现与脆性 X 智力低下基因(FMR1)的前突变等位基因相关的两种疾病(脆性 X 相关原发性卵巢功能不全[FXPOI]和震颤/共济失调综合征[FXTAS])之后,许多研究都检查了其他潜在的合并症,包括神经心理学缺陷。在这里,通过对 18-50 岁的 FMR1 前突变携带者和非携带者的病史访谈获得的自我报告诊断的频率进行了分析。研究对象包括 537 名女性,其中 334 名携带前突变,151 名男性,其中 37 名携带前突变。携带前突变的男性与非携带者相比,报告任何疾病的比率并没有更高,这与年龄、族裔/种族和家庭收入有关。携带前突变的女性报告心理健康障碍(即注意力缺陷多动障碍[ADHD]、焦虑、抑郁)的频率明显高于非携带者。然而,在调整了协变量后,这些增加的比率在统计学上并不显著。进一步的随访分析检查了卵巢功能障碍作为合并症的原因的后果。有卵巢功能不全迹象(即不规则周期)的女性报告甲状腺问题和抑郁/焦虑的比率更高。由于只有女性,而不是男性,更经常报告这些情况,因此应该探讨 FXPOI 与女性激素不规则之间的关系,以寻找与报告的医疗条件增加之间的潜在联系。

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