From the Institute for Human Genetics and the Department of Epidemiology and Biostatistics, University of California, San Francisco; the Division of Research, Kaiser Permanente, Oakland, Calif.; and the Environmental Health Investigations Branch, California Department of Public Health, Richmond.
Am J Psychiatry. 2014 Nov 1;171(11):1206-13. doi: 10.1176/appi.ajp.2014.13101359.
This study was designed to examine the pattern of familial recurrence of autism spectrum disorder (ASD) in terms of genetic and environmental contributions related to timing of birth.
The authors linked California Department of Developmental Services records with state birth certificates to identify all siblings and half siblings of individuals affected with ASD born between 1990 and 2003. A total of 6,616 full siblings, 644 maternal half siblings, and 299 paternal half siblings born after ASD index cases were used to calculate recurrence risks. Control families, identified through matching to cases, were included for comparison (a total of 29,384 siblings).
The overall sibling recurrence risk was 10.1%, compared with a prevalence of 0.52% in siblings of controls. The recurrence risk in second-born children was higher (11.5%) than in later-born siblings (7.3%); a similar pattern was observed for maternal half siblings (6.5% for second-born compared with 3.0% for later-born siblings; 4.8% overall). The recurrence risk was significantly higher for siblings who immediately followed the index case in birth order compared with those later in birth order. The recurrence risk for paternal half siblings (2.3%) was half the overall recurrence risk for maternal half siblings but was similar to that for later-born maternal half siblings. An exponential effect of short interbirth interval was observed, with the recurrence risk reaching 14.4% for an interbirth interval of 18 months or less, compared with 6.8% for an interval of 4 years or more. An identical phenomenon was observed in maternal half siblings.
The results support genetic susceptibility in the familial recurrence of ASD along with factors related to timing of birth.
本研究旨在探讨与出生时间相关的遗传和环境因素对自闭症谱系障碍(ASD)家族复发模式的影响。
作者将加利福尼亚州发育服务部的记录与州出生证明相联系,以确定所有在 1990 年至 2003 年间出生的患有 ASD 的个体的兄弟姐妹和同父异母/同母异父兄弟姐妹。共有 6616 对全同胞、644 对同母异父同胞和 299 对同父异母同胞在 ASD 索引病例后出生,用于计算复发风险。通过与病例相匹配来识别对照家庭,并将其纳入比较(共有 29384 对兄弟姐妹)。
整体同胞复发风险为 10.1%,而对照组兄弟姐妹的患病率为 0.52%。二胎的复发风险较高(11.5%),而晚出生的兄弟姐妹的复发风险较低(7.3%);同母异父的情况也类似(二胎为 6.5%,晚出生的为 3.0%;总体为 4.8%)。出生顺序上紧随索引病例的兄弟姐妹的复发风险明显高于出生顺序较晚的兄弟姐妹。与同母异父的兄弟姐妹相比,父系半同胞的复发风险(2.3%)减半,但与晚出生的同母异父的兄弟姐妹相似。观察到短间隔出生的指数效应,间隔 18 个月或更短的复发风险为 14.4%,而间隔 4 年或更长的复发风险为 6.8%。同母异父的情况也观察到了相同的现象。
结果支持 ASD 家族复发的遗传易感性以及与出生时间相关的因素。