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重度抑郁症的多基因评分与酒精依赖风险

Polygenic Scores for Major Depressive Disorder and Risk of Alcohol Dependence.

作者信息

Andersen Allan M, Pietrzak Robert H, Kranzler Henry R, Ma Li, Zhou Hang, Liu Xiaoming, Kramer John, Kuperman Samuel, Edenberg Howard J, Nurnberger John I, Rice John P, Tischfield Jay A, Goate Alison, Foroud Tatiana M, Meyers Jacquelyn L, Porjesz Bernice, Dick Danielle M, Hesselbrock Victor, Boerwinkle Eric, Southwick Steven M, Krystal John H, Weissman Myrna M, Levinson Douglas F, Potash James B, Gelernter Joel, Han Shizhong

机构信息

Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City.

US Department of Veterans Affairs (VA) National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven.

出版信息

JAMA Psychiatry. 2017 Nov 1;74(11):1153-1160. doi: 10.1001/jamapsychiatry.2017.2269.

Abstract

IMPORTANCE

Major depressive disorder (MDD) and alcohol dependence (AD) are heritable disorders with significant public health burdens, and they are frequently comorbid. Common genetic factors that influence the co-occurrence of MDD and AD have been sought in family, twin, and adoption studies, and results to date have been promising but inconclusive.

OBJECTIVE

To examine whether AD and MDD overlap genetically, using a polygenic score approach.

DESIGN, SETTINGS, AND PARTICIPANTS: Association analyses were conducted between MDD polygenic risk score (PRS) and AD case-control status in European ancestry samples from 4 independent genome-wide association study (GWAS) data sets: the Collaborative Study on the Genetics of Alcoholism (COGA); the Study of Addiction, Genetics, and Environment (SAGE); the Yale-Penn genetic study of substance dependence; and the National Health and Resilience in Veterans Study (NHRVS). Results from a meta-analysis of MDD (9240 patients with MDD and 9519 controls) from the Psychiatric Genomics Consortium were applied to calculate PRS at thresholds from P < .05 to P ≤ .99 in each AD GWAS data set.

MAIN OUTCOMES AND MEASURES

Association between MDD PRS and AD.

RESULTS

Participants analyzed included 788 cases (548 [69.5%] men; mean [SD] age, 38.2 [10.8] years) and 522 controls (151 [28.9.%] men; age [SD], 43.9 [11.6] years) from COGA; 631 cases (333 [52.8%] men; age [SD], 35.0 [7.7] years) and 756 controls (260 [34.4%] male; age [SD] 36.1 [7.7] years) from SAGE; 2135 cases (1375 [64.4%] men; age [SD], 39.4 [11.5] years) and 350 controls (126 [36.0%] men; age [SD], 43.5 [13.9] years) from Yale-Penn; and 317 cases (295 [93.1%] men; age [SD], 59.1 [13.1] years) and 1719 controls (1545 [89.9%] men; age [SD], 64.5 [13.3] years) from NHRVS. Higher MDD PRS was associated with a significantly increased risk of AD in all samples (COGA: best P = 1.7 × 10-6, R2 = 0.026; SAGE: best P = .001, R2 = 0.01; Yale-Penn: best P = .035, R2 = 0.0018; and NHRVS: best P = .004, R2 = 0.0074), with stronger evidence for association after meta-analysis of the 4 samples (best P = 3.3 × 10-9). In analyses adjusted for MDD status in 3 AD GWAS data sets, similar patterns of association were observed (COGA: best P = 7.6 × 10-6, R2 = 0.023; Yale-Penn: best P = .08, R2 = 0.0013; and NHRVS: best P = .006, R2 = 0.0072). After recalculating MDD PRS using MDD GWAS data sets without comorbid MDD-AD cases, significant evidence was observed for an association between the MDD PRS and AD in the meta-analysis of 3 GWAS AD samples without MDD cases (best P = .007).

CONCLUSIONS AND RELEVANCE

These results suggest that shared genetic susceptibility contributes modestly to MDD and AD comorbidity. Individuals with elevated polygenic risk for MDD may also be at risk for AD.

摘要

重要性

重度抑郁症(MDD)和酒精依赖(AD)是具有重大公共卫生负担的遗传性疾病,且它们常常合并出现。人们已在家族、双胞胎和收养研究中探寻影响MDD和AD共病的常见遗传因素,迄今为止的结果虽有前景但尚无定论。

目的

使用多基因评分方法来检验AD和MDD在基因层面是否存在重叠。

设计、设置和参与者:在来自4个独立全基因组关联研究(GWAS)数据集的欧洲血统样本中,对MDD多基因风险评分(PRS)与AD病例对照状态进行关联分析,这些数据集分别是:酒精中毒遗传学合作研究(COGA);成瘾、遗传学和环境研究(SAGE);耶鲁 - 宾夕法尼亚物质依赖基因研究;以及退伍军人健康与恢复力研究(NHRVS)。将来自精神基因组学联盟的MDD(9240例MDD患者和9519例对照)的荟萃分析结果应用于在每个AD GWAS数据集中计算P值从<0.05到≤0.99阈值的PRS。

主要结局和测量指标

MDD PRS与AD之间的关联。

结果

分析的参与者包括来自COGA的788例病例(548例[69.5%]男性;平均[标准差]年龄,38.2[10.8]岁)和522例对照(151例[28.9%]男性;年龄[标准差],43.9[11.6]岁);来自SAGE的631例病例(333例[52.8%]男性;年龄[标准差],35.0[7.7]岁)和756例对照(260例[34.4%]男性;年龄[标准差]36.1[7.7]岁);来自耶鲁 - 宾夕法尼亚的2135例病例(1375例[64.4%]男性;年龄[标准差],39.4[11.5]岁)和350例对照(126例[36.0%]男性;年龄[标准差],43.5[13.9]岁);以及来自NHRVS的317例病例(295例[93.1%]男性;年龄[标准差],59.1[13.1]岁)和1719例对照(1545例[89.9%]男性;年龄[标准差],64.5[13.3]岁)。在所有样本中,较高的MDD PRS与AD风险显著增加相关(COGA:最佳P = 1.7×10⁻⁶,R² = 0.026;SAGE:最佳P = 0.001,R² = 0.01;耶鲁 - 宾夕法尼亚:最佳P = 0.035,R² = 0.0018;NHRVS:最佳P = 0.004,R² = 0.0074),在对4个样本进行荟萃分析后有更强的关联证据(最佳P = 3.3×10⁻⁹)。在3个AD GWAS数据集中针对MDD状态进行调整的分析中,观察到了类似的关联模式(COGA:最佳P = 7.6×10⁻⁶,R² = 0.023;耶鲁 - 宾夕法尼亚:最佳P = 0.08,R² = 0.0013;NHRVS:最佳P = 0.006,R² = 0.0072)。在使用不包含MDD - AD共病病例的MDD GWAS数据集重新计算MDD PRS后,在对3个无MDD病例的GWAS AD样本进行的荟萃分析中观察到MDD PRS与AD之间存在显著关联证据(最佳P = 0.007)。

结论及意义

这些结果表明,共同的遗传易感性对MDD和AD共病有一定程度的影响。MDD多基因风险升高的个体也可能有患AD的风险。

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