Department of Health Management and Policy, University of Iowa, IA.
Department of Economics, University of Iowa, IA.
J Gerontol A Biol Sci Med Sci. 2018 Mar 14;73(4):477-483. doi: 10.1093/gerona/glx154.
Relationships between genetic risks for chronic diseases and long-run wellbeing are largely unexplored. We examined the associations between genetic predispositions to several chronic conditions and long-term functional health and socioeconomic status (SES).
We used data on a nationally representative sample of 9,317 adults aged 65 years or older from the 1992 to 2012 Health and Retirement Survey (HRS) in the US. Survey data were linked to genetic data on nearly 2 million single-nucleotide polymorphisms (SNPs). We measured individual-level genetic predispositions for coronary-artery disease, type 2 diabetes (T2D), obesity, rheumatoid arthritis (RA), Alzheimer's disease, and major depressive disorder (MDD) by polygenic risk scores (PRS) derived from genome-wide association studies (GWAS). The outcomes were self-rated health, depressive symptoms, cognitive ability, activities of everyday life, educational attainment, and wealth. We employed regression analyses for the outcomes including all polygenic scores and adjusting for gender, birth period, and genetic ancestry.
The polygenic scores had important associations with functional health and SES. An increase in genetic risk for all conditions except T2D was significantly (p < .01) associated with reduced functional health and socioeconomic outcomes. The magnitudes of functional health declines were meaningful and in many cases equivalent in magnitude to several years of aging. These associations were robust to several sensitivity checks for ancestry and adjustment for parental educational attainment and age at death or the last interview if alive.
Stronger genetic predispositions for leading chronic conditions are related to worse long-run health and SES outcomes, likely reflecting the adverse effects of the onset of these conditions on one's wellbeing.
慢性疾病的遗传风险与长期健康之间的关系在很大程度上尚未得到探索。我们研究了几种慢性疾病的遗传易感性与长期功能健康和社会经济地位(SES)之间的关联。
我们使用了美国 1992 年至 2012 年健康与退休调查(HRS)中一个具有全国代表性的 9317 名 65 岁或以上成年人的样本数据。调查数据与近 200 万个单核苷酸多态性(SNP)的遗传数据相关联。我们通过来自全基因组关联研究(GWAS)的多基因风险评分(PRS)来衡量个体对冠状动脉疾病、2 型糖尿病(T2D)、肥胖、类风湿关节炎(RA)、阿尔茨海默病和重度抑郁症(MDD)的遗传易感性。结果是通过自我报告的健康状况、抑郁症状、认知能力、日常生活活动、受教育程度和财富来衡量的。我们使用回归分析来评估所有多基因评分的结果,并调整性别、出生时期和遗传祖先。
多基因评分与功能健康和 SES 有重要关联。除 T2D 外,所有疾病的遗传风险增加都与功能健康和社会经济结果下降显著相关(p <.01)。功能健康下降的幅度是有意义的,在许多情况下,与几年的衰老相当。这些关联在对祖先进行多次敏感性检查以及调整父母的受教育程度和死亡或如果仍然活着时的最后一次访谈年龄后仍然稳健。
对主要慢性疾病的遗传易感性越强,与长期健康和 SES 结果越差相关,这可能反映了这些疾病的发生对一个人幸福感的不利影响。