Sidorchuk Anna, Goodman Anna, Koupil Ilona
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2018 Feb 14;13(2):e0191855. doi: 10.1371/journal.pone.0191855. eCollection 2018.
To investigate whether and how social class and social mobility in grandparents and parents predict alcohol-related disorders (ARDs) in males and females aged 12+ years, and whether intergenerational social prediction of ARDs varies across time periods.
The study sample included four successive generations (G) of Swedish families from the Uppsala Birth Cohort Multigenerational Study: G0 born 1851-1912; G1 born 1915-1929; G2 born 1940-1964 and G3 born 1965-1989. Two study populations were created, each consisting of grandparents, parents and offspring: population I 'G0-G1-G2' (offspring n = 18 430) and population II 'G1-G2-G3' (offspring n = 26 469). Registers and archives provided data on ancestors' socio-demographic factors and ARD history, together with offspring ARD development between 1964-2008. Cox regression models examined the hazard of offspring ARD development according to grandparental social class and grandparental-to-parental social trajectories, controlling for offspring birth year, grandmother's and mother's marital status and parental ARDs.
Disadvantaged grandparental social class predicted increased ARD risk in offspring in population I, although the effect attenuated and became non-significant in males after adjusting for parental characteristics (adjusted hazard ratio (HR) = 1.80 (95%CI; 1.07, 3.03) in females, HR = 1.32 (95%CI; 0.93, 1.89) in males). In population II, no increase in ARD risk by grandparental social was evident. In both populations, males were at the highest ARD risk if both parents and grandparents belonged to disadvantaged social class (population I: HR = 1.82 (95%CI; 1.22-2.72); population II: HR = 1.68 (95%CI; 1.02-2.76)).
Intergenerational social patterning of ARDs appears to be time-contextual and gender-specific. The role of grandparental social class in developing ARDs in grandchildren seems to decline over time, while persistent grandparental-to-parental social disadvantage remains associated with higher ARD risk in males. When targeting higher risk groups, continuity of familial social disadvantage, particularly among males, should be considered.
调查祖父母和父母的社会阶层及社会流动是否以及如何预测12岁及以上男性和女性的酒精相关障碍（ARDs），以及ARDs的代际社会预测是否随时间段而变化。
研究样本包括来自乌普萨拉出生队列多代研究的四代瑞典家庭（G）：G0出生于1851 - 1912年；G1出生于1915 - 1929年；G2出生于1940 - 1964年；G3出生于1965 - 1989年。创建了两个研究群体，每个群体由祖父母、父母和后代组成：群体I“G0 - G1 - G2”（后代n = 18430）和群体II“G1 - G2 - G3”（后代n = 26469）。登记册和档案提供了关于祖先社会人口学因素和ARD病史的数据，以及1964 - 2008年间后代ARD的发展情况。Cox回归模型根据祖父母的社会阶层和祖父母到父母的社会轨迹，研究后代ARD发展的风险，同时控制后代出生年份、祖母和母亲的婚姻状况以及父母的ARDs。
在群体I中，祖父母社会阶层处于劣势预示着后代患ARD的风险增加，但在调整父母特征后，男性的这种影响减弱且变得不显著（女性调整后的风险比（HR）= 1.80（95%置信区间；1.07，3.03），男性HR = 1.32（95%置信区间；0.93，1.89））。在群体II中，祖父母社会阶层并未明显增加ARD风险。在两个群体中，如果父母和祖父母都属于社会阶层劣势群体，男性患ARD的风险最高（群体I：HR = 1.82（95%置信区间；1.22 - 2.72）；群体II：HR = 1.68（95%置信区间；1.02 - 2.76））。
ARDs的代际社会模式似乎具有时间背景和性别特异性。祖父母社会阶层在孙辈患ARDs方面的作用似乎随时间下降，而祖父母到父母持续的社会劣势仍与男性较高的ARD风险相关。在针对高风险群体时，应考虑家族社会劣势的持续性，尤其是在男性中。
