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自闭症谱系障碍(ASD)家族中注意缺陷多动障碍(ADHD)风险增加。

Increased risk of ADHD in families with ASD.

机构信息

Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France.

Centre de Psychiatrie et Neurosciences, INSERM U894 Team 1, Paris, France.

出版信息

Eur Child Adolesc Psychiatry. 2019 Feb;28(2):281-288. doi: 10.1007/s00787-018-1206-0. Epub 2018 Sep 28.

Abstract

Attention Deficit and Hyperactive Disorder (ADHD) and Autism Spectrum Disorders (ASD) are frequent comorbid neurodevelopmental conditions and the overlap between both disorders remains to be delineated. A more complete understanding of the shared genetic and environmental factors is needed. Using a family-based method, we evaluated the risk of ADHD in a group of relatives with an ASD proband (ASD-) and a group of relatives with an ASD and ADHD proband (ASD+). We enrolled 1245 individuals in the study: 499 probands, their 746 first-degree relatives and 140 controls. We used a multivariate generalized estimating equation (GEE) model, in which the dependent variable was the ADHD diagnosis in the relatives and the independent variable the ASD+ or ASD- in probands. We adjusted for sociodemographic factors (age, sex, IQ) and for the nature of the familial relationship with the affected proband (parent or sibling). Among the probands, there were 287 ASD- and 212 ASD+ individuals. ADHD was more frequent in relatives (19%) than in the control group (7%) (p = 0.001). The risk of ADHD was higher in the ASD+ relatives group than in the ASD- relatives group (GEE model OR 1.58 [95% CI 1.04-2.38], p = 0.032). This result was found in parents (OR 1.96 [95% CI  1.14-3.36], but not in siblings (OR 1.28 [95% CI 0.84-1.94], p = 0.434). Our study provides a representative estimate of the family distribution of ADHD in relatives of ASD probands but supports the modest effect of shared genetic and environmental factors between both disorders.

摘要

注意缺陷多动障碍(ADHD)和自闭症谱系障碍(ASD)是常见的共患神经发育障碍,两者之间的重叠仍有待阐明。需要更全面地了解两者共有的遗传和环境因素。我们采用基于家庭的方法,评估了一组 ASD 先证者(ASD-)亲属和一组 ASD 合并 ADHD 先证者(ASD+)亲属中 ADHD 的发病风险。我们共纳入了 1245 名研究对象:499 名先证者、746 名一级亲属和 140 名对照者。我们使用多元广义估计方程(GEE)模型,因变量为亲属的 ADHD 诊断,自变量为先证者的 ASD+或 ASD-。我们调整了社会人口统计学因素(年龄、性别、智商)和与受影响先证者的亲属关系性质(父母或兄弟姐妹)。先证者中,287 名为 ASD-,212 名为 ASD+。与对照组(7%)相比,亲属中 ADHD 的发病率更高(19%)(p=0.001)。在 ASD+亲属组中,ADHD 的发病风险高于 ASD-亲属组(GEE 模型 OR 1.58[95%CI 1.04-2.38],p=0.032)。这一结果在父母中发现(OR 1.96[95%CI 1.14-3.36]),但在兄弟姐妹中未发现(OR 1.28[95%CI 0.84-1.94],p=0.434)。我们的研究提供了 ASD 先证者亲属中 ADHD 家族分布的代表性估计值,但支持这两种疾病之间存在共同遗传和环境因素的适度影响。

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