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多基因风险:预测临床和流行病学青少年队列中的抑郁结局。

Polygenic Risk: Predicting Depression Outcomes in Clinical and Epidemiological Cohorts of Youths.

机构信息

Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich (Halldorsdottir, Czamara, Rex-Haffner, Binder); Center of Public Health Sciences (Halldorsdottir) and Landspitali National University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik (Arnarson); Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich (Piechaczek, Pehl, Wagenbuechler, Feldmann, Quickenstedt-Reinhardt, Allgaier, Greimel, Schulte-Körne); Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal (Soares de Matos); Department of Psychology, Faculty of Social Sciences, University of the German Federal Armed Forces, Neubiberg, Germany (Allgaier); KBO Heckscher Hospital, Munich (Freisleder); Department of Psychology and Logopedics, University of Helsinki, Helsinki (Kvist, Lahti, Räikkönen); Department of Psychiatry and Behavioral Sciences (Craighead, Binder) and Department of Psychology (Craighead), Emory University School of Medicine, Atlanta; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium (see online supplement for list of researchers).

出版信息

Am J Psychiatry. 2019 Aug 1;176(8):615-625. doi: 10.1176/appi.ajp.2019.18091014. Epub 2019 Apr 5.

Abstract

OBJECTIVE

Identifying risk factors for major depression and depressive symptoms in youths could have important implications for prevention efforts. This study examined the association of polygenic risk scores (PRSs) for a broad depression phenotype derived from a large-scale genome-wide association study (GWAS) in adults, and its interaction with childhood abuse, with clinically relevant depression outcomes in clinical and epidemiological youth cohorts.

METHODS

The clinical cohort comprised 279 youths with major depression (mean age=14.76 years [SD=2.00], 68% female) and 187 healthy control subjects (mean age=14.67 years [SD=2.45], 63% female). The first epidemiological cohort included 1,450 youths (mean age=13.99 years [SD=0.92], 63% female). Of those, 694 who were not clinically depressed at baseline underwent follow-ups at 6, 12, and 24 months. The replication epidemiological cohort comprised children assessed at ages 8 (N=184; 49.2% female) and 11 (N=317; 46.7% female) years. All cohorts were genome-wide genotyped and completed measures for major depression, depressive symptoms, and/or childhood abuse. Summary statistics from the largest GWAS to date on depression were used to calculate the depression PRS.

RESULTS

In the clinical cohort, the depression PRS predicted case-control status (odds ratio=1.560, 95% CI=1.230-1.980), depression severity (β=0.177, SE=0.069), and age at onset (β=-0.375, SE=0.160). In the first epidemiological cohort, the depression PRS predicted baseline depressive symptoms (β=0.557, SE=0.200) and prospectively predicted onset of moderate to severe depressive symptoms (hazard ratio=1.202, 95% CI=1.045-1.383). The associations with depressive symptoms were replicated in the second epidemiological cohort. Evidence was found for an additive, but not an interactive, effect of the depression PRS and childhood abuse on depression outcomes.

CONCLUSIONS

Depression PRSs derived from adults generalize to depression outcomes in youths and may serve as an early indicator of clinically significant levels of depression.

摘要

目的

识别青少年重度抑郁症和抑郁症状的风险因素对预防工作具有重要意义。本研究探讨了从成人全基因组关联研究(GWAS)中得出的广泛抑郁症表型的多基因风险评分(PRS)与临床和流行病学青年队列中与临床相关的抑郁结果之间的关联,以及其与儿童期虐待的相互作用。

方法

临床队列包括 279 名患有重度抑郁症的青少年(平均年龄=14.76 岁[标准差=2.00],68%为女性)和 187 名健康对照组(平均年龄=14.67 岁[标准差=2.45],63%为女性)。第一个流行病学队列包括 1450 名青少年(平均年龄=13.99 岁[标准差=0.92],63%为女性)。其中,694 名基线时无临床抑郁的青少年在 6、12 和 24 个月时进行了随访。复制的流行病学队列包括在 8 岁(N=184;49.2%为女性)和 11 岁(N=317;46.7%为女性)时进行评估的儿童。所有队列均进行全基因组基因分型,并完成了重度抑郁症、抑郁症状和/或儿童期虐待的评估。使用迄今为止关于抑郁症的最大 GWAS 的汇总统计数据来计算抑郁症 PRS。

结果

在临床队列中,抑郁症 PRS 预测病例对照状态(优势比=1.560,95%置信区间=1.230-1.980)、抑郁严重程度(β=0.177,SE=0.069)和发病年龄(β=-0.375,SE=0.160)。在第一个流行病学队列中,抑郁症 PRS 预测基线时的抑郁症状(β=0.557,SE=0.200),并前瞻性预测中度至重度抑郁症状的发病(风险比=1.202,95%置信区间=1.045-1.383)。在第二个流行病学队列中发现了与抑郁症状的关联。有证据表明,抑郁症 PRS 和儿童期虐待对抑郁结果的影响是累加的,而不是交互的。

结论

从成人中得出的抑郁症 PRS 可推广到青少年的抑郁结果,并且可能成为临床显著抑郁水平的早期指标。

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