Sørensen T I, Nielsen G G, Andersen P K, Teasdale T W
Department of Medicine, Hvidovre University Hospital, Copenhagen, Denmark.
N Engl J Med. 1988 Mar 24;318(12):727-32. doi: 10.1056/NEJM198803243181202.
To assess genetic and environmental influences on adult mortality, we followed 960 families that included children born during the period 1924 through 1926 who were placed early in life with adoptive parents unrelated to them. We evaluated the risks of dying from all causes or from specific groups of causes between the ages of 16 and 58 years for adoptees with a biologic or adoptive parent who died of the same cause before the age of either 50 or 70. We compared these risks with the adoptees' risk of dying from the same causes between the ages of 16 and 58 when either the biologic or adoptive parents were still alive at the ages of 50 and 70. The death of a biologic parent before the age of 50 resulted in relative risks of death in the adoptees of 1.71 (95 percent confidence interval, 1.14 to 2.57) for all causes, 1.98 (1.25 to 3.12) for natural causes, 5.81 (2.47 to 13.7) for infections, 4.52 (1.32 to 15.4) for cardiovascular and cerebrovascular causes, and 1.19 (0.16 to 8.99) for cancers. The death of an adoptive parent resulted in relative risks of death in the adoptees that were close to unity for all causes, natural causes, and infections, 3.02 (0.72 to 12.8) for vascular causes, and 5.16 (1.20 to 22.2) for cancers. A similar but weaker pattern was observed when either a biologic or adoptive parent died before the age of 70. We conclude that premature death in adults has a strong genetic background--especially death due to infections and vascular causes.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估基因和环境对成人死亡率的影响,我们追踪了960个家庭,这些家庭中的孩子出生于1924年至1926年期间,自幼被与他们无血缘关系的养父母收养。我们评估了亲生父母或养父母在50岁或70岁之前因相同原因死亡的被收养者在16岁至58岁之间死于各种原因或特定原因组的风险。我们将这些风险与亲生父母或养父母在50岁和70岁时仍然健在的被收养者在16岁至58岁之间死于相同原因的风险进行了比较。亲生父母在50岁之前死亡导致被收养者的全因死亡相对风险为1.71(95%置信区间为1.14至2.57),自然原因死亡相对风险为1.98(1.25至3.12),感染死亡相对风险为5.81(2.47至13.7),心血管和脑血管原因死亡相对风险为4.52(1.32至15.4),癌症死亡相对风险为1.19(0.16至8.99)。养父母死亡导致被收养者的全因、自然原因和感染死亡相对风险接近1,血管原因死亡相对风险为3.02(0.72至12.8),癌症死亡相对风险为5.16(1.20至22.2)。当亲生父母或养父母在70岁之前死亡时,观察到类似但较弱的模式。我们得出结论,成人过早死亡有很强的遗传背景——尤其是因感染和血管原因导致的死亡。(摘要截选至250词)