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亨廷顿病在移民群体和瑞典出生人群中的发病情况:对瑞典所有 18 岁及以上成年人的队列研究。

Huntington's disease among immigrant groups and Swedish-born individuals: a cohort study of all adults 18 years of age and older in Sweden.

机构信息

Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.

Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet Huddinge, Stockholm, Sweden.

出版信息

Neurol Sci. 2021 Sep;42(9):3851-3856. doi: 10.1007/s10072-021-05085-6. Epub 2021 Jan 30.

Abstract

BACKGROUND

There is a lack of studies of Huntington's disease (HD) in immigrants.

OBJECTIVE

To study the association between country of birth and incident HD in first-generation immigrants versus Swedish-born individuals and in second-generation immigrants versus Swedish-born individuals with Swedish-born parents.

METHODS

Study populations included all adults aged 18 years and older in Sweden, i.e., in the first-generation study 6,042,891 individuals with 1034 HD cases and in the second-generation study 4,860,469 individuals with 1001 cases. HD was defined as having at least one registered diagnosis of HD in the National Patient Register. The incidence of HD in different first-generation immigrant groups versus Swedish-born individuals was assessed by Cox regression, expressed as hazard ratios (HRs) and 95% confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighborhood socioeconomic status.

RESULTS

Mean age-standardized incidence rates per 100,000 person-years were for all Swedish-born 0.82 and for all foreign born 0.53 and for all men 0.73 and for all women 0.81, with the highest incidence rates for the group 80-84 years of age. After adjusting for potential confounders, the HRs were lower in women in the first- and second-generation, i.e., 0.49 (95% CI 0.36-0.67) and 0.63 (95% 0.45-0.87), respectively, and also among women from Finland or with parents from Finland.

SIGNIFICANCE

In general, the risk of HD was lower in first-generation and second-generation immigrant women but not among male immigrants.

摘要

背景

目前针对移民的亨廷顿病(HD)研究较少。

目的

研究出生国与第一代移民中 HD 发病的相关性,以及第一代移民和出生于瑞典、父母均出生于瑞典的二代移民中 HD 发病的相关性。

方法

研究人群包括瑞典所有年龄在 18 岁及以上的成年人,即第一代研究中共有 6042891 人,其中有 1034 例 HD 患者;第二代研究中有 4860469 人,其中有 1001 例 HD 患者。国家患者登记处至少有一个 HD 诊断记录即可诊断为 HD。通过 Cox 回归评估不同第一代移民群体与瑞典出生者相比 HD 的发病率,以风险比(HR)和 95%置信区间(CI)表示。这些模型按性别分层,并根据年龄、在瑞典的地理居住情况、教育水平、婚姻状况和社区社会经济地位进行了调整。

结果

年龄标准化发病率的平均值为每 100000 人年 0.82 例,在所有瑞典出生者中为 0.53 例,在所有外国出生者中为 0.53 例,在所有男性中为 0.73 例,在所有女性中为 0.81 例,发病率最高的是 80-84 岁年龄组。在调整了潜在混杂因素后,第一代和第二代移民中的女性 HR 分别为 0.49(95%CI 0.36-0.67)和 0.63(95%CI 0.45-0.87),而来自芬兰或父母均来自芬兰的女性 HR 也较低。

意义

一般来说,第一代和第二代移民女性 HD 的发病风险较低,但男性移民则不然。

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