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战斗部署后多基因风险评分与创伤后应激症状轨迹的关联。

Associations of polygenic risk scores with posttraumatic stress symptom trajectories following combat deployment.

作者信息

Campbell-Sills Laura, Papini Santiago, Norman Sonya B, Choi Karmel W, He Feng, Sun Xiaoying, Kessler Ronald C, Ursano Robert J, Jain Sonia, Stein Murray B

机构信息

Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.

Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.

出版信息

Psychol Med. 2023 Oct;53(14):6733-6742. doi: 10.1017/S0033291723000211. Epub 2023 Mar 6.

Abstract

BACKGROUND

Identification of genetic risk factors may inform the prevention and treatment of posttraumatic stress disorder (PTSD). This study evaluates the associations of polygenic risk scores (PRS) with patterns of posttraumatic stress symptoms following combat deployment.

METHOD

US Army soldiers of European ancestry ( = 4900) provided genomic data and ratings of posttraumatic stress symptoms before and after deployment to Afghanistan in 2012. Latent growth mixture modeling was used to model posttraumatic stress symptom trajectories among participants who provided post-deployment data ( = 4353). Multinomial logistic regression models tested independent associations between trajectory membership and PRS for PTSD, major depressive disorder (MDD), schizophrenia, neuroticism, alcohol use disorder, and suicide attempt, controlling for age, sex, ancestry, and exposure to potentially traumatic events, and weighted to account for uncertainty in trajectory classification and missing data.

RESULTS

Participants were classified into low-severity (77.2%), increasing-severity (10.5%), decreasing-severity (8.0%), and high-severity (4.3%) posttraumatic stress symptom trajectories. Standardized PTSD-PRS and MDD-PRS were associated with greater odds of membership in the high-severity low-severity trajectory [adjusted odds ratios and 95% confidence intervals, 1.23 (1.06-1.43) and 1.18 (1.02-1.37), respectively] and the increasing-severity low-severity trajectory [1.12 (1.01-1.25) and 1.16 (1.04-1.28), respectively]. Additionally, MDD-PRS was associated with greater odds of membership in the decreasing-severity low-severity trajectory [1.16 (1.03-1.31)]. No other associations were statistically significant.

CONCLUSIONS

Higher polygenic risk for PTSD or MDD is associated with more severe posttraumatic stress symptom trajectories following combat deployment. PRS may help stratify at-risk individuals, enabling more precise targeting of treatment and prevention programs.

摘要

背景

识别遗传风险因素可能为创伤后应激障碍(PTSD)的预防和治疗提供依据。本研究评估多基因风险评分(PRS)与战斗部署后创伤后应激症状模式之间的关联。

方法

2012年,具有欧洲血统的美国陆军士兵(n = 4900)提供了基因组数据以及部署到阿富汗前后的创伤后应激症状评分。潜在增长混合模型用于对提供部署后数据的参与者(n = 4353)的创伤后应激症状轨迹进行建模。多项逻辑回归模型测试了PTSD、重度抑郁症(MDD)、精神分裂症、神经质、酒精使用障碍和自杀未遂的轨迹类别与PRS之间的独立关联,同时控制年龄、性别、血统以及接触潜在创伤事件的情况,并进行加权以考虑轨迹分类和缺失数据中的不确定性。

结果

参与者被分为低严重程度(77.2%)、严重程度增加(10.5%)、严重程度降低(8.0%)和高严重程度(4.3%)的创伤后应激症状轨迹。标准化的PTSD-PRS和MDD-PRS与高严重程度轨迹相对于低严重程度轨迹的更高归属概率相关[调整后的优势比和95%置信区间分别为1.23(1.06 - 1.43)和1.18(1.02 - 1.37)],以及严重程度增加轨迹相对于低严重程度轨迹的更高归属概率相关[分别为1.12(1.01 - 1.25)和1.16(1.04 - 1.28)]。此外,MDD-PRS与严重程度降低轨迹相对于低严重程度轨迹的更高归属概率相关[1.16(1.03 - 1.31)]。没有其他关联具有统计学意义。

结论

PTSD或MDD的多基因风险较高与战斗部署后更严重的创伤后应激症状轨迹相关。PRS可能有助于对高危个体进行分层,从而使治疗和预防计划的靶向性更加精确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd72/10600824/ba072a253711/S0033291723000211_fig1.jpg

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