Qi Baiyu, Thornton Laura M, Breiner Courtney E, Kuja-Halkola Ralf, Baker Jessica H, Lichtenstein Paul, Lundström Sebastian, Agrawal Arpana, Bulik Cynthia M, Munn-Chernoff Melissa A
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Alcohol Clin Exp Res (Hoboken). 2023 Sep;47(9):1677-1689. doi: 10.1111/acer.15150. Epub 2023 Sep 17.
Twin studies have demonstrated shared genetic and environmental effects between eating disorders and alcohol involvement in adults and middle adolescents. However, fewer studies have focused on late adolescents or investigated a wide range of eating disorder dimensions and alcohol involvement subscales in both sexes. We examined genetic and environmental correlations among three eating disorder dimensions and two alcohol involvement subscale scores in late adolescent twins using bivariate twin models.
Participants were 3568 female and 2526 male same-sex twins aged 18 years old from the Child and Adolescent Twin Study in Sweden. The Eating Disorder Inventory-2 (EDI) assessed the drive for thinness, bulimia, and body dissatisfaction. Alcohol involvement was assessed with the Alcohol Use Disorder Identification Test consumption (AUDIT-C) and problem (AUDIT-P) subscales.
Only phenotypic and twin correlations in female twins met our threshold for twin modeling. The proportion of total variance for each trait accounted for by additive genetic factors ranged from 0.50 to 0.64 in female twins, with the rest explained by nonshared environmental factors and measurement error. Shared environmental factors played a minimal role in the variance of each trait. The strongest genetic correlation (r ) emerged between EDI bulimia and AUDIT-P (r = 0.46, 95% confidence interval: 0.37, 0.55), indicating that the proportion of genetic variance of one trait that was shared with the other trait was 0.21. Nonshared environmental correlations between eating disorder dimensions and alcohol involvement ranged from 0.03 to 0.13.
We observed distinct patterns of genetic and environmental effects for co-occurring eating disorder dimensions and alcohol involvement in female vs. male twins, supporting sex-specific treatment strategies for late adolescents with comorbid eating disorders and alcohol use disorder. Our findings emphasize the importance of assessing family history of multiple eating disorder dimensions while treating late adolescents with problematic alcohol use, and vice versa, to improve detection and treatment.
双胞胎研究表明，饮食失调与成年人及青少年中期的酒精使用之间存在共同的遗传和环境影响。然而，较少有研究关注青少年晚期，或调查两性中广泛的饮食失调维度和酒精使用相关分量表。我们使用双变量双胞胎模型，研究了青少年晚期双胞胎中三种饮食失调维度与两种酒精使用相关分量表得分之间的遗传和环境相关性。
参与者为来自瑞典儿童和青少年双胞胎研究的3568名18岁女性和2526名18岁男性同性双胞胎。饮食失调量表-2（EDI）评估了对瘦身的追求、暴食和身体不满。酒精使用情况通过酒精使用障碍识别测试消耗量（AUDIT-C）和问题（AUDIT-P）分量表进行评估。
只有女性双胞胎中的表型和双胞胎相关性达到了我们进行双胞胎建模的阈值。在女性双胞胎中，加性遗传因素占每个性状总方差的比例在0.50至0.64之间，其余部分由非共享环境因素和测量误差解释。共享环境因素在每个性状的方差中作用极小。EDI暴食与AUDIT-P之间出现了最强的遗传相关性（r = 0.46，95%置信区间：0.37，0.55），表明一个性状与另一个性状共享的遗传方差比例为0.21。饮食失调维度与酒精使用之间的非共享环境相关性在0.03至0.13之间。
我们观察到女性和男性双胞胎在并发饮食失调维度和酒精使用方面存在不同的遗传和环境影响模式，这支持了针对患有共病饮食失调和酒精使用障碍的青少年晚期的性别特异性治疗策略。我们的研究结果强调，在治疗有酒精使用问题的青少年晚期时，评估多种饮食失调维度的家族史很重要，反之亦然，以改善检测和治疗。
