自闭症谱系障碍研究识别病例的自身免疫性疾病风险：一项纵向、基于人群的出生队列研究。

Risk of Autoimmune Disease in Research-Identified Cases of Autism Spectrum Disorder: A Longitudinal, Population-Based Birth Cohort Study.

机构信息

Division of Pediatric Neurology/Neurodevelopment, Department of Pediatrics, Baylor College of Medicine, San Antonio, TX.

Department of Pediatrics, Mayo Clinic, Rochester, MN.

出版信息

J Dev Behav Pediatr. 2024 Jan 1;45(1):e46-e53. doi: 10.1097/DBP.0000000000001232.

DOI:10.1097/DBP.0000000000001232

PMID:38364086

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10878713/

Abstract

OBJECTIVE

Determine the risk of autoimmune disease in research-identified cases of autism spectrum disorder (ASD) compared with referents using a longitudinal, population-based birth cohort.

METHODS

ASD incident cases were identified from a population-based birth cohort of 31,220 individuals. Inclusive ASD definition based on DSM-IV-TR autistic disorder, Asperger syndrome, and pervasive developmental disorder, not otherwise specified, was used to determine ASD cases. For each ASD case, 2 age- and sex-matched referents without ASD were identified. Diagnosis codes assigned between birth and December 2017 were electronically obtained. Individuals were classified as having an autoimmune disorder if they had at least 2 diagnosis codes more than 30 days apart. Cox proportional hazards models were fit to estimate the hazard ratio (HR) between ASD status and autoimmune disorder.

RESULTS

Of 1014 ASD cases, 747 (73.7%) were male. Fifty ASD cases and 59 of the 1:2 matched referents were diagnosed with first autoimmune disorder at the median age of 14 and 17.1 years, respectively. ASD cases had increased risk of autoimmune disease compared with matched referents (HR 1.74; 95% confidence interval [CI], 1.21-2.52). The increased risk was statistically significant among male patients (HR 2.01; 95% CI, 1.26-3.21) but not among the smaller number of female subjects (HR 1.38; 95% CI, 0.76-2.50).

CONCLUSION

This study provides evidence from a longitudinal, population-based birth cohort for co-occurrence of ASD and autoimmune disorders. Thus, children with ASD should be monitored for symptoms of autoimmune disease and appropriate workup initiated.

摘要

目的

通过一项基于人群的纵向出生队列研究，比较自闭症谱系障碍（ASD）确诊病例与参照者的自身免疫性疾病风险。

方法

从一个基于人群的 31220 人出生队列中确定 ASD 发病病例。采用基于 DSM-IV-TR 自闭症障碍、阿斯伯格综合征和未特定的广泛性发育障碍的包容性 ASD 定义来确定 ASD 病例。为每个 ASD 病例确定 2 名年龄和性别匹配的无 ASD 参照者。通过电子方式获取出生至 2017 年 12 月之间的诊断代码。如果个体至少有 2 个相隔 30 天以上的诊断代码，则将其归类为患有自身免疫性疾病。使用 Cox 比例风险模型估计 ASD 状态与自身免疫性疾病之间的风险比（HR）。

结果

在 1014 例 ASD 病例中，747 例（73.7%）为男性。50 例 ASD 病例和 59 例 1:2 匹配参照者分别在中位数年龄为 14 岁和 17.1 岁时被诊断出患有首次自身免疫性疾病。与匹配参照者相比，ASD 病例患自身免疫性疾病的风险增加（HR 1.74；95%置信区间 [CI]，1.21-2.52）。这种风险在男性患者中具有统计学意义（HR 2.01；95%CI，1.26-3.21），但在女性患者中则不显著（HR 1.38；95%CI，0.76-2.50）。