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全国队列中自闭症谱系障碍的完整身体共病谱

Complete Spectrum of Physical Comorbidities with Autism Spectrum Disorder in a Nationwide Cohort.

作者信息

Steinhausen Hans-Christoph, Villumsen Martin Dalgaard, Støving René Klinkby, Bilenberg Niels

机构信息

Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark.

Department of Child and Adolescent Psychiatry, Psychiatric University Hospital of Zurich, Zurich, Switzerland.

出版信息

J Autism Dev Disord. 2024 Jul 27. doi: 10.1007/s10803-024-06476-2.

Abstract

The associations between autism spectrum disorder (ASD) and physical diseases (PD) based on ICD-8 and ICD-10 diagnoses were studied, comparing with the risks of the general population. All individuals diagnosed before 30th April 2018 with ASD (n = 12,063) and a 5% random sample of the general population (n = 41,251) were drawn from Danish registers of the birth cohorts 1984-1995. For each of the entire spectrum of 13 PD categories, participants were followed from birth to first diagnosis, death, emigration, or 31st December 2017, whichever came first. Time from inclusion at birth to time of first physical diagnosis, accounting for censoring, was studied by use of time-stratified Cox models. When compared to the control sample, the individuals with ASD had a substantial added immediate risk in infancy and in childhood for 12 of the 13 categories. Particularly prominent were estimated associations for nervous system diseases at ages 0-9, and diseases of the eye and adnexa at ages 0-11. The associations were observed for both sexes, but were stronger among females than males, especially for genitourinary system diseases. On the cumulative scale, individuals with ASD were at pronounced greater risk through follow-up for 8 categories, with the greatest cumulative risk of respiratory system diseases, which at ages 5 and 30 was 24.9% and 41.5% for the ASD cohort while for the control sample it was 16.3% and 34.5% at the same ages. Especially in infancy and childhood, the present study found increased risks for a multitude of physical diseases.

摘要

基于国际疾病分类第8版(ICD - 8)和第10版(ICD - 10)诊断结果,研究了自闭症谱系障碍(ASD)与躯体疾病(PD)之间的关联,并与普通人群的患病风险进行比较。从丹麦1984 - 1995年出生队列登记册中选取了所有在2018年4月30日前被诊断为ASD的个体(n = 12,063)以及5%的普通人群随机样本(n = 41,251)。对于13种PD类别中的每一种,从出生开始对参与者进行随访,直至首次诊断、死亡、移民或2017年12月31日,以先发生者为准。使用时间分层Cox模型研究了从出生纳入到首次躯体诊断的时间,并考虑了删失情况。与对照样本相比,ASD个体在婴儿期和儿童期的13个类别中有12个类别存在显著增加的直接患病风险。特别突出的是0 - 9岁时神经系统疾病以及0 - 11岁时眼及附属器疾病的估计关联。男女均观察到了这些关联,但在女性中比男性更强,尤其是对于泌尿生殖系统疾病。在累积尺度上,ASD个体在随访期间有8个类别存在明显更高的风险,呼吸系统疾病的累积风险最高,在5岁和30岁时,ASD队列的累积风险分别为24.9%和41.5%,而对照样本在相同年龄时分别为16.3%和34.5%。本研究发现,特别是在婴儿期和儿童期,多种躯体疾病的患病风险增加。

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