Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China.
The National Centre for Register-based Research, Aarhus University, Denmark.
J Affect Disord. 2024 Nov 1;364:279-285. doi: 10.1016/j.jad.2024.08.011. Epub 2024 Aug 12.
The interplay between genetic and lifestyle factors in the development of bipolar disorder (BD) remains unclear.
A cohort study was carried out on 365,517 participants from the UK Biobank. Lifestyle scores, based on smoking, physical activity, diet, alcohol consumption, sedentary behavior, sleep duration, and social contact, were grouped as favorable (scores 6-7), intermediate (scores 4-5), or unfavorable (scores 0-3). The BD polygenic risk score (PRS) was also categorized into high, intermediate, and low-risk groups using PRS tertiles. Cox regression models determined hazard ratios (HRs) and 95 % confidence intervals (CIs) for BD.
During the 12.9-year follow-up, 529 individuals developed BD. Comparing those with favorable lifestyles to those with unfavorable participants, the HR of developing BD was 3.28 (95 % CI, 2.76-3.89). Similarly, individuals with a high PRS had a risk of 3.20 (95 % CI, 2.83-3.63) compared to those with a low PRS. Notably, individuals with both a high PRS and an unfavorable lifestyle had a significantly higher risk of BD (HR = 6.31, 95 % CI, 4.14-9.63) compared to those with a low PRS and a favorable lifestyle. Additionally, the interaction between PRS and lifestyle contributed an additional risk, with a relative excess risk of 1.74 (95 % CI, 0.40-3.07) and an attributable proportion due to the interaction of 0.37 (95 % CI, 0.16-0.58).
Our findings suggest that genetic liability for BD, measured as PRS, and lifestyle have an additive effect on the risk of developing BD. A favorable lifestyle was associated with a reduced risk of developing BD.
遗传和生活方式因素在双相情感障碍（BD）的发展中的相互作用仍不清楚。
对来自英国生物库的 365517 名参与者进行了队列研究。生活方式评分基于吸烟、身体活动、饮食、饮酒、久坐行为、睡眠时长和社会接触，分为有利（评分 6-7）、中等（评分 4-5）或不利（评分 0-3）。BD 多基因风险评分（PRS）也根据 PRS 三分位数分为高、中、低风险组。Cox 回归模型确定了 BD 的风险比（HR）和 95%置信区间（CI）。
在 12.9 年的随访期间，529 人患上了 BD。与生活方式有利的参与者相比，生活方式不利的参与者发生 BD 的 HR 为 3.28（95%CI，2.76-3.89）。同样，与 PRS 低的个体相比，PRS 高的个体发生 BD 的风险为 3.20（95%CI，2.83-3.63）。值得注意的是，与 PRS 低且生活方式有利的个体相比，PRS 高且生活方式不利的个体发生 BD 的风险显著更高（HR=6.31，95%CI，4.14-9.63）。此外，PRS 和生活方式之间的相互作用增加了风险，相对超额风险为 1.74（95%CI，0.40-3.07），交互归因比例为 0.37（95%CI，0.16-0.58）。
我们的研究结果表明，BD 的遗传易感性，以 PRS 衡量，以及生活方式对 BD 的发病风险有相加作用。有利的生活方式与降低发生 BD 的风险相关。
