在138,592名退伍军人中,未发现阿尔茨海默病遗传学作为战斗暴露与创伤后应激障碍风险关联的调节因素存在复制情况。

No Replication of Alzheimer's Disease Genetics as a Moderator of Combat Exposure's Association with PTSD risk in 138,592 Combat Veterans.

作者信息

Wolf Erika J, Miller Mark W, Zhang Rui, Sherva Richard, Harrington Kelly M, Fonda Jennifer R, Daskalakis Nikolaos P, Gaziano J Michael, Logue Mark W

机构信息

National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA.

Boston University Chobanian & Avedisian School of Medicine, Department of Psychiatry, Boston, MA, 02118, USA.

出版信息

Nat Ment Health. 2024 Apr 4;2:553-561. doi: 10.1038/s44220-024-00225-1.

Abstract

Large-scale cohort and epidemiological studies suggest that posttraumatic stress disorder (PTSD) confers risk for late-onset Alzheimer's disease (AD) and related dementias (ADRD); however, the basis for this association remains unclear. Several prior studies of military Veterans have reported that carriers of the apolipoprotein E () ε4 gene variant are at heightened risk for the development of PTSD following combat exposure, suggesting that PTSD and ADRD may share some genetic risk. This cohort study was designed to further examine the hypothesis that ADRD genetic risk also confers risk for PTSD. To do so, we examined ε4 and ε2 genotypes, an AD polygenic risk score (PRS), and other Veteran-relevant risk factors for PTSD in age-stratified groups of individuals of European ( = 123,372) and African ( = 15,220) ancestry in the US Department of Veterans Affairs' Million Veteran Program. Analyses revealed no significant main effect associations between the ε4 (or ε2) genotype or the AD PRS on PTSD severity or diagnosis. There were also no significant interactions between measures of AD genetic risk and either combat exposure severity or history of head injury in association with PTSD in any age group. We conclude that the association between PTSD and the primary ADRD genetic risk factor, ε4, that was reported previously was not replicable in the largest relevant dataset in the world. Thus, the epidemiological association between PTSD and ADRD is not likely to be driven by the major genetic factors underlying ADRD risk.

摘要

大规模队列研究和流行病学研究表明,创伤后应激障碍(PTSD)会增加迟发性阿尔茨海默病(AD)及相关痴呆症(ADRD)的发病风险;然而,这种关联的基础仍不清楚。先前对退伍军人的几项研究报告称,载脂蛋白E(APOE)ε4基因变异携带者在经历战斗暴露后患PTSD的风险更高,这表明PTSD和ADRD可能存在一些共同的遗传风险。这项队列研究旨在进一步检验ADRD遗传风险也会增加PTSD风险这一假设。为此,我们在美国退伍军人事务部的百万退伍军人计划中,对欧洲血统(n = 123,372)和非洲血统(n = 15,220)的年龄分层个体组中的APOE ε4和ε2基因型、AD多基因风险评分(PRS)以及其他与退伍军人相关的PTSD风险因素进行了研究。分析显示,APOE ε4(或ε2)基因型或AD PRS与PTSD严重程度或诊断之间没有显著的主效应关联。在任何年龄组中,AD遗传风险指标与战斗暴露严重程度或头部受伤史与PTSD之间也没有显著的相互作用。我们得出结论,先前报道的PTSD与主要ADRD遗传风险因素APOE ε4之间的关联在世界上最大的相关数据集中无法复制。因此,PTSD与ADRD之间的流行病学关联不太可能由ADRD风险的主要遗传因素驱动。

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