Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan.
Eur J Epidemiol. 2024 Oct;39(10):1161-1170. doi: 10.1007/s10654-024-01166-w. Epub 2024 Nov 4.
The mechanism underlying the co-occurrence of major depressive disorder (MDD) and gynecological diseases remains unclear. This study aimed to investigate the familial co-aggregation and shared genetic loading between MDD and gynecological diseases, namely dysmenorrhea, endometriosis, uterine leiomyomas (UL), and polycystic ovary syndrome (PCOS). Overall, 2,121,632 females born 1970-1999 with parental information were enrolled from the Taiwan National Health Insurance Research Database (NHIRD); 25,142 same-sex twins and 951,779 persons with full-sibling(s) were selected. Genome-wide genotyping data were available for 67,882 unrelated female participants from the Taiwan Biobank linked to the NHIRD. A generalized linear model with a logistic link function was used to examine the associations of individual history, family history in parents/full-siblings/same-sex twins, and polygenic risk scores (PRS) for MDD with the risk of gynecological diseases; generalized estimating equations were used to consider the non-independence of data. Both parents affected with MDD was associated with four gynecological diseases, and its magnitude of association was higher than either affected parent; maternal MDD showed a higher magnitude of association than paternal MDD. Full-siblings of patients with MDD had a higher risk of four gynecological diseases; same-sex twins of patients with MDD had a greater association with dysmenorrhea and PCOS. PRS for MDD was associated with dysmenorrhea and endometriosis. Familial co-aggregation was observed in the co-occurrence of MDD and four gynecological diseases. There exists a shared polygenic liability between MDD and dysmenorrhea and endometriosis. Individuals with MDD-affected relatives or a higher PRS for MDD should be monitored for gynecological diseases.
重度抑郁症（MDD）和妇科疾病同时发生的机制尚不清楚。本研究旨在探讨 MDD 与妇科疾病（痛经、子宫内膜异位症、子宫肌瘤（UL）和多囊卵巢综合征（PCOS））之间的家族聚集和共同遗传负荷。从台湾全民健康保险研究数据库（NHIRD）中总共纳入了 1970 年至 1999 年出生的 2121632 名女性，这些女性均有父母信息；选择了 25142 对同性别双胞胎和 951779 名具有全同胞的人。从与 NHIRD 相关联的台湾生物银行获得了 67882 名无关女性参与者的全基因组基因分型数据。使用具有逻辑链接函数的广义线性模型来检查个体病史、父母/全同胞/同性别双胞胎中的家族史以及 MDD 的多基因风险评分（PRS）与妇科疾病风险之间的关联；广义估计方程用于考虑数据的非独立性。父母双方均患有 MDD 与四种妇科疾病相关，其关联程度高于任何一方患病；母亲 MDD 的关联程度高于父亲 MDD。MDD 患者的全同胞患四种妇科疾病的风险较高；MDD 患者的同性别双胞胎与痛经和 PCOS 的关联更大。MDD 的 PRS 与痛经和子宫内膜异位症有关。在 MDD 和四种妇科疾病同时发生时观察到家族聚集。MDD 和痛经以及子宫内膜异位症之间存在共同的多基因易感性。有 MDD 患病亲属或 MDD PRS 较高的个体应监测妇科疾病。
