Holmberg Anna, Pol-Fuster Josep, Kuja-Halkola Ralf, Larsson Henrik, Lichtenstein Paul, Chang Zheng, D'Onofrio Brian M, Brikell Isabell, Sidorchuk Anna, Isomura Kayoko, Crowley James J, Martinsson Lina, Rück Christian, Mataix-Cols David, Fernández de la Cruz Lorena
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
BMJ Ment Health. 2025 Jan 19;28(1):e301323. doi: 10.1136/bmjment-2024-301323.
Obsessive-compulsive disorder (OCD) is associated with an increased risk of morbidity and mortality due to cardiometabolic disorders. Whether this association is driven by familial factors is unknown. This population-based family study explored the familial co-aggregation of OCD and cardiometabolic disorders.
We identified 6 049 717 individuals born in Sweden between 1950 and 2008, including 50 212 individuals with OCD, and followed them up to 2020. These individuals were linked to their mothers, fathers, full siblings, maternal and paternal half siblings, aunts, uncles and cousins. We estimated the risk of cardiovascular diseases (CVD) and metabolic disorders (including obesity, type 2 diabetes and hyperlipidaemia), comparing the relatives of probands with and without OCD. Cox proportional hazards regression models, incorporating time-varying exposures, estimated HRs.
OCD was associated with an increased risk of CVD (HR 1.47; 95% CI 1.43 to 1.51), obesity (HR 1.69; 95% CI 1.63 to 1.74), type 2 diabetes (HR 2.01; 95% CI 1.90 to 2.12) and hyperlipidaemia (HR 1.42; 95% CI 1.33 to 1.52). The relatives of probands with OCD exhibited small increased risks of CVD (HRs from 1.01 to 1.11) and obesity (HRs from 1.03 to 1.20). Slightly increased risks for type 2 diabetes were observed in mothers (HR 1.11; 95% CI 1.07 to 1.15) and full siblings (HR 1.12; 95% CI 1.05 to 1.20), while for hyperlipidaemia it was only observed in mothers (HR 1.06; 95% CI 1.02 to 1.10).
Our results do not support a major contribution of familial factors to the association between OCD and cardiometabolic disorders, suggesting a more prominent role of unique environmental factors.
强迫症（OCD）与因心血管代谢紊乱导致的发病和死亡风险增加有关。这种关联是否由家族因素驱动尚不清楚。这项基于人群的家族研究探讨了强迫症与心血管代谢紊乱的家族共聚集情况。
我们确定了1950年至2008年在瑞典出生的6049717人，其中包括50212名强迫症患者，并对他们随访至2020年。这些人与他们的母亲、父亲、亲兄弟姐妹、同父异母或同母异父的兄弟姐妹、姑姑、叔叔和表亲建立了联系。我们估计了心血管疾病（CVD）和代谢紊乱（包括肥胖、2型糖尿病和高脂血症）的风险，比较了有强迫症和无强迫症先证者的亲属。采用纳入随时间变化暴露因素的Cox比例风险回归模型估计风险比（HR）。
强迫症与心血管疾病风险增加相关（HR 1.47；95%置信区间1.43至1.51）、肥胖（HR 1.69；95%置信区间1.63至1.74）、2型糖尿病（HR 2.01；95%置信区间1.90至2.12）和高脂血症（HR 1.42；95%置信区间1.33至1.52）。有强迫症先证者的亲属患心血管疾病（HR为1.01至1.11）和肥胖（HR为1.03至1.20）的风险略有增加。在母亲（HR 1.11；95%置信区间1.07至1.15）和亲兄弟姐妹（HR 1.12；95%置信区间1.05至1.20）中观察到2型糖尿病风险略有增加，而高脂血症仅在母亲中观察到（HR 1.06；95%置信区间1.02至1.10）。
我们的结果不支持家族因素对强迫症与心血管代谢紊乱之间关联的主要贡献，提示独特环境因素的作用更为突出。
