Kendler K S, Prescott C A
Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0126, USA.
Br J Psychiatry. 1998 Oct;173:345-50. doi: 10.1192/bjp.173.4.345.
Although cocaine use in women has increased substantially over the past half-century, we understand little about the aetiology in women of cocaine use and abuse, and know almost nothing about the role of genetic factors.
We obtained by telephone interview a history of lifetime cocaine use, abuse and dependence from 1934 individual twins from female-female pairs ascertained through a population-based registry, including both members of 485 monozygotic (MZ) and 335 dizygotic (DZ) pairs.
The prevalence of lifetime cocaine use, abuse and dependence were 14.0%, 3.3% and 2.3%. Probandwise concordance rates, in MZ and DZ twins, respectively, were: cocaine use 54% and 42%; cocaine abuse 47% and 8% and cocaine dependence 35% and 0%. In MZ and DZ twins, odds ratios were: cocaine use 14.2 and 6.7 and cocaine abuse 40.8 and 2.7. Biometrical model-fitting suggested that twin resemblance for liability to cocaine use was due to both genetic and familial-environmental factors while twin resemblance for cocaine abuse and symptoms of dependence was due solely to genetic factors. Estimated heritabilities were: cocaine use 0.39, cocaine abuse 0.79 and symptoms of dependence 0.65.
The vulnerability to cocaine use and particularly cocaine abuse and dependence in women is substantially influenced by genetic factors.
尽管在过去半个世纪中，女性使用可卡因的情况大幅增加，但我们对女性使用和滥用可卡因的病因了解甚少，对遗传因素的作用几乎一无所知。
通过电话访谈，我们从基于人群登记系统确定的1934对女性双胞胎中获取了她们一生使用、滥用和依赖可卡因的病史，其中包括485对同卵双胞胎（MZ）和335对异卵双胞胎（DZ）的两名成员。
一生使用、滥用和依赖可卡因的患病率分别为14.0%、3.3%和2.3%。在同卵双胞胎和异卵双胞胎中，先证者一致率分别为：使用可卡因54%和42%；滥用可卡因47%和8%；依赖可卡因35%和0%。在同卵双胞胎和异卵双胞胎中，优势比分别为：使用可卡因14.2和6.7；滥用可卡因40.8和2.7。生物统计学模型拟合表明，双胞胎在使用可卡因易感性方面的相似性归因于遗传因素和家庭环境因素，而在滥用可卡因和依赖症状方面的相似性仅归因于遗传因素。估计的遗传度分别为：使用可卡因0.39，滥用可卡因0.79，依赖症状0.65。
女性对使用可卡因，尤其是滥用和依赖可卡因的易感性受遗传因素的显著影响。
