在有物质使用障碍的个体中诊断并发症的时间的社会和多基因危险因素:一种全现象生存分析
Peter B Barr1,2,3,4, Zoe E Neale1,2,4, Tim B Bigdeli1,2,4,5
1SUNY Downstate Health Sciences University, Department of Psychiatry and Behavioral Sciences.
medRxiv : the preprint server for health sciences
|December 23, 2024
概括
收入等社会决定因素显著影响物质使用障碍 (SUD) 风险. 多基因分数 (PGS) 可以预测SUD并发症的时间和严重程度.
科学领域:
- 基因组学就是基因组学.
- 公共卫生 公共卫生
- 精神病学是一个精神病学.
背景情况:
- 药物使用障碍 (SUD) 经常与精神和身体健康状况同时发生.
- 电子健康记录 (EHR) 和全现象关联研究 (PheWAS) 已被用于探索这些重叠,但分析通常是横截面的.
- 了解风险因素和并发症诊断之间的时间关系对于有效干预至关重要.
研究的目的:
- 研究健康的社会决定因素和遗传风险因素与SUD患者共患病诊断的时间之间的关联.
- 用EHR和全基因组测序数据来描述与社会决定因素相关的SUD终身风险.
- 为了检查多基因分数 (PGS) 的预测价值,用于初始SUD诊断后的并发症诊断的时间.
主要方法:
- 利用了来自我们所有人研究计划的EHR和全基因组测序数据 (N = 287,012).
- 在被诊断为SUD的个体中进行了生存分析 (N = 17,460),以评估PGS与共发病诊断的时间之间的关联.
- 采用全现象生存分析来评估各种风险因素和诊断时间表之间的关系.
主要成果:
- 在社会和人口风险因素和终身SUD诊断之间发现了显著的关联,收入<10K美元增加了4.5倍的几率 (OR = 4.48).
- 酒精使用障碍,精神分裂症和PTSD的多基因分数与各自诊断的时间有关 (HRs从1.10到1.15不等).
- 持续吸烟的多基因分数与随后吸烟相关的并发症和额外的SUD诊断的时间有关 (HR = 1.16).
结论:
- 社会决定因素,特别是收入,在SUD的终身风险中发挥着重要作用.
- 多基因分数为超出初始风险的结果提供了有价值的见解,包括并发性疾病的时间和严重程度.
- 这些发现突出了SUD及其伴随性疾病中社会和遗传因素的复杂相互作用,为未来的研究和临床实践提供了信息.
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