PDF(Pubmed)
Abstract：
Determine the risk of autoimmune disease in research-identified cases of autism spectrum disorder (ASD) compared with referents using a longitudinal, population-based birth cohort.
ASD incident cases were identified from a population-based birth cohort of 31,220 individuals. Inclusive ASD definition based on DSM-IV-TR autistic disorder, Asperger syndrome, and pervasive developmental disorder, not otherwise specified, was used to determine ASD cases. For each ASD case, 2 age- and sex-matched referents without ASD were identified. Diagnosis codes assigned between birth and December 2017 were electronically obtained. Individuals were classified as having an autoimmune disorder if they had at least 2 diagnosis codes more than 30 days apart. Cox proportional hazards models were fit to estimate the hazard ratio (HR) between ASD status and autoimmune disorder.
Of 1014 ASD cases, 747 (73.7%) were male. Fifty ASD cases and 59 of the 1:2 matched referents were diagnosed with first autoimmune disorder at the median age of 14 and 17.1 years, respectively. ASD cases had increased risk of autoimmune disease compared with matched referents (HR 1.74; 95% confidence interval [CI], 1.21-2.52). The increased risk was statistically significant among male patients (HR 2.01; 95% CI, 1.26-3.21) but not among the smaller number of female subjects (HR 1.38; 95% CI, 0.76-2.50).
This study provides evidence from a longitudinal, population-based birth cohort for co-occurrence of ASD and autoimmune disorders. Thus, children with ASD should be monitored for symptoms of autoimmune disease and appropriate workup initiated.
ASD incident cases were identified from a population-based birth cohort of 31,220 individuals. Inclusive ASD definition based on DSM-IV-TR autistic disorder, Asperger syndrome, and pervasive developmental disorder, not otherwise specified, was used to determine ASD cases. For each ASD case, 2 age- and sex-matched referents without ASD were identified. Diagnosis codes assigned between birth and December 2017 were electronically obtained. Individuals were classified as having an autoimmune disorder if they had at least 2 diagnosis codes more than 30 days apart. Cox proportional hazards models were fit to estimate the hazard ratio (HR) between ASD status and autoimmune disorder.
Of 1014 ASD cases, 747 (73.7%) were male. Fifty ASD cases and 59 of the 1:2 matched referents were diagnosed with first autoimmune disorder at the median age of 14 and 17.1 years, respectively. ASD cases had increased risk of autoimmune disease compared with matched referents (HR 1.74; 95% confidence interval [CI], 1.21-2.52). The increased risk was statistically significant among male patients (HR 2.01; 95% CI, 1.26-3.21) but not among the smaller number of female subjects (HR 1.38; 95% CI, 0.76-2.50).
This study provides evidence from a longitudinal, population-based birth cohort for co-occurrence of ASD and autoimmune disorders. Thus, children with ASD should be monitored for symptoms of autoimmune disease and appropriate workup initiated.
摘要：
目的：确定研究确定的自闭症谱系障碍（ASD）病例中自身免疫性疾病的风险，基于人口的出生队列。
方法：ASD事件病例来自31,220例基于人群的出生队列。基于DSM-IV-TR自闭症的包容性ASD定义，阿斯伯格综合症,和广泛性发育障碍，未指定，用于确定ASD病例。对于每个ASD案例，确定了2个没有ASD的年龄和性别匹配的参考对象。从出生到2017年12月之间分配的诊断代码是通过电子方式获得的。如果个体相隔30天以上有至少2个诊断代码，则将其归类为患有自身免疫性疾病。Cox比例风险模型适用于评估ASD状态和自身免疫性疾病之间的风险比（HR）。
结果：在1014例ASD病例中，747（73.7%）为男性。50例ASD病例和59例1：2匹配的对象在14岁和17.1岁的中位年龄被诊断为首次自身免疫性疾病。分别。与匹配的参照者相比，ASD病例自身免疫性疾病的风险增加(HR1.74;95%置信区间[CI]，1.21-2.52)。男性患者的风险增加具有统计学意义（HR2.01;95％CI，1.26-3.21），但女性受试者人数较少（HR1.38;95％CI，0.76-2.50）。
结论：这项研究提供了纵向证据，ASD和自身免疫性疾病并发发生的基于人群的出生队列。因此，应监测ASD患儿的自身免疫性疾病症状,并开始适当的检查.
方法：ASD事件病例来自31,220例基于人群的出生队列。基于DSM-IV-TR自闭症的包容性ASD定义，阿斯伯格综合症,和广泛性发育障碍，未指定，用于确定ASD病例。对于每个ASD案例，确定了2个没有ASD的年龄和性别匹配的参考对象。从出生到2017年12月之间分配的诊断代码是通过电子方式获得的。如果个体相隔30天以上有至少2个诊断代码，则将其归类为患有自身免疫性疾病。Cox比例风险模型适用于评估ASD状态和自身免疫性疾病之间的风险比（HR）。
结果：在1014例ASD病例中，747（73.7%）为男性。50例ASD病例和59例1：2匹配的对象在14岁和17.1岁的中位年龄被诊断为首次自身免疫性疾病。分别。与匹配的参照者相比，ASD病例自身免疫性疾病的风险增加(HR1.74;95%置信区间[CI]，1.21-2.52)。男性患者的风险增加具有统计学意义（HR2.01;95％CI，1.26-3.21），但女性受试者人数较少（HR1.38;95％CI，0.76-2.50）。
结论：这项研究提供了纵向证据，ASD和自身免疫性疾病并发发生的基于人群的出生队列。因此，应监测ASD患儿的自身免疫性疾病症状,并开始适当的检查.
