背景:遗传和生活方式因素在双相情感障碍(BD)发展中的相互作用仍不清楚。
方法:对来自英国生物银行的365,517名参与者进行了队列研究。生活方式得分,基于吸烟,身体活动,饮食,酒精消费,久坐的行为,睡眠持续时间,和社会接触,被分组为有利(得分6-7),中级(分数4-5),或不利(得分0-3)。BD多基因风险评分(PRS)也被归类为高,中间,和使用PRS三元率的低风险人群。Cox回归模型确定了BD的风险比(HR)和95%置信区间(CI)。
结果:在12.9年的随访中,529人患有BD。比较那些有良好生活方式的人和那些有不利参与者的人,发展中BD的HR为3.28(95%CI,2.76-3.89)。同样,与低PRS患者相比,高PRS患者的风险为3.20(95%CI,2.83-3.63).值得注意的是,与PRS低且生活方式良好的个体相比,PRS高且生活方式不利的个体患BD的风险显著更高(HR=6.31,95%CI,4.14~9.63).此外,PRS和生活方式之间的相互作用带来了额外的风险,相对超额风险为1.74(95%CI,0.40-3.07),归因于相互作用的比例为0.37(95%CI,0.16-0.58)。
结论:我们的研究结果表明,BD的遗传倾向,以PRS测量,和生活方式对患BD的风险有累加效应。良好的生活方式与患BD的风险降低有关。
BACKGROUND: The interplay between genetic and lifestyle factors in the development of bipolar disorder (BD) remains unclear.
METHODS: A cohort study was carried out on 365,517 participants from the UK Biobank. Lifestyle scores, based on smoking, physical activity, diet, alcohol consumption, sedentary behavior, sleep duration, and social contact, were grouped as favorable (scores 6-7), intermediate (scores 4-5), or unfavorable (scores 0-3). The BD polygenic risk score (PRS) was also categorized into high, intermediate, and low-risk groups using PRS tertiles. Cox regression models determined hazard ratios (HRs) and 95 % confidence intervals (CIs) for BD.
RESULTS: During the 12.9-year follow-up, 529 individuals developed BD. Comparing those with favorable lifestyles to those with unfavorable participants, the HR of developing BD was 3.28 (95 % CI, 2.76-3.89). Similarly, individuals with a high PRS had a risk of 3.20 (95 % CI, 2.83-3.63) compared to those with a low PRS. Notably, individuals with both a high PRS and an unfavorable lifestyle had a significantly higher risk of BD (HR = 6.31, 95 % CI, 4.14-9.63) compared to those with a low PRS and a favorable lifestyle. Additionally, the interaction between PRS and lifestyle contributed an additional risk, with a relative excess risk of 1.74 (95 % CI, 0.40-3.07) and an attributable proportion due to the interaction of 0.37 (95 % CI, 0.16-0.58).
CONCLUSIONS: Our findings suggest that genetic liability for BD, measured as PRS, and lifestyle have an additive effect on the risk of developing BD. A favorable lifestyle was associated with a reduced risk of developing BD.