| 1. |
- Leone, Marica, et al.
(författare)
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FAMILIAL LIABILITY FOR ENDOCRINE-METABOLIC DISORDERS AND DEPRESSION
- 2021
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Ingår i: European Neuropsychopharmacology. - : Elsevier. - 0924-977X .- 1873-7862. ; 51, s. e112-e112
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Endocrine-metabolic disorders are common in individuals with depression. Better understanding of the underlying factors contributing to their concomitant occurrence is needed. This study investigates the familial co-aggregation of depression and endocrine-metabolic disorders and estimates the contribution of genetic and environmental risk factors to their co-occurrence.Methods: We conducted a population-based cohort study using Swedish national data. A total of 2,263,311 individuals born between 1973 and 1996 were included and followed up until death, emigration, or December 31, 2013, whichever occurred first. Each participant was linked to their biological parents, allowing identification of full-, maternal half-, and paternal half-siblings. We investigated clinical diagnoses of depression and endocrine-metabolic disorders diagnosed at any point during the follow-up period, grouping the latter into autoimmune disorders (i.e., hypothyroidism, Graves’ disease, and type 1 diabetes) and non-autoimmune disorders (i.e., type 2 diabetes, obesity, and polycystic ovarian syndrome). Logistic regression and Cox proportional hazards regression were used to estimate the association between endocrine-metabolic disorders and depression within the same individual and across siblings. Quantitative genetic modeling was performed to investigate the relative contribution of genetic and environmental influences.Results: Individuals diagnosed with endocrine-metabolic disorders had significantly higher risk of depression, with odds ratios ranging from 1.43 [95% CI, 1.30-1.57] for Graves’ disease to 2.44 [2.37-2.50] for obesity. Overall, increased risks extended to full- and half-siblings. Quantitative genetic modeling showed that shared genetic factors explained the phenotypic correlations between endocrine-metabolic disorders and depression to different extents (ranging from 36% for autoimmune hypothyroidism, to 74% for obesity), except for type 1 diabetes, for which the association was mainly explained by non-shared environmental factors (84%).Discussion: Endocrine-metabolic disorders and depression co-occur in individuals and display familial co-aggregation. Shared genetic risk factors explained much of this relationship, but unique environmental influences also contributed significantly. These findings expand the current knowledge of the etiological sources of comorbidity between somatic and psychiatric disorders, which could guide future research aiming at identifying the pathophysiological mechanisms and potentially intervention targets.
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| 2. |
- Leone, Marica, et al.
(författare)
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Genetic and Environmental Contribution to the Co-Occurrence of Endocrine-Metabolic Disorders and Depression : A Nationwide Swedish Study of Siblings
- 2022
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Ingår i: American Journal of Psychiatry. - : HighWire Press. - 0002-953X .- 1535-7228. ; 179:11, s. 824-832
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Depression is common in individuals with endocrine-metabolic disorders and vice versa, and a better understanding of the underlying factors contributing to the comorbidity of these disorders is needed. This study investigated the familial coaggregation of depression and endocrine-metabolic disorders and estimated the contribution of genetic and environmental factors to their co-occurrence.METHODS: This population-based cohort study included 2.2 million individuals born in Sweden between 1973 and 1996, with follow-up through 2013. Participants were linked to their biological parents, allowing identification of full siblings, maternal half siblings, and paternal half siblings. Diagnoses of depression and endocrine-metabolic conditions were investigated, with the latter grouped into autoimmune disorders (autoimmune hypothyroidism, Graves' disease, and type 1 diabetes) and non-autoimmune disorders (type 2 diabetes, obesity, and polycystic ovary syndrome). Logistic regression and Cox regression were used to estimate the associations between endocrine-metabolic disorders and depression within the same individual and across siblings. Quantitative genetic modeling was performed to investigate the relative contribution of genetic and environmental influences.RESULTS: Individuals with endocrine-metabolic disorders had a significantly higher risk of depression, with odds ratios ranging from 1.43 (95% CI=1.30, 1.57) for Graves' disease to 3.48 (95% CI=3.25, 3.72) for type 2 diabetes. Increased risks extended to full and half siblings. These correlations were mainly explained by shared genetic influences for non-autoimmune conditions, and by nonshared environmental factors for autoimmune disorders, especially for type 1 diabetes.CONCLUSIONS: These findings provide phenotypic and etiological insights into the co-occurrence of depression and various endocrine-metabolic conditions, which could guide future research aiming at identifying pathophysiological mechanisms and intervention targets.
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| 3. |
- Liu, Shengxin, et al.
(författare)
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Age-related physical health of older autistic adults in Sweden : a longitudinal, retrospective, population-based cohort study
- 2023
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Ingår i: The lancet. Healthy longevity. - : Elsevier. - 2666-7568. ; 4:7, s. e307-e315
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Research of health outcomes in older autistic adults (≥45 years) is concerningly scarce, and little is known about whether intellectual disability and sex affect the health outcomes of this population. The aim of this study was to investigate the association between autism and physical health conditions in older adults and to examine these associations by intellectual disability and sex.METHODS: We conducted a longitudinal, retrospective, population-based cohort study of the Swedish population born between Jan 1, 1932, and Dec 31, 1967, using linked data from the nationwide Total Population Register and the National Patient Register. We excluded individuals who died or emigrated before the age of 45 years, or with any chromosomal abnormalities. Follow-up started at age 45 years for all individuals, and ended at emigration, death, or Dec 31, 2013 (the latest date of available follow-up), whichever was soonest. Diagnoses of autism, intellectual disability, 39 age-related physical conditions, and five types of injury (outcomes) were obtained from the National Patient Register. For each outcome, we calculated 25-year cumulative incidence and used Cox models to estimate hazard ratios (HRs). All analyses were repeated separately by intellectual disability and sex.FINDINGS: Of 4 200 887 older adults (2 063 718 women [49·1%] and 2 137 169 men [50·9%]) in the study cohort, 5291 (0·1%) had a diagnosis of autism recorded in the National Patient Register. Older autistic adults (median follow-up 8·4 years [IQR 4·2-14·6]) had higher cumulative incidence and HRs of various physical conditions and injuries than their non-autistic counterparts (median follow-up 16·4 years [8·2-24·4]). In autistic individuals, the highest cumulative incidence was observed for bodily injuries (50·0% [95% CI 47·6-52·4]). Conditions that autistic adults were at higher risk of than were non-autistic adults included heart failure (HR 1·89 [95% CI 1·61-2·22]), cystitis (2·03 [1·66-2·49]), glucose dysregulation (2·96 [2·04-4·29]), iron deficiency anaemia (3·12 [2·65-3·68]), poisoning (4·63 [4·13-5·18]), and self-harm (7·08 [6·24-8·03]). These increased risks mainly persisted regardless of intellectual disability or sex.INTERPRETATION: Our data indicate that older autistic adults are at substantially increased risk of age-related physical conditions and injuries compared with non-autistic adults. These findings highlight the need for collaborative efforts from researchers, health services, and policy makers to provide older autistic individuals with the necessary support to attain healthy longevity and a high quality of life.
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| 4. |
- Liu, Shengxin
(författare)
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Comorbidity between neurodevelopmental disorders and childhood-onset type 1 diabetes
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Childhood-onset type 1 diabetes and neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, and intellectual disability, globally represent substantial health challenges. Each condition places a substantial challenge on the individuals, their families, and healthcare systems. The comorbidity between these two types of disorders has been a research focus, with findings suggesting a higher prevalence of neurodevelopmental disorders among individuals with childhood-onset type 1 diabetes. However, the underlying mechanism of this comorbidity remains largely unknown, and the potential alteration in the health and socio-economic outcomes due to this comorbidity remains unexplored. This thesis aimed to elucidate the potential mechanisms behind the comorbidity between childhood-onset type 1 diabetes and neurodevelopmental disorders and explore its impact on health and education outcomes, with the goal of improving early detection, prevention, and management strategies to enhance the quality of life for the affected children and adolescents. In Study I, we examined the impact of childhood-onset type 1 diabetes and the role of glycemic control on the risk of subsequent neurodevelopmental disorders. We found that individuals with childhood-onset type 1 diabetes had a higher risk of developing neurodevelopmental disorders than the general population. Notably, this risk was highest among those with less optimal glycemic control. These findings provided insight into the role of glycemic control, a crucial diabetes-related factor, in the occurrence of comorbidity between childhood-onset type 1 diabetes and neurodevelopmental disorders. In Study II, we investigated the potential contribution from shared familial liability to the comorbidity between childhood-onset type 1 diabetes and neurodevelopmental disorders. We found that the elevated risk of neurodevelopmental disorders did not only appear in individuals with childhood-onset type 1 diabetes but also in their full-siblings. The general family co-aggregation pattern and the results of the quantitative genetic modeling, however, did not conclusively show that familial liability contributes to the comorbidity. This ambiguity underscores the need for subsequent research to further elucidate the underlying causes of this comorbidity. In Study III, we explored the impacts of neurodevelopmental disorders on long-term glycemic control and the risk of diabetic complications in individuals with childhoodonset type 1 diabetes. We found that neurodevelopmental disorders, particularly ADHD and intellectual disability, were associated with increased risk of poor glycemic control and diabetic complications such as nephropathy and retinopathy. These observations highlight that taking neurodevelopmental aspects into account can be crucial when designing interventions and follow-ups for individuals with childhood-onset type 1 diabetes. In Study IV, evaluated the interplay between childhood-onset type 1 diabetes, ADHD, and academic outcomes, spanning from compulsory education to university levels. We found that children and adolescents with both type 1 diabetes and ADHD were significantly less likely to achieve educational milestones, crossing different education levels, and had less favorable compulsory school performances compared to their peers without these conditions. These results underline the importance of providing targeted support to minimize the educational gap between the affected children and adolescents and their peers.
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| 5. |
- Liu, Shengxin, et al.
(författare)
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Early-Onset Type 2 Diabetes and Mood, Anxiety, and Stress-Related Disorders: A Genetically Informative Register-Based Cohort Study.
- 2022
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Ingår i: Diabetes care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 45:12, s. 2950-2956
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Tidskriftsartikel (refereegranskat)abstract
- To assess the association and familial coaggregation between early-onset type 2 diabetes (diagnosed before age 45 years) and mood, anxiety, and stress-related disorders and estimate the contribution of genetic and environmental factors to their co-occurrence.This population-based cohort study included individuals born in Sweden during 1968-1998, from whom pairs of full siblings, half-siblings, and cousins were identified. Information on diagnoses of early-onset type 2 diabetes and mood (including unipolar depression and bipolar disorder), anxiety, and stress-related disorders was obtained from the National Patient Register. Logistic and Cox regression models were used to assess the phenotypic association and familial coaggregation between type 2 diabetes and psychiatric disorders. Quantitative genetic modeling was conducted in full and maternal half-sibling pairs to estimate the relative contributions of genetic and environmental factors to the association.Among a total of 3,061,192 individuals, 7,896 (0.3%) were diagnosed with early-onset type 2 diabetes. These individuals had higher risks of any diagnosis (odds ratio [OR] 3.62 [95% CI 3.44, 3.80]) and specific diagnosis of unipolar depression (3.97 [3.75, 4.22]), bipolar disorder (4.17 [3.68, 4.73]), anxiety (3.76 [3.54, 3.99]), and stress-related disorders (3.35 [3.11, 3.61]). Relatives of individuals with early-onset type 2 diabetes also had higher overall risks of the examined psychiatric disorders (ORs 1.03-1.57). These associations are largely explained by genetic factors (51-78%), with the rest explained by nonshared environmental factors.Our findings highlight the burden of mood, anxiety, and stress-related disorders in early-onset type 2 diabetes and demonstrate that shared familial liability may contribute to their co-occurrence, suggesting that in the future research investigators should aim to identify shared risk factors and ultimately refine preventive and intervention strategies.
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| 6. |
- Liu, Shengxin, et al.
(författare)
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Psychotropic Medication Use in Children and Adolescents With Type 1 Diabetes
- 2023
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 6:10
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: Children and adolescents with type 1 diabetes (T1D) face elevated risks of psychiatric disorders. Despite their nonnegligible adverse effects, psychotropic medications are a common cost-effective approach to alleviating psychiatric symptoms, but evidence regarding their dispensation to children and adolescents with T1D remains lacking. OBJECTIVE: To examine the trends and patterns of psychotropic medication dispensation among children and adolescents with T1D in Sweden between 2006 and 2019.DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from multiple Swedish registers. The main study cohort included children and adolescents residing in Sweden from 2006 to 2019 and was followed up until the earliest of December 31, 2019, 18th birthday, emigration, or death. Data analyses were conducted from November 1, 2022, to April 30, 2023.EXPOSURES: Type 1 diabetes.MAIN OUTCOMES AND MEASURES: The primary outcomes were trends and patterns of psychotropic medication dispensation (including antipsychotics, antidepressants, anxiolytics, hypnotics, mood stabilizers, and medications for attention-deficit/hyperactivity disorder [ADHD]), psychotropic medication initiation, and history of neurodevelopmental and psychiatric diagnosis. Cumulative incidence curves and Cox proportional hazard models were used to estimate the aggregated incidence and hazard ratios of medication initiation after diabetes onset. RESULTS: Of 3 723 745 children and adolescents (1 896 199 boys [50.9%]), 13 200 (0.4%; 7242 boys [54.9%]) had T1D (median [IQR] age at diagnosis, 11.1 [7.6-14.7] years). Between 2006 and 2019, psychotropic medication dispensation increased from 0.85% (95% CI, 0.65%-1.10%) to 3.84% (3.11%-4.69%) among children and from 2.72% (95% CI, 2.15%-3.39%) to 13.54% (95% CI, 12.88%-14.23%) among adolescents with T1D, consistently higher than their peers without T1D. The most commonly dispensed medications included hypnotics, ADHD medications, anxiolytics, and selective serotonin reuptake inhibitors, and all exhibited increasing trends. For those with T1D, psychiatric care was the primary prescription source, and up to 50.1% of treatments lasted more than 12 months. In addition, children and adolescents with T1D showed higher cumulative incidence and hazard ratios of medication initiation after diabetes onset than their same-age and same-sex counterparts.CONCLUSIONS AND RELEVANCE: This cohort study found an increasing trend in psychotropic medication dispensation among children and adolescents with T1D from 2006 to 2019, persistently higher than those without T1D. These findings call for further in-depth investigations into the benefits and risks of psychotropic medications within this population and highlight the importance of integrating pediatric diabetes care and mental health care for early detection of psychological needs and careful monitoring of medication use.
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| 7. |
- Lyu, Yezhe, 1987-, et al.
(författare)
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Effect of Tin on Microstructure and Mechanical Properties of Compacted Graphite Iron
- 2015
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Ingår i: International Journal of Cast Metals Research. - : Maney Publishing. - 1364-0461 .- 1743-1336. ; 28:5, s. 263-268
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Tidskriftsartikel (refereegranskat)abstract
- This experiment investigated the effect of tin in an amount up to 0.121 wt.% on the microstructure and mechanical properties of compacted graphite iron (CGI). Graphite and matrix evolution was emphasized with the help of scanning electron microscopy. The results indicate that Sn in experimental range reduces graphite size. Pearlite quantity would increase with the increasing Sn and reaches over 95% when Sn is greater than 0.057 wt.%. Sn helps to narrow the lamellar spacing of pearlite from sorbitic pearlite (320 nm) to troostitic pearlite (83 nm) when Sn increases from 0.003 wt.% to 0.057 wt.%. Appropriate Sn addition promotes the tensile strength and impact toughness and the samples containing 0.057 wt.% Sn perform the highest values of 410.7 MPa and 9.11 J/cm2, respectively. Elongation declines with increasing Sn content because of the emergence of more pearlite. Samples containing excessive Sn experience sharply deterioration in mechanical properties due brittle cementite.
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| 8. |
- Påhlsson-Notini, Andreas, et al.
(författare)
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Substance use-related problems in mild intellectual disability : A Swedish nationwide population-based cohort study with sibling comparison
- 2024
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Ingår i: JCPP Advances. - : John Wiley & Sons. - 2692-9384. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Evidence for substance use-related problems in individuals with mild intellectual disability is sparse and mainly limited to selected psychiatric populations. We evaluated the risk of substance use-related problems in individuals with mild intellectual disability compared to the general population. Additionally, we have performed secondary sibling comparison analyses to account for familial confounding.METHODS: We conducted a population-based cohort study of individuals born in Sweden between 1973 and 2003. A total of 18,307 individuals with mild intellectual disability were compared to 915,350 reference individuals from the general population and 18,996 full siblings of individuals with mild intellectual disability. Information on mild intellectual disability and substance use-related problems was obtained from several Swedish national and regional school and healthcare registers. Substance use-related problems were measured via corresponding diagnostic and legal codes and included alcohol use disorder, drug use disorder, alcohol-related somatic disease, conviction for a substance-related crime, and substance-related death.RESULTS: Individuals with mild intellectual disability had a higher risk of any substance use-related problem compared to the general population (HR, 1.81; 95% CI, 1.72-1.91), both in males (HR, 1.76; 95% CI, 1.65-1.89) and females (HR, 1.89; 95% CI, 1.74-2.05). The risks of substance use-related problems were particularly elevated among individuals with mild intellectual disability and psychiatric comorbidities (HR, 2.21-8.24). The associations were attenuated in the sibling comparison models.CONCLUSIONS: Individuals with mild intellectual disability, especially those with psychiatric comorbidity, are at an elevated risk of substance use-related problems. Familial factors shared by full siblings contribute considerably to the association between mild intellectual disability and substance use-related problems.
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