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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005683naa a2200445 4500
001oai:DiVA.org:oru-71659
003SwePub
008190122s2019 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:140696297
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-716592 URI
0247 a https://doi.org/10.1001/jamaneurol.2018.42792 DOI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1406962972 URI
040 a (SwePub)orud (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Brander, Gustafu Karolinska Institutet4 aut
2451 0a Association of Tourette Syndrome and Chronic Tic Disorder With Metabolic and Cardiovascular Disorders
264 1b American Medical Association,c 2019
338 a print2 rdacarrier
500 a Funding Agencies:Tourettes Action  TALFC17Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences  340-2013-5867
520 a Importance: There are limited data concerning the risk of metabolic and cardiovascular disorders among individuals with Tourette syndrome (TS) or chronic tic disorder (CTD).Objective: To investigate the risk of metabolic and cardiovascular disorders among individuals with TS or CTD over a period of 40 years.Design, Settings, and Participants: This longitudinal population-based cohort study included all individuals living in Sweden between January 1, 1973, and December 31, 2013. Families with clusters of full siblings discordant for TS or CTD were further identified. Data analyses were conducted from August 1, 2017, to October 11, 2018.Exposures: Previously validated International Classification of Diseases diagnoses of TS or CTD in the Swedish National Patient Register.Main Outcomes and Measures: Registered diagnoses of obesity, dyslipidemia, hypertension, type 2 diabetes, and cardiovascular diseases (including ischemic heart diseases, arrhythmia, cerebrovascular diseases and transient ischemic attack, and arteriosclerosis).Results: Of the 14 045 026 individuals in the cohort, 7804 individuals (5964 males [76.4%]; median age at first diagnosis, 13.3 years [interquartile range, 9.9-21.3 years]) had a registered diagnosis of TS or CTD in specialist care. Of 2 675 482 families with at least 2 singleton full siblings, 5141 families included siblings who were discordant for these disorders. Individuals with TS or CTD had a higher risk of any metabolic or cardiovascular disorders compared with the general population (hazard ratio adjusted by sex and birth year [aHR], 1.99; 95% CI, 1.90-2.09) and sibling controls (aHR for any disorder, 1.37; 95% CI, 1.24-1.51). Specifically, individuals with TS or CTD had higher risks for obesity (aHR, 2.76; 95% CI, 2.47-3.09), type 2 diabetes (aHR, 1.67; 95% CI, 1.42-1.96), and circulatory system diseases (aHR, 1.76; 95% CI, 1.67-1.86). The risk of any cardiometabolic disorder was significantly greater in males than in females (aHR, 2.13; 95% CI, 2.01-2.26 vs aHR, 1.79; 95% CI, 1.64-1.96), as was the risk of obesity (aHR, 3.24; 95% CI, 2.83-3.70 vs aHR, 1.97; 95% CI, 1.59-2.44). The risks were already evident from childhood (the groups were significantly different by age 8 years) and were significantly reduced with the exclusion of individuals with comorbid attention-deficit/hyperactivity disorder (aHR, 1.52; 95% CI, 1.42-1.62), while excluding other comorbidities did not significantly affect the results. Compared with patients with TS or CTD who were not taking antipsychotics, patients with a longer duration of antipsychotic treatment (>1 year) had significantly lower risks of metabolic and cardiovascular disorders.Conclusions and Relevance: The findings of this study suggest that TS and CTD are associated with a substantial risk of metabolic and cardiovascular disorders. The results highlight the importance of carefully monitoring cardiometabolic health in patients with TS or CTD across the lifespan, particularly in those with comorbid attention-deficit/hyperactivity disorder.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Psykiatri0 (SwePub)302152 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Psychiatry0 (SwePub)302152 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Neurologi0 (SwePub)302072 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Neurology0 (SwePub)302072 hsv//eng
7001 a Isomura, Kayokou Karolinska Institutet4 aut
7001 a Chang, Zhengu Karolinska Institutet4 aut
7001 a Kuja-Halkola, Ralfu Karolinska Institutet4 aut
7001 a Almqvist, Catarinau Karolinska Institutet4 aut
7001 a Larsson, Henrik,d 1975-u Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden4 aut0 (Swepub:oru)hiln
7001 a Mataix-Cols, Davidu Karolinska Institutet4 aut
7001 a Fernández de la Cruz, Lorenau Karolinska Institutet4 aut
7102 a Karolinska Institutetb Institutionen för medicinska vetenskaper4 org
7730 t JAMA Neurologyd : American Medical Associationg 76:4, s. 454-461q 76:4<454-461x 2168-6149x 2168-6157
8564 u https://jamanetwork.com/journals/jamaneurology/articlepdf/2719821/jamaneurology_brander_2019_oi_180097.pdf
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-71659
8564 8u https://doi.org/10.1001/jamaneurol.2018.4279
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:140696297

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