父母患有酒精相关肝病的后代的不良健康后果:丹麦全国队列研究。

IF 15.8 1区 医学 Q1 Medicine PLoS Medicine Pub Date : 2024-10-23 eCollection Date: 2024-10-01 DOI:10.1371/journal.pmed.1004483
Peter Jepsen, Joe West, Anna Kirstine Kjær Larsen, Anna Emilie Kann, Frederik Kraglund, Joanne R Morling, Colin Crooks, Gro Askgaard
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引用次数: 0

摘要

背景:父母酗酒会对后代造成伤害。父母被诊断患有酒精相关肝病(ALD)可能是对后代进行预防干预的一个机会。我们调查了后代一生中出现不良健康后果的风险,以及这些风险与父母教育水平和 ALD 诊断之间的关系:我们利用全国范围内的健康登记来识别 1996 年至 2018 年丹麦被诊断为 ALD 的父母的后代以及年龄和性别匹配的比较者(20:1)。我们估算了总体和社会经济阶层中不良健康结果的医院接触发病率比(IRR)。我们采用自控设计来研究父母确诊 ALD 后的第一年是否更有可能出现健康后果。在父母患有 ALD 的 60,804 名后代中,15 岁至 60 岁期间因精神疾病、中毒、骨折或受伤、酒精特异性诊断、其他药物滥用和死亡而接触医院的发生率均高于比较者。与社会经济地位高的人相比,社会经济地位低的人的后代的相关性更强:父母一方为小学文化程度的 ALD 患者,其后代因中毒入院的 IRR 为 2.2,而父母一方为受过高等教育的 ALD 患者,其后代因中毒入院的 IRR 为 1.0。在父母被诊断为 ALD 后的一年内,后代因精神疾病和中毒入院的风险增加。例如,在首次因精神疾病入院的 13-25 岁后代中,父母确诊 ALD 后第一年与其他时间相比的 IRR 为 1.29(95% CI 1.13,1.47)。主要的局限性是无法纳入不涉及医院接触的不良健康结果:结论:父母患有 ALD 的后代在其父母被诊断为 ALD 后不久,其心理健康状况不佳和自残等健康后果的发生率会长期升高。教育程度低的父母的后代尤其容易受到影响。这项研究强调了在父母因 ALD 住院治疗时向后代进行宣传的机会。
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Adverse health outcomes in offspring of parents with alcohol-related liver disease: Nationwide Danish cohort study.

Background: Parental drinking can cause harm to the offspring. A parent's diagnosis of alcohol-related liver disease (ALD) might be an opportunity to reach offspring with preventive interventions. We investigated offspring risk of adverse health outcomes throughout life, their association with their parent's educational level and diagnosis of ALD.

Methods and findings: We used nationwide health registries to identify offspring of parents diagnosed with ALD in Denmark 1996 to 2018 and age- and sex-matched comparators (20:1). We estimated the incidence rate ratios (IRRs) of hospital contacts with adverse health outcomes, overall and in socioeconomic strata. We used a self-controlled design to examine whether health outcomes were more likely to occur during the first year after the parent's ALD diagnosis. The 60,804 offspring of parents with ALD had a higher incidence rate of hospital contacts from age 15 to 60 years for psychiatric disease, poisoning, fracture or injury, alcohol-specific diagnoses, other substance abuse, and of death than comparators. Associations were stronger for offspring with low compared to high socioeconomic position: The IRR for admission due to poisoning was 2.2 versus 1.0 for offspring of an ALD parent with a primary level versus a highly educated ALD parent. Offspring had an increased risk for admission with psychiatric disease and poisoning in the year after their parent's ALD diagnosis. For example, among offspring whose first hospital contact with psychiatric disease was at age 13 to 25 years, the IRR in the first year after their parent's ALD diagnosis versus at another time was 1.29 (95% CI 1.13, 1.47). Main limitation was inability to include adverse health outcomes not involving hospital contact.

Conclusions: Offspring of parents with ALD had a long-lasting higher rate of health outcomes associated with poor mental health and self-harm that increased shortly after their parent's diagnosis of ALD. Offspring of parents of low educational level were particularly vulnerable. This study highlights an opportunity to reach out to offspring in connection with their parent's hospitalization with ALD.

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来源期刊
PLoS Medicine
PLoS Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
17.60
自引率
0.60%
发文量
227
审稿时长
4-8 weeks
期刊介绍: PLOS Medicine is a prominent platform for discussing and researching global health challenges. The journal covers a wide range of topics, including biomedical, environmental, social, and political factors affecting health. It prioritizes articles that contribute to clinical practice, health policy, or a better understanding of pathophysiology, ultimately aiming to improve health outcomes across different settings. The journal is unwavering in its commitment to uphold the highest ethical standards in medical publishing. This includes actively managing and disclosing any conflicts of interest related to reporting, reviewing, and publishing. PLOS Medicine promotes transparency in the entire review and publication process. The journal also encourages data sharing and encourages the reuse of published work. Additionally, authors retain copyright for their work, and the publication is made accessible through Open Access with no restrictions on availability and dissemination. PLOS Medicine takes measures to avoid conflicts of interest associated with advertising drugs and medical devices or engaging in the exclusive sale of reprints.
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