Associations between Allergic and Autoimmune Diseases with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder within Families: A Population-Based Cohort Study
Abstract
:1. Introduction
1.1. Etiologies of Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder
1.2. Effects of Immunological Diseases on ASD and ADHD
1.3. Aim of Current Study
2. Methods
2.1. Population
2.2. Measures
2.2.1. Exposure
2.2.2. Outcomes and Covariates
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | N = 1,386,260 |
---|---|
Child’s covariates | |
Sex | |
Boys | 661,957 (47.8) |
Girls | 724,303 (52.2) |
Age | 9.7 ± 2.3 |
Disease | |
Autism spectrum disorder | 13,885 (1.0) |
Attention-deficit/hyperactivity disorder | 71,219 (5.1) |
Any allergic diseases | 756,970 (54.6) |
Asthma | 354,301 (25.6) |
Allergic rhinitis | 565,663 (40.8) |
Atopic dermatitis | 276,898 (20.0) |
Any autoimmune diseases | 3487 (0.3) |
Rheumatoid arthritis | 420 (0.03) |
Sjogren syndrome | 544 (0.04) |
Psoriasis | 2140 (0.2) |
Systemic lupus erythematosus | 440 (0.03) |
Ankylosing spondylitis | 98 (0.01) |
Mother’s covariates | |
Age of childbirth | 29.8 ± 4.7 |
Any allergic diseases | 417,840 (30.1) |
Asthma | 88,399 (6.4) |
Allergic rhinitis | 355,629 (25.7) |
Atopic dermatitis | 56,810 (4.1) |
Any autoimmune diseases | 35,930 (2.6) |
Rheumatoid arthritis | 9074 (0.7) |
Sjogren syndrome | 12,841 (0.9) |
Psoriasis | 12,752 (0.9) |
Systemic lupus erythematosus | 5941 (0.4) |
Ankylosing spondylitis | 3722 (0.3) |
Father’s covariates | |
Age of childbirth | 32.8 ± 5.3 |
Any allergic diseases | 322,019 (23.2) |
Asthma | 67,629 (4.9) |
Allergy rhinitis | 280,981 (20.3) |
Atopic dermatitis | 25,265 (1.8) |
Any autoimmune diseases | 25,247 (1.8) |
Rheumatoid arthritis | 6364 (0.5) |
Sjogren syndrome | 4177 (0.3) |
Psoriasis | 14,729 (1.1) |
Systemic lupus erythematosus | 918 (0.1) |
Ankylosing spondylitis | 11,189 (0.8) |
Within-Individual | Mother | Father | Full-Sibling | |||||
---|---|---|---|---|---|---|---|---|
aHR (95% CI) | p-Value | aHR (95% CI) | p-Value | aHR (95% CI) | p-Value | aHR (95% CI) | p-Value | |
Autism spectrum disorder | ||||||||
Any autoimmune diseases | 1.00 (0.71–1.40) | 0.977 | 1.05 (0.96–1.16) | 0.292 | 1.03 (0.92–1.17) | 0.584 | 1.00 (0.60–1.66) | 0.985 |
Rheumatoid arthritis | 1.92 (0.96–3.86) | 0.067 | 1.13 (0.94–1.37) | 0.201 | 1.03 (0.82–1.31) | 0.778 | 0.57 (0.08–4.04) | 0.571 |
Sjogren syndrome | 0.94 (0.40–2.23) | 0.890 | 1.10 (0.94–1.30) | 0.242 | 0.96 (0.70–1.31) | 0.775 | 1.15 (0.64–2.07) | 0.636 |
Psoriasis | 0.91 (0.58–1.42) | 0.666 | 0.96 (0.80–1.15) | 0.660 | 1.01 (0.86–1.18) | 0.904 | 1.09 (0.28–4.33) | 0.899 |
SLE | 0.68 (0.22–2.13) | 0.508 | 1.14 (0.90–1.44) | 0.277 | 0.95 (0.49–1.83) | 0.868 | 1.19 (1.13–1.25) | <0.001 |
Any allergic diseases | 1.67 (1.62–1.74) | <0.001 | 1.30 (1.25–1.36) | <0.001 | 1.20 (1.16–1.24) | <0.001 | 1.16 (1.09–1.24) | <0.001 |
Asthma | 1.40 (1.35–1.45) | <0.001 | 1.38 (1.30–1.46) | <0.001 | 1.16 (1.08–1.25) | <0.001 | 0.99 (0.59–1.65) | 0.969 |
Allergic rhinitis | 1.79 (1.73–1.85) | <0.001 | 1.30 (1.26–1.34) | <0.001 | 1.20 (1.16–1.24) | <0.001 | 0.57 (0.08–4.04) | 0.571 |
Atopic dermatitis | 1.41 (1.36–1.46) | <0.001 | 1.12 (1.04–1.21) | 0.002 | 1.03 (0.91–1.16) | 0.640 | 1.16 (0.65–2.10) | 0.612 |
Attention-deficit/hyperactivity disorder | ||||||||
Any autoimmune diseases | 1.12 (0.97–1.29) | 0.123 | 1.26 (1.21–1.32) | <0.001 | 1.06 (1.00–1.13) | 0.033 | 1.06 (0.86–1.30) | 0.585 |
Rheumatoid arthritis | 1.34 (0.92–1.94) | 0.127 | 1.40 (1.29–1.51) | <0.001 | 1.00 (0.89–1.12) | 0.933 | 1.29 (0.73–2.26) | 0.380 |
Sjogren syndrome | 0.67 (0.43–1.04) | 0.071 | 1.30 (1.21–1.40) | <0.001 | 1.15 (1.01–1.31) | 0.029 | 1.05 (0.80–1.37) | 0.725 |
Psoriasis | 1.28 (1.09–1.51) | 0.002 | 1.13 (1.05–1.22) | <0.001 | 1.07 (1.00–1.14) | 0.050 | 1.71 (1.04–2.82) | 0.035 |
SLE | 0.84 (0.54–1.30) | 0.426 | 1.28 (1.16–1.41) | <0.001 | 1.09 (0.82–1.44) | 0.553 | 1.26 (1.24–1.28) | <0.001 |
Any allergic diseases | 1.65 (1.63–1.69) | <0.001 | 1.35 (1.33–1.37) | <0.001 | 1.12 (1.10–1.14) | <0.001 | 1.22 (1.19–1.25) | <0.001 |
Asthma | 1.44 (1.42–1.46) | <0.001 | 1.49 (1.46–1.54) | <0.001 | 1.19 (1.15–1.23) | <0.001 | 1.06 (0.87–1.31) | 0.553 |
Allergic rhinitis | 1.74 (1.71–1.77) | <0.001 | 1.35 (1.32–1.38) | <0.001 | 1.11 (1.09–1.13) | <0.001 | 1.28 (0.73–2.25) | 0.390 |
Atopic dermatitis | 1.34 (1.31–1.37) | <0.001 | 1.21 (1.16–1.27) | <0.001 | 1.02 (0.97–1.07) | 0.441 | 1.05 (0.81–1.38) | 0.698 |
Disease | None Has This Disease | Only One Family Member Has This Disease | Two or Three Family Members Have This Disease | ASD | ADHD | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
n | n | n | aHR1 (95% CI) | p | aHR2 (95% CI) | p | aHR1 (95% CI) | p | aHR2 (95% CI) | p | |
Any autoimmune diseases | 1,323,304 | 61,303 | 1653 | 1.02 | 0.635 | 1.45 | 0.070 | 1.17 | <0.001 | 1.37 | 0.001 |
(0.94–1.11) | (0.97–2.15) | (1.13–1.22) | (1.13–1.65) | ||||||||
Rheumatoid arthritis | 1,370,606 | 15,450 | 204 | 1.10 | 0.180 | 1.82 | 0.231 | 1.22 | <0.001 | 1.28 | 0.378 |
(0.96–1.28) | (0.68–4.86) | (1.14–1.31) | (0.74–2.22) | ||||||||
Sjogren syndrome | 1,369,102 | 16,769 | 389 | 1.01 | 0.845 | 1.91 | 0.071 | 1.25 | <0.001 | 1.18 | 0.433 |
(0.88–1.17) | (0.95–3.86) | (1.18–1.32) | (0.78–1.81) | ||||||||
Psoriasis | 1,357,064 | 28,798 | 398 | 0.98 | 0.739 | 1.25 | 0.615 | 1.11 | <0.001 | 1.55 | 0.019 |
(0.87–1.10) | (0.52–3.00) | (1.06–1.16) | (1.07–2.23) | ||||||||
SLE | 1,379,021 | 7180 | 59 | 1.08 | 0.457 | 1.65 | 0.623 | 1.24 | <0.001 | 1.29 | 0.620 |
(0.88–1.34) | (0.23–11.95) | (1.13–1.36) | (0.47–3.58) | ||||||||
Any allergic diseases | 423,086 | 534,230 | 428,944 | 1.40 | <0.001 | 1.85 | <0.001 | 1.44 | <0.001 | 1.86 | <0.001 |
(1.34–1.47) | (1.77–1.93) | (1.41–1.47) | (1.82–1.90) | ||||||||
Asthma | 952,772 | 364,005 | 69,483 | 1.32 | <0.001 | 1.64 | <0.001 | 1.39 | <0.001 | 1.76 | <0.001 |
(1.27–1.37) | (1.54–1.74) | (1.37–1.41) | (1.71–1.81) | ||||||||
Allergic rhinitis | 583,521 | 479,033 | 323,706 | 1.45 | <0.001 | 1.87 | <0.001 | 1.46 | <0.001 | 1.83 | <0.001 |
(1.39–1.51) | (1.80–1.94) | (1.43–1.49) | (1.79–1.87) | ||||||||
Atopic dermatitis | 1,061,009 | 275,223 | 50,028 | 1.29 | <0.001 | 1.51 | <0.001 | 1.42 | <0.001 | 1.87 | <0.001 |
(1.25–1.33) | (1.46–1.58) | (1.39–1.45) | (1.82–1.92) |
Disease | ASD | ADHD | ||
---|---|---|---|---|
aHR (95% CI) | p-Value | aHR (95% CI) | p-Value | |
Any autoimmune diseases | 1.02 (0.87–1.19) | 0.808 | 1.18 (1.10–1.27) | <0.001 |
Rheumatoid arthritis | 1.10 (0.82–1.50) | 0.520 | 1.42 (1.24–1.63) | <0.001 |
Sjogren syndrome | 1.15 (0.83–1.61) | 0.401 | 1.13 (0.98–1.30) | 0.093 |
Psoriasis | 0.93 (0.73–1.18) | 0.529 | 1.04 (0.95–1.15) | 0.392 |
Systemic lupus erythematosus | 1.20 (0.59–2.44) | 0.612 | 1.16 (0.87–1.56) | 0.315 |
Any allergic diseases | 1.06 (1.01–1.12) | 0.010 | 1.20 (1.17–1.23) | <0.001 |
Asthma | 1.16 (1.06–1.27) | <0.001 | 1.23 (1.19–1.29) | <0.001 |
Allergic rhinitis | 1.06 (1.01–1.11) | 0.018 | 1.20 (1.18–1.22) | <0.001 |
Atopic dermatitis | 1.02 (0.87–1.19) | 0.808 | 1.18 (1.10–1.27) | <0.001 |
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Li, D.-J.; Tsai, C.-S.; Hsiao, R.C.; Chen, Y.-L.; Yen, C.-F. Associations between Allergic and Autoimmune Diseases with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder within Families: A Population-Based Cohort Study. Int. J. Environ. Res. Public Health 2022, 19, 4503. https://doi.org/10.3390/ijerph19084503
Li D-J, Tsai C-S, Hsiao RC, Chen Y-L, Yen C-F. Associations between Allergic and Autoimmune Diseases with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder within Families: A Population-Based Cohort Study. International Journal of Environmental Research and Public Health. 2022; 19(8):4503. https://doi.org/10.3390/ijerph19084503
Chicago/Turabian StyleLi, Dian-Jeng, Ching-Shu Tsai, Ray C. Hsiao, Yi-Lung Chen, and Cheng-Fang Yen. 2022. "Associations between Allergic and Autoimmune Diseases with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder within Families: A Population-Based Cohort Study" International Journal of Environmental Research and Public Health 19, no. 8: 4503. https://doi.org/10.3390/ijerph19084503