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Birth order and narcolepsy risk among genetically susceptible individuals: a population-based case-control study.

Abstract：

BACKGROUND:Birth order may play a role in autoimmune diseases and early childhood infections, both factors implicated in the etiology of narcolepsy. We investigated the association between birth order and narcolepsy risk in a population-based case-control study in which all study subjects were HLA-DQB1*0602 positive. METHODS:Subjects were 18-50 years old, residents of King County, Washington, and positive for HLA-DQB1*0602. Birth order was obtained from administered interviews. We used logistic regression to generate odds ratios adjusted for income and African American race. RESULTS:Analyses included 67 cases (mean age 34.3 [SD=9.1], 70.2% female) and 95 controls (mean age 35.1 [SD=8.8], 58.1% female). Associations for birth order were as follows: first born (cases 38.8% vs. controls 50.2%, OR=1.0; reference), second born (cases 29.9% vs. controls 32.9%, OR=1.6; 95% CI 0.7, 3.7), and third born or higher (cases 31.3% vs. controls 16.8%, OR=2.5; 95% CI 1.0, 6.0). A linear trend was significant (p<0.05). Sibling number, sibling gender, having children, and number of children did not differ significantly between narcolepsy cases and controls. CONCLUSIONS:Narcolepsy risk was significantly associated with higher birth order in this population-based study of genetically susceptible individuals. This finding supports an environmental influence on narcolepsy risk through an autoimmune mechanism, early childhood infections, or both.

journal_name

Sleep Med

journal_title

Sleep medicine

authors

Watson NF,Ton TG,Koepsell TD,Longstreth WT Jr

doi

10.1016/j.sleep.2011.09.010

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

310-3

issue

3

eissn

1389-9457

issn

1878-5506

pii

S1389-9457(11)00385-6

journal_volume

13

pub_type

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