酒癮與血清素轉運蛋白基因之相關性研究：以信義鄉為例; The study of alcoholism and serotnin transporter gene in Hsin-Yi township

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Title:	酒癮與血清素轉運蛋白基因之相關性研究：以信義鄉為例;The study of alcoholism and serotnin transporter gene in Hsin-Yi township
Authors:	李昆昌
Contributors:	中國醫藥學院環境醫學研究所
Keywords:	酒癮;血清素轉運蛋白;alcoholism;serotonin transporter
Date:	1992
Issue Date:	2009-12-22 13:58:00 (UTC+8)
Abstract:	摘要研究背景：許多研究顯示血清素轉運蛋白（5-HTT）啟動子基因（serotonin transporter promoter gene）與酒癮的形成有關，但其機制及所扮演之角色目前仍無定論。本研究的目的主要在探討台灣中部某山地鄉鎮（居民52% 為原住民）其5-HTT基因型與酒癮之關係，並且亦探討酒癮之其他危險因子，包括年齡、性別、種族、酒精暴露史、家庭功能、社經狀態等。方法：本研究先以一橫斷性研究為基礎，利用「心理衛生及飲酒問題防治問卷表」總共訪視993位有飲酒習慣者，篩選出542位酒癮者，再利用病例（在這裡指盛行病例）對照研究的方法，分層隨機抽樣抽出206位酒癮者為研究對象，以1比1方式對性別、年齡作配對後，選取206位無酒癮者與189位不喝酒者為對照組進行分析。結果：與原住民酒癮有關的因素包括年齡（40歲以下者比40歲以上者的OR=2.4，P<0.01）、飲酒年數（20年以上者比10年以下者的OR=2.4，P<0.01）與家庭有飲酒習慣的人（OR=2.6，P<0.001）；而非原住民則包括從事工作（農林漁牧業者比無業或退休者的OR=4.6，P<0.05；其他（指非農林漁牧業者）比無業或退休者的OR=6，P<0.05）、家庭功能（不好者的OR=4.6，P<0.01）與經濟問題（OR=3.5，P<0.01）等。進一步配對種族的因素後，與酒癮相關的因素包括飲酒起始年齡（30歲以上者比30歲以下者的OR=7.7，P<0.05）、單親家庭（OR=10.7，P<0.05）、暴力問題（OR=6.1，P<0.05）等，而5-HTT基因型的勝算比（odds ratio）有提高，且接近顯著（SS/LL的OR=4.2，P=0.085；LS/LL的OR=3.4，P=0.11）。本研究並沒有發現短型（S）對偶基因在酒癮與非酒癮的分布有差異。結論：本研究結果顯示，在原住民中，酒癮的危險因子包括年齡、飲酒年數與家庭飲酒習慣；而非原住民則包括從事工作、家庭功能與暴力問題。當性別與年齡配對後5-HTT基因型與酒癮的相關性不顯著，但進一步配對種族因素後，5-HTT基因型則有較高的顯著性。; Abstract Background：Recent studies reported that the serotonin transporter (5-HTT) promoter polymorphism, a 44-bp deletion resulting in short (S) or long (L) alleles, is related to alcoholism. However, studies of the role of 5-HTT gene in alcoholism have still not in a consensus. In this study, we tested the hypothesis in a mid-Taiwan township (52% of its habitants are aborigines) that whether the 5-HTT gene is susceptible to alcoholism. Other risk factors including age, sex, race, history of drinking, family functions, and socioeconomic status, etc, are also investigated. Method：In a cross-sectional study, we screened 542 alcoholics out of 993 as subjects who had drinking habits. A stratified random sampling was administrated and 206 subjects were selected. With age- and sex-matching design, we also selected 206 non-alcoholics and 189 nondrinkers to serve as two control sets for comparison. Result：The risk factors related to alcoholism in aborigines includes age >40 (OR=2.4, p<0.01), duration of drinking in years >20/<10 (OR=2.4, p<0.01) and familial ambience of drinking (OR=2.6, P<0.001); By choosing retirement or unemployment people as a referent group, the risk factors in non-aborigines included people with agricultural or fishery related occupation (OR=4.6, p<0.05); nonagricultural or non-fishery (OR=6.0, P<0.05). The odds ratios of people with poor ‘family function’ and low-income is 4.6 (p<0.01) and 3.5 (p<0.01), respectively. When the variable ‘race’ is further matched on, the risk factors included age of onset of drinking >30 (OR=7.7, P<0.05), one-parent family (OR=10.7, P<0.05), and family violence problems (OR=6.1, P<0.05); and in this conditional space, the odds ratios of 5-HTT genotypes have large values with mild significance in that the odds ratios of SS/LL and LS/LL are 4.2 (p=0.09) and 3.4 (p=0.11). However, the S-allele frequency is not significantly different between alcoholics and non-alcoholics. Conclusion：Our findings indicated that the risk factors of alcoholism includes age, duration of drinking and familial ambience of drinking in aborigines; occupation, poor family function and low-income in non-aborigines. The association of 5-HTT genotype and alcoholism is not significant when age and sex are matched, and is mild significant when race was further matched.
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