Association of healthy lifestyle factors and genetic liability with bipolar disorder: Findings from the UK Biobank

Guoxian Li; Qida He; Mengtong Sun; Ze Ma; Hanqing Zhao; Yu Wang; Zhaolong Feng; Tongxing Li; Jiadong Chu; Wei Hu; Xuanli Chen; Qiang Han; Na Sun; Xiaoqin Liu; Hongpeng Sun; Yueping Shen

doi:10.1016/j.jad.2024.08.011

Association of healthy lifestyle factors and genetic liability with bipolar disorder: Findings from the UK Biobank

Guoxian Li, Qida He, Mengtong Sun, Ze Ma, Hanqing Zhao, Yu Wang, Zhaolong Feng, Tongxing Li, Jiadong Chu, Wei Hu, Xuanli Chen, Qiang Han, Na Sun, Xiaoqin Liu, Hongpeng Sun, Yueping Shen

National Centre for Register-based Research

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: The interplay between genetic and lifestyle factors in the development of bipolar disorder (BD) remains unclear. Methods: A cohort study was carried out on 365,517 participants from the UK Biobank. Lifestyle scores, based on smoking, physical activity, diet, alcohol consumption, sedentary behavior, sleep duration, and social contact, were grouped as favorable (scores 6–7), intermediate (scores 4–5), or unfavorable (scores 0–3). The BD polygenic risk score (PRS) was also categorized into high, intermediate, and low-risk groups using PRS tertiles. Cox regression models determined hazard ratios (HRs) and 95 % confidence intervals (CIs) for BD. Results: During the 12.9-year follow-up, 529 individuals developed BD. Comparing those with favorable lifestyles to those with unfavorable participants, the HR of developing BD was 3.28 (95 % CI, 2.76–3.89). Similarly, individuals with a high PRS had a risk of 3.20 (95 % CI, 2.83–3.63) compared to those with a low PRS. Notably, individuals with both a high PRS and an unfavorable lifestyle had a significantly higher risk of BD (HR = 6.31, 95 % CI, 4.14–9.63) compared to those with a low PRS and a favorable lifestyle. Additionally, the interaction between PRS and lifestyle contributed an additional risk, with a relative excess risk of 1.74 (95 % CI, 0.40–3.07) and an attributable proportion due to the interaction of 0.37 (95 % CI, 0.16–0.58). Conclusions: Our findings suggest that genetic liability for BD, measured as PRS, and lifestyle have an additive effect on the risk of developing BD. A favorable lifestyle was associated with a reduced risk of developing BD.

Original language	English
Journal	Journal of Affective Disorders
Volume	364
Pages (from-to)	279-285
Number of pages	7
ISSN	0165-0327
DOIs	https://doi.org/10.1016/j.jad.2024.08.011
Publication status	Published - 1 Nov 2024

Keywords

Bipolar disorder
Cohort study
Healthy lifestyle
Polygenic risk score
UK Biobank

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10.1016/j.jad.2024.08.011

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@article{e954f2b76a9f441aacd2092d0bfc5e61,

title = "Association of healthy lifestyle factors and genetic liability with bipolar disorder: Findings from the UK Biobank",

abstract = "Background: The interplay between genetic and lifestyle factors in the development of bipolar disorder (BD) remains unclear. Methods: A cohort study was carried out on 365,517 participants from the UK Biobank. Lifestyle scores, based on smoking, physical activity, diet, alcohol consumption, sedentary behavior, sleep duration, and social contact, were grouped as favorable (scores 6–7), intermediate (scores 4–5), or unfavorable (scores 0–3). The BD polygenic risk score (PRS) was also categorized into high, intermediate, and low-risk groups using PRS tertiles. Cox regression models determined hazard ratios (HRs) and 95 % confidence intervals (CIs) for BD. Results: During the 12.9-year follow-up, 529 individuals developed BD. Comparing those with favorable lifestyles to those with unfavorable participants, the HR of developing BD was 3.28 (95 % CI, 2.76–3.89). Similarly, individuals with a high PRS had a risk of 3.20 (95 % CI, 2.83–3.63) compared to those with a low PRS. Notably, individuals with both a high PRS and an unfavorable lifestyle had a significantly higher risk of BD (HR = 6.31, 95 % CI, 4.14–9.63) compared to those with a low PRS and a favorable lifestyle. Additionally, the interaction between PRS and lifestyle contributed an additional risk, with a relative excess risk of 1.74 (95 % CI, 0.40–3.07) and an attributable proportion due to the interaction of 0.37 (95 % CI, 0.16–0.58). Conclusions: Our findings suggest that genetic liability for BD, measured as PRS, and lifestyle have an additive effect on the risk of developing BD. A favorable lifestyle was associated with a reduced risk of developing BD.",

keywords = "Bipolar disorder, Cohort study, Healthy lifestyle, Polygenic risk score, UK Biobank",

author = "Guoxian Li and Qida He and Mengtong Sun and Ze Ma and Hanqing Zhao and Yu Wang and Zhaolong Feng and Tongxing Li and Jiadong Chu and Wei Hu and Xuanli Chen and Qiang Han and Na Sun and Xiaoqin Liu and Hongpeng Sun and Yueping Shen",

year = "2024",

month = nov,

day = "1",

doi = "10.1016/j.jad.2024.08.011",

language = "English",

volume = "364",

pages = "279--285",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier BV",

}

Association of healthy lifestyle factors and genetic liability with bipolar disorder: Findings from the UK Biobank. / Li, Guoxian; He, Qida; Sun, Mengtong et al.
In: Journal of Affective Disorders, Vol. 364, 01.11.2024, p. 279-285.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Association of healthy lifestyle factors and genetic liability with bipolar disorder

T2 - Findings from the UK Biobank

AU - Li, Guoxian

AU - He, Qida

AU - Sun, Mengtong

AU - Ma, Ze

AU - Zhao, Hanqing

AU - Wang, Yu

AU - Feng, Zhaolong

AU - Li, Tongxing

AU - Chu, Jiadong

AU - Hu, Wei

AU - Chen, Xuanli

AU - Han, Qiang

AU - Sun, Na

AU - Liu, Xiaoqin

AU - Sun, Hongpeng

AU - Shen, Yueping

PY - 2024/11/1

Y1 - 2024/11/1

N2 - Background: The interplay between genetic and lifestyle factors in the development of bipolar disorder (BD) remains unclear. Methods: A cohort study was carried out on 365,517 participants from the UK Biobank. Lifestyle scores, based on smoking, physical activity, diet, alcohol consumption, sedentary behavior, sleep duration, and social contact, were grouped as favorable (scores 6–7), intermediate (scores 4–5), or unfavorable (scores 0–3). The BD polygenic risk score (PRS) was also categorized into high, intermediate, and low-risk groups using PRS tertiles. Cox regression models determined hazard ratios (HRs) and 95 % confidence intervals (CIs) for BD. Results: During the 12.9-year follow-up, 529 individuals developed BD. Comparing those with favorable lifestyles to those with unfavorable participants, the HR of developing BD was 3.28 (95 % CI, 2.76–3.89). Similarly, individuals with a high PRS had a risk of 3.20 (95 % CI, 2.83–3.63) compared to those with a low PRS. Notably, individuals with both a high PRS and an unfavorable lifestyle had a significantly higher risk of BD (HR = 6.31, 95 % CI, 4.14–9.63) compared to those with a low PRS and a favorable lifestyle. Additionally, the interaction between PRS and lifestyle contributed an additional risk, with a relative excess risk of 1.74 (95 % CI, 0.40–3.07) and an attributable proportion due to the interaction of 0.37 (95 % CI, 0.16–0.58). Conclusions: Our findings suggest that genetic liability for BD, measured as PRS, and lifestyle have an additive effect on the risk of developing BD. A favorable lifestyle was associated with a reduced risk of developing BD.

AB - Background: The interplay between genetic and lifestyle factors in the development of bipolar disorder (BD) remains unclear. Methods: A cohort study was carried out on 365,517 participants from the UK Biobank. Lifestyle scores, based on smoking, physical activity, diet, alcohol consumption, sedentary behavior, sleep duration, and social contact, were grouped as favorable (scores 6–7), intermediate (scores 4–5), or unfavorable (scores 0–3). The BD polygenic risk score (PRS) was also categorized into high, intermediate, and low-risk groups using PRS tertiles. Cox regression models determined hazard ratios (HRs) and 95 % confidence intervals (CIs) for BD. Results: During the 12.9-year follow-up, 529 individuals developed BD. Comparing those with favorable lifestyles to those with unfavorable participants, the HR of developing BD was 3.28 (95 % CI, 2.76–3.89). Similarly, individuals with a high PRS had a risk of 3.20 (95 % CI, 2.83–3.63) compared to those with a low PRS. Notably, individuals with both a high PRS and an unfavorable lifestyle had a significantly higher risk of BD (HR = 6.31, 95 % CI, 4.14–9.63) compared to those with a low PRS and a favorable lifestyle. Additionally, the interaction between PRS and lifestyle contributed an additional risk, with a relative excess risk of 1.74 (95 % CI, 0.40–3.07) and an attributable proportion due to the interaction of 0.37 (95 % CI, 0.16–0.58). Conclusions: Our findings suggest that genetic liability for BD, measured as PRS, and lifestyle have an additive effect on the risk of developing BD. A favorable lifestyle was associated with a reduced risk of developing BD.

KW - Bipolar disorder

KW - Cohort study

KW - Healthy lifestyle

KW - Polygenic risk score

KW - UK Biobank

UR - http://www.scopus.com/inward/record.url?scp=85201392904&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2024.08.011

DO - 10.1016/j.jad.2024.08.011

M3 - Journal article

C2 - 39137837

SN - 0165-0327

VL - 364

SP - 279

EP - 285

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Association of healthy lifestyle factors and genetic liability with bipolar disorder: Findings from the UK Biobank

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