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研究生:黃小耘
研究生(外文):Shiao-Yun Huang
論文名稱:乙醇脫氫酶1B (ADH1B)與乙醛脫氫酶2 (ALDH2)的遺傳變異與青少年飲酒行為之關聯
論文名稱(外文):Relations of Genetic Variants in Alcohol Dehydrogenase-1B (ADH1B) and Aldehyde Dehydrogenase-2 (ALDH2) to Adolescent Alcohol Use
指導教授:陳為堅陳為堅引用關係
口試委員:陳娟瑜郭柏秀郭千哲
口試日期:2013-07-23
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:流行病學與預防醫學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:英文
論文頁數:53
中文關鍵詞:青少年年齡青春期乙醇脫氫酶1B乙醛脫氫酶2飲酒行為
外文關鍵詞:Adolescentagepubertyaldehyde dehydrogenasealcohol dehydrogenasealcohol use behavior
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背景與目的:
酒精是青少年最常使用的物質,並且會影響青少年的後續生理發展以及增加日後飲酒問題的可能性。酒精代謝酶基因乙醇脫氫酶1B (ADH1B)與乙醛脫氫酶2 (ALDH2)對酒精依賴與成癮所具之保護效果已經被廣泛研究。但過去研究多為成人族群、並且使用病例對照研究法來探討酒精依賴與成癮。較少研究以發展的觀點來探討疾病發展階段中較早期的酒精使用狀況。故本研究的目的為:(一)分別探討ALDH2與ADH1B的基因型與較早期的青少年飲酒行為變化的關係。(二)進一步探討基因的效果是否在不同年齡有差別。(三)進一步探討基因的效果是否在不同青春期狀態有差異。(四)檢驗ADH1B的效果在控制ALDH2後是否會浮現。
方法:
本研究運用「兒童酒精相關經驗追蹤計畫(Alcohol-Related Experiences among Children, AREC)」2006-2007年原就讀於台北市國小學童、抽樣追蹤期飲酒行為,排除未曾飲酒者與未提供口水檢體者,尚有384人可放入分析,了解酒精代謝基因與後續飲酒行為的關係。分析紙筆問卷內容飲酒相關與社會人口學資料、並進行基因型鑑定,以卡方檢定進行組別比較並進一步以邏輯斯回歸控制共變項以了解基因與初期飲酒行為的關係、並探詢可能的交互作用。
結果:
研究結果發現ALDH2在合併不同年級時與飲酒行為無顯著相關。ALDH2與年級或者青春期的交互作用有顯著效應。ALDH2的保護效果只有在四年級中達到顯著,在六年級則無顯著相關。此外、ALDH2的保護效果只有在早期青春期達到顯著,在已進入青春期則無顯著相關,且ALDH2與青春期交互作用又較年齡為佳。而在控制ALDH2 後,ADH1B與青少年飲酒行為並無顯著關係
結論:本研究顯示,酒精代謝基因ALDH2的作用,對青少年早期的飲酒行為變化的影響,相對於ADH1B有更顯著的影響。但隨著年齡的增長或者進入青春期,此保護作用略減。而與青春期的交互作用又較年齡為佳。未來可以進一步探討相關因素。

Background and aims:
Alcohol is one of the most frequently used substances in adolescence and could increase risk of alcohol use problems. Alcohol metabolizing enzyme genes, alcohol dehydrogenase-1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) have exhibit strong protective effect on alcohol use problems. However, past studies were mostly from case-control studies involving adults with severe outcome due to chronic consumption behavior of alcohol. Relatively few studies investigated early stage of alcohol use by developmental perspective.
Hence, the aims of this study are to (1) test the effects of ALDH2 and ADH1B genotypes on behavioral changes in alcohol consumption in adolescents, respectively, via follow-up design; (2) to examine the potential age difference in the effects of ALDH2 and ADH1B genotypes; (3) to examine the potential puberty status difference of the effects of ALDH2 and ADH1B genotypes; and (4) to further investigate the effects of ADH1B when controlling for ALDH2..
Methods:
A longitudinal sample of 4th and 6th grade students (N = 384) in Taipei city, Taiwan in 2006-2007 who had experienced alcohol provided information of alcohol use experience and sociodemographic measures via self-administered questionnaires. Participants provided saliva for genotyping the ALDH2 (rs671) polymorphism and ADH1B (rs1229984) polymorphism (rs1229984) using Taqman Analysis. Chi-square test was conducted for comparing personal and genetic traits between different alcohol-use patterns. Logistic regression was further used to control covariates and to exam the potential interaction of genetic factor and age or puberty, respectively.
Results:
The effect of ALDH2 was not related to alcohol use outcome when combined both grades. There was significant age difference and puberty difference in behavioral changes in alcohol use. The effect of ALDH2 reveals only in 4th grade students and in pre and early puberty group students. The interaction of pubertal status and ALDH2 seems to be stronger then age. ADH1B was not significantly related to behavioral changes in alcohol use even when controlled for ALDH2 status.
Conclusions:
This study demonstrated that the effect of ALDH2 in behavioral changes in adolescent’s early alcohol use is more significant than ADH1B. However, the protective effect declined with age and pubertal status. The effect of ALDH2 is stronger when adolescents are in pre or early puberty. Further factors should be investigated.

口試委員審定書 I
致謝 II
中文摘要 IV
Abstract VI
CONTENTS VIII
LIST OF TABLES IX
LIST OF FIGURES X
LIST OF APPENDICES XI
1. Introduction 1
2. Methods 5
2.1. STUDY PARTICIANTS 5
2.2. MEASURE 6
2.2.1. Adolescent alcohol use behavior 7
2.2.2. Parental drinking 8
2.2.3. Parental education level 9
2.2.4. Monthly allowance 9
2.2.5. Puberty 9
2.2.6. DNA genotyping 10
2.3. DATA ANALYSIS 11
3. Results 13
4. Discussion 17
References 21
Tables 27
Figures 36
Appendix 38


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