Clustering of hypertension, diabetes, and obesity in adult male twins: same genes or same environments?

  • Carmelli D
  • Cardon L
  • Fabsitz R
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We investigated the mediating role of genetic factors in the clustering of hypertension, diabetes, and obesity, using the twin registry maintained by the National Academy of Sciences--National Research Council. The study sample included 2,508 male twin pairs born between 1917 and 1927 who responded to a mailed questionnaire that covered demographic variables, cardiovascular risk factors, and health behaviors. The incidence of hypertension and diabetes in this cohort was ascertained from subjects' self-report of a physician diagnosis and/or the use of prescription medications. The body-mass index calculated from self-reports of height and weight was used as a measure of obesity. Descriptive analyses indicated probandwise concordance rates of 34.0%, 31.2%, and 32.7%, respectively, for the joint occurrences of hypertension and diabetes, hypertension and obesity, and diabetes and obesity in MZ twin pairs. Corresponding concordance rates in DZ twin pairs were 8.1%, 14.9%, and 2.8%. The probandwise concordance for the clustering of all three conditions in the same individuals was 31.6% in MZ pairs and 6.3% in DZ pairs (relative risk 5.0; X2(1) = 2.6; P < .15). Multivariate genetic modeling of the correlation in liabilities to develop these conditions suggested the presence of a common latent factor mediating the clustering of hypertension, diabetes, and obesity in this twin sample. This common factor was influenced by both genetic and environmental effects (59% 8 genetic, 41% environmental). The genetic influences on the common latent factor were due to dominant rather than additive sources; the environmental influences appeared to be specific rather than shared by co-twins.

Author-supplied keywords

  • Aged
  • Chi-Square Distribution
  • Cluster Analysis
  • Comorbidity
  • Diabetes Mellitus
  • Diabetes Mellitus: epidemiology
  • Diabetes Mellitus: genetics
  • Diseases in Twins
  • Diseases in Twins: epidemiology
  • Diseases in Twins: genetics
  • Environment
  • Genes, Dominant
  • Genetic Variation
  • Humans
  • Hypertension
  • Hypertension: epidemiology
  • Hypertension: genetics
  • Male
  • Middle Aged
  • Military Personnel
  • Models, Genetic
  • Multivariate Analysis
  • Obesity
  • Obesity: epidemiology
  • Obesity: genetics
  • Prevalence
  • Risk
  • Twins, Dizygotic
  • Twins, Monozygotic
  • United States
  • United States: epidemiology

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  • D Carmelli

  • L R Cardon

  • R Fabsitz

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