Genetic influences in irritable bowel syndrome: A twin study
Genetic influences in irritable bowel syndrome: A twin study
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DOI：
10.1111/j.1572-0241.2005.41700.x
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发表时间：
2005-06-01
影响因子：
9.8
通讯作者：
Trudgill, NJ
中科院分区：
文献类型：
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作者：
Mohammed, I;Cherkas, LF;Trudgill, NJ
背景：在肠易激综合征(IBS)患者的家庭中已经描述了腹痛或肠道不适症状的聚集。这可能是由于环境因素，包括对腹部症状的获得性反应或遗传因素对IBS的病因的影响。目的：通过评估同卵(MZ)和异卵(DZ)双胞胎的IBS症状，确定遗传因素对IBS的相对贡献。方法：从国家志愿者登记的双胞胎登记中确定4480对未选定的双胞胎，完成有效问卷。结果：共5,032名受试者回答，应答率为56%。1,870对完全双生子：888MZ对(82对男性，平均年龄51岁，SD13(19-81岁)岁)和982对DZ对(69对男性，52岁，SD13(20-82岁))。MZ和DZ双胞胎的IBS患病率分别为17%和16%。MZ和DZ双生子的病例符合率无显著差异(28%对27%，p=NS)。Logistic回归分析显示年龄降低和心身评分增加与IBS独立相关。多因素责任阈值模型表明，独特的和共享的环境因素的组合为IBS提供了最佳模型。相反，躯体化表现出适度的遗传性。结论：遗传因素对IBS的影响很小或没有影响，其中主要影响似乎是环境因素。
BACKGROUND: Aggregation of symptoms of abdominal pain or bowel disturbance has been described in the families of patients with irritable bowel syndrome (IBS). This may be due to environmental factors, including learned responses to abdominal symptoms or a genetic contribution to the etiology of IBS.OBJECTIVES: To determine the relative contribution of genetic factors to IBS by evaluating IBS symptoms in monozygotic (MZ) and dizygotic (DZ) twins.METHODS: A total of 4,480 unselected twin pairs identified from a national volunteer twin register were asked to complete a validated questionnaire. IBS was defined by the Rome II criteria.RESULTS: A total of 5,032 subjects replied (56% response rate). One thousand eight hundred seventy complete twin pairs were evaluable; 888 MZ pairs (82 male pairs, mean age 51, SD 13 (range 19-81) yr) and 982 DZ pairs (69 male pairs, age 52, SD 13 (20-82) yr). The prevalence of IBS was 17% in MZ and 16% in DZ twins. There was no significant difference in casewise concordance rates between the MZ and DZ twins (28%vs 27%, p= NS). Logistic regression analysis revealed that decreasing age and increasing psychosomatic score were independently associated with IBS. Multifactorial liability threshold modeling suggested that a combination of unique and shared environmental factors provided the best model for IBS. In contrast, somatization was shown to be moderately heritable.CONCLUSION: Genetic factors are of little or no influence on IBS where the predominant influences appear to be environmental.