Genetic influence on Stress Urinary Incontinence and Pelvic Organ Prolapse
Genetic influence on Stress Urinary Incontinence and Pelvic Organ Prolapse
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DOI：
10.1016/j.eururo.2007.12.004
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发表时间：
2008-10-01
期刊：
影响因子：
23.4
通讯作者：
Lichtenstein, Paul
中科院分区：
文献类型：
--
作者：
Altman, Daniel;Forsman, Mats;Lichtenstein, Paul
目的：确定遗传和环境因素对压力性尿失禁和盆腔器官脱垂手术易感性的影响。方法：我们使用瑞典双胞胎登记处来确定所有出生于1926年至1958年的具有已知合子的同性女性双胞胎。压力性尿失禁和盆腔器官脱垂手术的发生通过与瑞典住院患者登记处的交叉链接来确定。通过比较同卵和异卵雌性双胞胎，我们确定了双胞胎的相似性以及遗传和环境因素导致的表型差异的相对比例。使用统计模型，估计了由遗传性与共享和非共享环境影响解释的盆底手术的风险。结果：共鉴定出3376对完全同卵双生子和5067对同卵双生子。与同卵双生子相比，同卵双生子具有更大的双生子相似性，这表明基因成分对压力性尿失禁和盆腔器官脱垂手术的病因都有影响。对于这两种疾病，遗传因素和非共有环境因素同样贡献了约40%的易感性差异。共同的环境约占这两种疾病总变异的五分之一。结论：遗传因素与压力性尿失禁和盆腔器官脱垂的发生有关，但环境因素的影响较大。显著的环境影响表明，良性盆底手术的风险是可以干预的。2007年欧洲泌尿外科协会。爱思唯尔出版，版权所有。
Objectives: To determine the genetic and environmental influence on the liability for stress urinary incontinence and pelvic organ prolapse surgery. Methods: We used the Swedish Twin Registry to identify all same-sex female twin pairs with known zygosity born from 1926 to 1958. Occurrence of stress urinary incontinence and pelvic organ prolapse surgery was determined by cross-linkage to the Swedish Inpatient Registry. By comparing mono- and dizygotic female twins, we determined twin similarity and the relative proportions of phenotypic variance resulting from genetic and environmental factors. Using statistical modelling, the liability for pelvic floor surgery explained by heritability versus shared and non-shared environmental effects was estimated. Results: We identified 3376 complete monozygotic and 5067 dizygotic same-sex female twin pairs. There was greater twin similarity among monozygotic compared with dizygotic twins, which indicates the influence of a genetic component to the aetiology of both stress urinary incontinence and pelvic organ prolapse surgery. For both disorders, genetic and non-shared environmental factors equally contributed about 40% of the variation in liability. Shared environment accounted for approximately one fifth of the total variance for the two disorders. Conclusions: Genetic effects contribute to the occurrence of both stress urinary incontinence and pelvic organ prolapse, but the influence of environmental factors is substantial. Significant environmental effects suggest that the liability for benign pelvic floor surgery is amenable to intervention. 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.