MORTALITY AMONG TWINS AFTER AGE-6 - FETAL ORIGINS HYPOTHESIS VERSUS TWIN METHOD
MORTALITY AMONG TWINS AFTER AGE-6 - FETAL ORIGINS HYPOTHESIS VERSUS TWIN METHOD
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DOI：
10.1136/bmj.310.6977.432
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发表时间：
1995-02-18
影响因子：
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通讯作者：
YASHIN, AI
中科院分区：
文献类型：
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作者：
CHRISTENSEN, K;VAUPEL, JW;YASHIN, AI
目的：检验胎儿起源假说和经典双胞胎方法的有效性。设计一对双胞胎均存活到6岁的同卵双胞胎。受试者-8495名出生于1870-1900年，一直跟踪到1991年12月31日的双胞胎个体。主要观察指标-死亡率按队列计算，结果-双胞胎和一般人群的死亡率没有显著差异，但60-89岁的女性双胞胎死亡率是普通人群的1.14倍(SE 0.03)，在30.59岁时，女性异卵双胞胎的死亡率是同卵双胞胎的1.77倍(0.18)。此外，同卵和异卵双胞胎的死亡率在6岁以后没有一致的差异。结论：根据胎儿起源假说，胎儿宫内发育迟缓增加了成人发病率和死亡率的风险。双胞胎，尤其是同卵双胞胎，在子宫中会经历发育迟缓。本研究的结果表明，胎儿起源假说不适用于双胞胎所经历的宫内发育迟缓。此外，这些数据与最近声称经典的双胞胎方法不适用于成人疾病研究的基本假设不一致。然而，目前的研究是基于双胞胎都活到6岁的所有双胞胎中的三分之一。这一选择的可能影响可以在未来对围产期和婴儿死亡率较低的较年轻双胞胎的队列研究中进行评估。
Objective-To test the validity of the fetal origins hypothesis and the classic twin method.Design-Follow up study of pairs of same twins in which both twins survived to age 6.Setting-Denmark.Subjects-8495 twin individuals born 1870-1900, followed through to 31 December 1991.Main outcome measures-Mortality calculated on a cohort basis,Results-Mortality among twins and the general population was not significantly different except among females aged 60-89, in whom mortality among twins was 1.14 times (SE 0.03) higher than in the general population, Mortality among female dizygotic twins was 1.77 times (0.18) higher than among monozygotic twins at age 30.59. Otherwise, mortality for monozygotic and dizygotic twins did not consistently differ after age 6.Conclusion-According to the fetal origins hypothesis the risk of adult morbidity and mortality is heightened by retardation in intrauterine growth. Twins, and in particular monozygotic twins, experience growth retardation in utero. The findings in the present study suggest that the fetal origins hypothesis is not true for the retardation in intrauterine growth experienced by twins. Furthermore, the data are inconsistent with the underlying assumption of a recent claim that the classic twin method is invalid for studies of adult diseases. The present study is, however, based on the one third of all pairs of twins in which both twins survived to age 6. The possible impact of this selection can be evaluated in future studies of cohorts of younger twins with lower perinatal and infant mortality.