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Panminerva Medica 2003 June;45(2):109-15


lingua: Inglese

The impact of genes and pre- and postnatal environment on the metabolic syndrome. Evidence from twin studies

Poulsen P. 1, Vaag A. 2

1 Diabetes Research Center Odense University Hospital, Odense C, Denmark
2 Steno Diabetes Center, Gentofte, Denmark


Our population-based Danish twin study dem­on­strated a ­genetic influ­ence on sev­eral of the com­po­nents ­included in the meta­bolic syn­drome, i.e. glu­cose intol­er­ance, ­overall ­obesity, sys­tolic and dia­stolic ­blood pres­sure and low ­levels of HDL-cho­les­terol. Abdominal ­obesity, ­insulin resis­tance and hyper­trig­ly­cer­i­daemia had, on the ­other ­hand, a rel­a­tively ­higher envi­ron­mental aet­io­log­ical com­po­nent. Furthermore we dem­on­strated a dif­fer­ence in aetio­logy ­among ­male and ­female ­twins indi­cating an influ­ence of sex on sev­eral of the com­po­nents in the meta­bolic syn­drome. Studies ­have dem­on­strated an ­impact of the intra­ute­rine envi­ron­ment (i.e. low ­birth ­weight) for the devel­op­ment of the com­po­nents in the meta­bolic syn­drome. The ­validity of con­clu­sions ­drawn ­from clas­sical ­twin ­studies has there­fore ­been ques­tioned due to the dif­ferent pre­natal cir­cum­stances char­ac­ter­ising mono­zy­gotic (MZ) and diz­y­gotic (DZ) pre­gnan­cies. Due to a poten­tially ­more ­adverse intra­ute­rine envi­ron­ment ­among MZ com­pared to DZ ­twins, MZ ­twins may be ­more ­prone to ­develop var­ious meta­bolic abnor­mal­ities. Our find­ings of a ­higher glu­cose and ­insulin pro­files ­after ­oral glu­cose inges­tion, and ­recently ­lower ­insulin-stim­u­lated glu­cose ­uptake — indi­cating glu­cose intol­er­ance and ­insulin resis­tance — ­together ­with ­higher ­levels of ­total-cho­les­terol and tri­gly­ce­rides ­among MZ com­pared to DZ ­twins dem­on­strate an ­effect of ­zygosity (i.e. intra­ute­rine envi­ron­ment) on ­these meta­bolic var­i­ables and there­fore ques­tion the assump­tion of ­equal pre- and post­natal envi­ron­ment in MZ and DZ ­twins. Our ­studies pro­vide fur­ther evi­dence for a pre­natal com­po­nent in the aetio­logy of the com­po­nents ­included in the syn­drome and ques­tion the ­validity of clas­sical ­twin ­studies on phe­no­types ­with a ­known pre­natal aet­io­log­ical com­po­nent. However, our ­present knowl­edge is cur­rently far too insuf­fi­cient to dis­card the ­results ­from clas­sical ­twin ­studies con­cerning the rel­a­tive ­role of ­genes ­versus envi­ron­ment for the devel­op­ment of the meta­bolic and hae­mod­y­namic com­po­nents ­included in the meta­bolic syn­drome.

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