丹麦双胞胎中炎症性肠病的一致性。一项全国性研究的结果。

Concordance of inflammatory bowel disease among Danish twins. Results of a nationwide study.

作者信息

Orholm M, Binder V, Sørensen T I, Rasmussen L P, Kyvik K O

机构信息

Dept. of Internal Medicine, Elsinore Hospital, Denmark.

出版信息

Scand J Gastroenterol. 2000 Oct;35(10):1075-81. doi: 10.1080/003655200451207.

DOI:10.1080/003655200451207

PMID:11099061

Abstract

BACKGROUND

Previous studies have shown an increased risk of inflammatory bowel disease (IBD) among relatives of patients with Crohn disease and ulcerative colitis. In the present study the probandwise concordance rates for ulcerative colitis and Crohn disease among mono- and dizygotic twins were estimated. Further we aimed to evaluate whether smoking habits might influence the concordance, and to look for clinical characteristics of concordant versus discordant twin pairs.

METHODS

Among the 38,507 identified twins born in Denmark from 1953 to 1982, a questionnaire was sent to the 34,076 who previously had accepted to participate in studies. For twins reporting IBD, the diagnosis was verified by applying standard criteria to records requested from hospitals or practitioners.

RESULTS

Among the 29,421 (86.3%) twins answering the questionnaire, 103 pairs had at least one twin who suffered from IBD. In the Crohn disease group five of 10 monozygotic pairs, but none of 27 dizygotic pairs were concordant. In the ulcerative colitis group three of 21 monozygotic, and two of 44 dizygotic pairs were concordant. The probandwise concordance rate among monozygotic pairs was 58.3% for Crohn disease and 18.2% for ulcerative colitis; among the dizygotic pairs the rates were 0 and 4.5%, respectively. The frequency of smokers was higher among twins with Crohn disease and lower among twins with ulcerative colitis compared to the frequency in the twin register. Furthermore, smoking habits were found to be of significance for discordance for disease. Regarding the clinical characteristics no homogenous pattern was observed within the concordant pairs and the differences between concordant and discordant pairs were not significant.

CONCLUSION

The observation of a significantly higher concordance rate among monozygotic than among dizygotic twin pairs strongly points to a genetic influence on occurrence of IBD, which seems to be more pronounced with regard to Crohn disease than to ulcerative colitis. Differences in smoking habits among the members of the discordant twin pairs may influence the discordance.

摘要

背景

先前的研究表明，克罗恩病和溃疡性结肠炎患者的亲属患炎症性肠病（IBD）的风险增加。在本研究中，对单卵双胞胎和双卵双胞胎中溃疡性结肠炎和克罗恩病的先证者一致率进行了估计。此外，我们旨在评估吸烟习惯是否可能影响一致性，并寻找一致与不一致双胞胎对的临床特征。

方法

在1953年至1982年出生于丹麦的38507名已识别双胞胎中，向之前同意参与研究的34076名发送了问卷。对于报告患有IBD的双胞胎，通过对从医院或从业者处索取的记录应用标准标准来核实诊断。

结果

在回答问卷的29421名（86.3%）双胞胎中，103对双胞胎中至少有一人患有IBD。在克罗恩病组中，10对单卵双胞胎中有5对一致，但27对双卵双胞胎中无一例一致。在溃疡性结肠炎组中，21对单卵双胞胎中有3对一致，44对双卵双胞胎中有2对一致。单卵双胞胎对中克罗恩病的先证者一致率为58.3%，溃疡性结肠炎为18.2%；双卵双胞胎对中的一致率分别为0和4.5%。与双胞胎登记册中的频率相比，患有克罗恩病的双胞胎中吸烟者的频率较高，而患有溃疡性结肠炎的双胞胎中吸烟者的频率较低。此外，发现吸烟习惯对疾病的不一致性具有重要意义。关于临床特征，在一致的双胞胎对中未观察到同质模式，一致与不一致双胞胎对之间的差异不显著。