Jermendy György, Littvay Levente, Steinbach Rita, Jermendy Adám, Tárnoki Adám, Tárnoki Dávid, Métneki Júlia, Osztovits János
Fővárosi Bajcsy-Zsilinszky Kórház III. Belgyógyászati Osztály, Budapest, Maglódi út 89-91. 1106.
Orv Hetil. 2011 Aug 7;152(32):1265-71. doi: 10.1556/OH.2011.29165.
Both genetic and environmental factors play role in the pathogenesis of the metabolic syndrome. The magnitude of genetic and environmental influences on the components of metabolic syndrome may vary in different populations.
The present study was aimed to determine the effects of genetic and environmental factors on risk factors characteristic for the metabolic syndrome.
A total of 101 (63 monozygotic and 38 dizygotic) adult twin pairs (n=202; mean age: 43.3±15.8 years) were investigated. Medical history was recorded and physical examination was carried out for each subject. Fasting venous blood samples were used for measuring laboratory parameters. The presented estimates include the heritability structural equation (A-C-E) model results. In Model-1, all presented parameters are age- and gender- corrected. In Model-2, parameters were corrected for age, gender, body mass index and waist circumference.
Heritability in waist circumference (as well as in other anthropometric parameters such as weight and height) was high (Model-1: 71.0-88.1%). Similarly, genetic factors had the highest proportion of total phenotypic variance in systolic and diastolic blood pressure (Model-2: 57.1% and 57.7%, respectively). Based on the results of Model-2, unique environmental factors dominate alterations in serum triglycerides values (55.9%) while shared environmental factors proved to be substantial in alterations of HDL-cholesterol and fasting blood glucose values (58.1% and 57.1%, respectively). Comparing the results of Model-1 and Model-2, the difference in A-C-E model varied from 0.0% to 17.1%, indicating that only a minor proportion of genetic and environmental influences can be explained by the effects of anthropometric parameters.
Among adult Hungarian healthy people, genetic factors have substantial influence on waist circumference and blood pressure values while environmental factors dominate alterations in serum triglycerides, HDL-cholesterol and fasting blood glucose values. The different heritability of individual risk factors challenges the original unifying concept of the metabolic syndrome. The results may be useful for establishing and implementing primary cardiovascular prevention both at individual and population levels.
遗传因素和环境因素在代谢综合征的发病机制中均起作用。遗传和环境对代谢综合征各组分的影响程度在不同人群中可能有所不同。
本研究旨在确定遗传和环境因素对代谢综合征特征性危险因素的影响。
共调查了101对成年双胞胎(63对同卵双胞胎和38对异卵双胞胎,共202人;平均年龄:43.3±15.8岁)。记录每位受试者的病史并进行体格检查。采集空腹静脉血样以测定实验室参数。给出的估计值包括遗传度结构方程(A - C - E)模型结果。在模型1中,所有给出的参数均进行了年龄和性别校正。在模型2中,参数校正了年龄、性别、体重指数和腰围。
腰围(以及体重和身高等同人体测量参数)的遗传度较高(模型1:71.0 - 88.1%)。同样,收缩压和舒张压的总表型变异中遗传因素所占比例最高(模型2:分别为57.1%和57.7%)。根据模型2的结果,独特环境因素在血清甘油三酯值变化中占主导(55.9%),而共享环境因素在高密度脂蛋白胆固醇和空腹血糖值变化中作用显著(分别为58.1%和57.1%)。比较模型1和模型2的结果,A - C - E模型的差异在0.0%至17.1%之间,表明人体测量参数的影响仅能解释一小部分遗传和环境影响。
在匈牙利成年健康人群中,遗传因素对腰围和血压值有显著影响,而环境因素在血清甘油三酯、高密度脂蛋白胆固醇和空腹血糖值变化中占主导。个体危险因素的不同遗传度对代谢综合征最初的统一概念提出了挑战。这些结果可能有助于在个体和人群层面建立和实施心血管疾病一级预防。