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Noviello D, Costantino A, Muscatello A, Bandera A, Consonni D, Vecchi M, Basilisco G. Functional gastrointestinal and somatoform symptoms five months after SARS-CoV-2 infection: A controlled cohort study. Neurogastroenterol Motil 2022; 34:e14187. [PMID: 34060710 PMCID: PMC8209890 DOI: 10.1111/nmo.14187] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/07/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gastrointestinal infections represent a risk factor for functional gastrointestinal and somatoform extraintestinal disorders. We investigated the prevalence and relative risk (RR) of gastrointestinal and somatoform symptoms 5 months after SARS-CoV-2 infection compared with a control cohort. METHODS One hundred and sixty-four SARS-CoV-2 infected patients and 183 controls responded to an online questionnaire about symptoms and signs during the acute phase of the infection and after 4.8 ± 0.3 months. Presence and severity of gastrointestinal symptoms, somatization, anxiety, and depression were recorded with standardized questionnaires. Stool form and presence of irritable bowel syndrome (IBS) were also recorded. Any association between exposure to infection and symptoms was evaluated by calculating crude and adjusted RR values and score differences with 95% confidence intervals (CI). KEY RESULTS Fever, dyspnea, loss of smell/taste/weight, diarrhea, myalgia, arthralgia, and asthenia were reported by more than 40% of patients during the acute phase. Compared with controls, adjusted RRs for loose stools, chronic fatigue, and somatization were increased after infection: 1.88 (95% CI 0.99-3.54), 2.24 (95% CI 1.48-3.37), and 3.62 (95% CI 1.01-6.23), respectively. Gastrointestinal sequelae were greater in patients with diarrhea during the acute phase. CONCLUSIONS & INFERENCES Mild gastroenterological symptoms persist 5 months after SARS-CoV-2 infection, in particular in patients reporting diarrhea in the acute phase. Infected patients are at increased risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional gastrointestinal and somatoform disorders may have a common biological origin.
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Affiliation(s)
- Daniele Noviello
- Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
| | - Andrea Costantino
- Gastroenterology and Endoscopy UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Antonio Muscatello
- Infectious Disease UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Alessandra Bandera
- Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
- Infectious Disease UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Dario Consonni
- Epidemiology UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Maurizio Vecchi
- Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
- Gastroenterology and Endoscopy UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Guido Basilisco
- Gastroenterology and Endoscopy UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
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Bergmans RS, Rapp A, Kelly KM, Weiss D, Mezuk B. Understanding the relationship between type 2 diabetes and depression: lessons from genetically informative study designs. Diabet Med 2021; 38:e14399. [PMID: 32924175 PMCID: PMC8990216 DOI: 10.1111/dme.14399] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/19/2020] [Accepted: 09/03/2020] [Indexed: 12/11/2022]
Abstract
AIMS To conduct a systematic review in order to comprehensively synthesize the findings from a diverse range of genetically informative studies on comorbid depression and type 2 diabetes. METHODS Database searches (1 January 2008 to 1 June 2020) in PubMed and EMBASE were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eligible reports employed any type of genetically informed design, including twin modelling, Mendelian randomization, genome-wide association studies, polygenetic risk scores, or linkage disequilibrium score regression. Searches generated 451 unique citations, and 16 manuscripts met the inclusion criteria. RESULTS The included studies addressed three aetiological models of the depression-diabetes relationship: uni- or bi-directional phenotypic causation; shared genetic liability; or gene-environment interaction. From these studies, there is modest evidence that type 2 diabetes is causally related to risk of developing depression, but much more limited evidence that depression is causally related to risk of diabetes. There is little evidence of shared genetic liability between depression and diabetes or of gene-environment interaction. CONCLUSIONS Findings from genetically informed studies are mixed but provide some support for the uni- or bi-directional phenotypic model of depression and type 2 diabetes. Future studies should also explore the hypothesis that this relationship may be influenced by shared environmental risk factors. Findings can inform multifaceted approaches to diabetes prevention and care that reflect how psychosocial factors contribute to type 2 diabetes risk and outcomes.
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Affiliation(s)
- R. S. Bergmans
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - A. Rapp
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - K. M. Kelly
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - D. Weiss
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
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Jansweijer JA, van Spaendonck-Zwarts KY, Tanck MWT, van Tintelen JP, Christiaans I, van der Smagt JJ, Vermeer AMC, Bos JM, Moss AJ, Swan H, Priori SG, Rydberg A, Tfelt-Hansen J, Ackerman MJ, Olivotto I, Charron P, Gimeno JR, van den Berg MP, Wilde AAM, Pinto YM. Heritability in genetic heart disease: the role of genetic background. Open Heart 2019; 6:e000929. [PMID: 31245010 PMCID: PMC6546190 DOI: 10.1136/openhrt-2018-000929] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/17/2019] [Accepted: 02/03/2019] [Indexed: 11/22/2022] Open
Abstract
Background Mutations in genes encoding ion channels or sarcomeric proteins are an important cause of hereditary cardiac disease. However, the severity of the resultant disease varies considerably even among those with an identical mutation. Such clinical variation is often thought to be explained largely by differences in genetic background or 'modifier genes'. We aimed to test the prediction that identical genetic backgrounds result in largely similar clinical expression of a cardiac disease causing mutation, by studying the clinical expression of mutations causing cardiac disease in monozygotic twins. Methods We compared first available clinical information on 46 monozygotic twin pairs and 59 control pairs that had either a hereditary cardiomyopathy or channelopathy. Results Despite limited power of this study, we found significant heritability for corrected QT interval (QTc) in long QT syndrome (LQTS). We could not detect significant heritability for structural traits, but found a significant environmental effect on thickness of the interventricular septum in hypertrophic cardiomyopathy. Conclusions Our study confirms previously found robust heritability for electrical traits like QTc in LQTS, and adds information on low or lacking heritability for structural traits in heritable cardiomyopathies. This may steer the search for genetic modifiers in heritable cardiac disease.
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Affiliation(s)
- Joeri A Jansweijer
- Heart Center, Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Michael W T Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - J Peter van Tintelen
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Clinical Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Imke Christiaans
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Jasper J van der Smagt
- Department of Medical Genetics, University Medical Center Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Alexa M C Vermeer
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - J Martijn Bos
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Arthur J Moss
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, New York, USA
| | - Heikki Swan
- Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Sylvia G Priori
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Annika Rydberg
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Jacob Tfelt-Hansen
- Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael J Ackerman
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Iacopo Olivotto
- Department of Cardiology, Careggi University Hospital, Florence, Italy
| | - Philippe Charron
- Department of Clinical Genetics, Hopital Ambroise-Pare, Boulogne-Billancourt, France
| | - Juan R Gimeno
- Department of Cardiology, Universitary Hospital Virgen Arrixaca, El Palmar, Murcia, Spain
| | | | - Arthur AM Wilde
- Heart Center, Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Centre of Excellence in Research of Hereditary Disorders, Princess Al-Jawhara Al-Brahim, Jeddah, Saudi Arabia
| | - Yigal M Pinto
- Heart Center, Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Enck P, Mazurak N. The "Biology-First" Hypothesis: Functional disorders may begin and end with biology-A scoping review. Neurogastroenterol Motil 2018; 30:e13394. [PMID: 29956418 DOI: 10.1111/nmo.13394] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/16/2018] [Indexed: 02/08/2023]
Abstract
While it is generally accepted that gastrointestinal infections can cause functional disturbances in the upper and lower gastrointestinal tract-known as postinfectious irritable bowel syndrome (PI-IBS) and functional dyspepsia (PI-FD)-it has still not been widely recognized that such an infection can also initiate functional non-intestinal diseases, and that non-intestinal infections can provoke both intestinal and non-intestinal functional disturbances. We conducted a scoping review of the respective literature and-on the basis of these data-hypothesize that medically unexplained functional symptoms and syndromes following an infection may have a biological (genetic, endocrine, microbiological) origin, and that psychological and social factors, which may contribute to the disease "phenotype," are secondary to this biological cause. If this holds true, then the search for psychological and social theories and factors to explain why one patient develops a chronic functional disorder while another does not is-at least for postinfectious states-misleading and detracts from exploring and identifying the true origins of these essentially biological disorders. The biopsychosocial model may, as the term implies, always begin with biology, also for functional (somatoform) disorders.
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Affiliation(s)
- P Enck
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - N Mazurak
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Sas AA, Vaez A, Jamshidi Y, Nolte IM, Kamali Z, D. Spector T, Riese H, Snieder H. Genetic and environmental influences on stability and change in baseline levels of C-reactive protein: A longitudinal twin study. Atherosclerosis 2017; 265:172-178. [DOI: 10.1016/j.atherosclerosis.2017.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 07/27/2017] [Accepted: 08/17/2017] [Indexed: 10/19/2022]
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Abstract
OBJECTIVES Blood pressure variability (BPV) and its reduction in response to antihypertensive treatment are predictors of clinical outcomes; however, little is known about its heritability. In this study, we examined the relative influence of genetic and environmental sources of variance of BPV and the extent to which it may depend on race or sex in young twins. METHODS Twins were enrolled from two studies. One study included 703 white twins (308 pairs and 87 singletons) aged 18-34 years, whereas another study included 242 white twins (108 pairs and 26 singletons) and 188 black twins (79 pairs and 30 singletons) aged 12-30 years. BPV was calculated from 24-h ambulatory blood pressure recording. RESULTS Twin modeling showed similar results in the separate analysis in both twin studies and in the meta-analysis. Familial aggregation was identified for SBP variability (SBPV) and DBP variability (DBPV) with genetic factors and common environmental factors together accounting for 18-40% and 23-31% of the total variance of SBPV and DBPV, respectively. Unique environmental factors were the largest contributor explaining up to 82-77% of the total variance of SBPV and DBPV. No sex or race difference in BPV variance components was observed. The results remained the same after adjustment for 24-h blood pressure levels. CONCLUSIONS The variance in BPV is predominantly determined by unique environment in youth and young adults, although familial aggregation due to additive genetic and/or common environment influences was also identified explaining about 25% of the variance in BPV.
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Abstract
The serotonin transporter gene has been hypothesized to influence, possibly in interaction with environmental factors, the vulnerability for depression. So far, genetic studies have tested the association of the repeat polymorphism (5-HTTLPR) with depression and whether it is moderated by exposure to stressful events. This has not yielded unequivocal results, even across meta-analyses. However, environmental factors may induce epigenetic changes in the structure of DNA that can influence gene expression. These epigenetic effects may be independent of the genetic polymorphisms in the gene region. This editorial reviews an article in this issue that compared the intrapair differences in depressive symptoms in monozygotic twin pairs with the intrapair differences of methylation at cytosine-guanine dinucleotide sites in the promoter region of the serotonin transporter gene. Differences in depressive symptoms were correlated with differences in methylation status, such that higher methylation, which, in this sample of identical twins, must be environmental in origin, is associated with more depressive symptoms. Noteworthy is the fact that the epigenetic effects were independent of the 5-HTTLPR. These results should encourage genome-wide testing of the contribution of epigenetic effects to depression.
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Wu T, Treiber FA, Snieder H. Genetic influence on blood pressure and underlying hemodynamics measured at rest and during stress. Psychosom Med 2013; 75:404-12. [PMID: 23576770 PMCID: PMC3672690 DOI: 10.1097/psy.0b013e31828d3cb6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study examined the genetic and environmental contributions to the individual differences in blood pressure (BP) levels and underlying hemodynamic characteristics at rest and during mental challenge tasks in a large twin cohort of youth. Including both European American and African American twins further allowed examination of potential ethnic differences. METHODS We studied cardiovascular reactivity to two stressors (car-driving simulation and a social stressor interview) in 308 European American and 223 African American twin pairs including monozygotic twin pairs and same-sex as well as opposite-sex dizygotic twin pairs (mean [standard deviation] age = 14.7 [3.1]). Variables included systolic and diastolic BP, heart rate, stroke volume, cardiac output, and total peripheral resistance. RESULTS Heritability indices for levels at rest and during stress were high (31%-73%) and comparable between ethnic groups. A common genetic factor accounted for both resting and stress levels explaining 23% to 58% of the total variance. The increases in heritability indices for BP and heart rate from rest to stress are mostly explained by newly emerging genetic influences on the added stress component. Indices for hemodynamic variables remained stable from rest to stress owing to a simultaneous decrease in genetic and environmental variances. CONCLUSIONS Cardiovascular measures obtained during rest and stress show substantial heritability that is comparable between individuals of African and European descent. Most of the variance in both resting and stress levels is explained by common genetic factors, although other genetic factors that only contribute to cardiovascular levels during stress are also important.
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Affiliation(s)
- Ting Wu
- Unit of Genetic Epidemiology and Bioinformatics, Department of Epidemiology, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Frank A Treiber
- Georgia Prevention Institute, Department of Pediatrics, Georgia Health Sciences University, Augusta, GA, USA
- Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Harold Snieder
- Unit of Genetic Epidemiology and Bioinformatics, Department of Epidemiology, University Medical Center Groningen, University of Groningen, the Netherlands
- Georgia Prevention Institute, Department of Pediatrics, Georgia Health Sciences University, Augusta, GA, USA
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Bosker FJ, Wu T, Gladkevich A, Ge D, Treiber FA, Snieder H. Urinary norepinephrine and epinephrine excretion rates are heritable, but not associated with office and ambulatory blood pressure. Hypertens Res 2012; 35:1164-70. [DOI: 10.1038/hr.2012.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Su S, Votaw J, Faber T, Khan D, Bremner JD, Goldberg J, Nichols K, Van Tosh A, Vaccarino V. Measurement of heritability of myocardial blood flow by positron emission tomography: the Twins Heart Study. Heart 2012; 98:495-9. [PMID: 22323242 DOI: 10.1136/heartjnl-2011-301080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To estimate the heritability of myocardial blood flow (MBF) and coronary flow reserve (CFR) measured with positron emission tomography (PET). DESIGN Cross-sectional twin study. SETTING General clinical research centre of a university hospital at Atlanta, USA. PATIENTS A sample of 180 middle-aged (mean±SD 55±2.9 years) male twins, including 107 monozygotic and 73 dizygotic twins. MAIN OUTCOME MEASURES All twins underwent imaging of MBF with PET (13)NH(3) at rest and after adenosine stress during a single imaging session. Structural equation modelling was used to estimate the heritability of MBF at rest and during adenosine stress, as well as of CFR. RESULTS The basal MBF (mean±SD) was 0.69±0.20 ml/min/g, and the MBF during adenosine stress was 1.70±0.49 ml/min/g; the CFR was 2.62±0.99. There was substantial heritability for MBF both at rest (0.48, 95% CI 0.29 to 0.64) and during adenosine stress (0.51, 95% CI 0.29 to 0.68), as well as CFR (0.48, 95% CI 0.26 to 0.65). CONCLUSIONS For the first time, a substantial genetic contribution to the interindividual variation in MBF and CFR measured with PET in middle-aged men has been demonstrated. The data suggest that a fruitful direction for future work would be the identification of genetic variants for early atherosclerotic stages assessed by PET imaging.
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Affiliation(s)
- Shaoyong Su
- Georgia Prevention Institute, Department of Pediatrics, Georgia Health Sciences University, School of Medicine, Augusta, Georgia, USA
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Fahy SJ, Sun C, Zhu G, Healey PR, Spector TD, Martin NG, Mitchell P, Wong TY, Mackey DA, Hammond CJ, Andrew T. The relationship between retinal arteriolar and venular calibers is genetically mediated, and each is associated with risk of cardiovascular disease. Invest Ophthalmol Vis Sci 2011; 52:975-81. [PMID: 20926817 DOI: 10.1167/iovs.10-5927] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Retinal arteriolar and venular calibers are highly heritable and associated with cardiovascular disease. This study was designed to investigate the relative influence of genetic and environmental factors on the high phenotypic correlation (r = 0.59) between these two traits and to assess the shared and specific influence of established and novel cardiovascular disease risk factors on them. METHODS A total of 1463 Caucasian female twins (706 monozygotic and 757 dizygotic), between 24 and 79 years of age, underwent retinal photography from which retinal arteriolar (mean, 153.75 ± 22.1 μm, SD) and venular (mean, 232.1 ± 36.6 μm) calibers were measured with semiautomated software. A bivariate heritability model was used to assess the genetic and environmental influences underlying both specific trait variance and the covariance between the vessel traits. The investigation was an assessment of phenotypic associations between retinal arteriolar and venular calibers and cardiovascular disease risk factors. RESULTS Additive genetic factors accounted for approximately three fourths of the covariance between retinal arteriolar and venular calibers within the cohort. This finding was replicated in a sample of 1981 twins from the Australian Twins Eye Study. The partial correlation showed that known risk factors accounted for only 5% of the covariance between arteriolar and venular calibers. Novel associations were found between venular caliber and β-cell function (P = 0.011) and insulin sensitivity (P = 0.002). CONCLUSIONS These results suggest that future gene-mapping studies may identify pleiotropic genetic variants influencing both retinal arteriolar and venular calibers. Genetic variants associated with retinal caliber and (risk factors for) cardiovascular disease should provide new etiologic insights into this complex disease.
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Affiliation(s)
- Samantha J Fahy
- Department of Twin Research and Genetic Epidemiology, King's College London, School of Medicine, London, United Kingdom.
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Abstract
OBJECTIVE To assess longitudinal changes in genetic and environmental influences on Type D personality and its subcomponents negative affectivity (NA) and social inhibition (SI) over a 9-year period. Most personality constructs have good retest reliability over long periods, with stability attributed to genes, and changes to environmental factors. Type D personality is stable across an 18-month period and is influenced by genetic factors. However, there is no knowledge on long-term stability, and the contributions of genes and environment to that stability. METHODS Type D personality was determined from survey data collected in 1991 (n = 3235; mean age = 17.3 years), 1997 (n = 3133; mean age = 25.3 years), and 2000 (n = 4456; mean age = 29.6 years) in a population sample of healthy twins. Multivariate structural equation modeling was employed. RESULTS Type D heritability ranged from 50% in 1997 to 34% in 2000, with the same genetic factor affecting Type D at all time points. Heritability of SI ranged from 49% (1991) to 42% (2000), with the same genetic factor influencing SI at all times. Heritability estimates for NA ranged from 45% (1991) to 40% (2000), with one genetic factor influencing NA at all times, and one genetic factor influencing NA at the second and third occasions. Different environmental factors acted on Type D, NA, and SI at each of the three measurement occasions. CONCLUSION Type D personality and both subcomponents are stable over time, which is largely due to genetic factors. Different unique environmental factors influence the Type D components at different occasions.
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Genetic and environmental influences on blood pressure and body mass index in Han Chinese: a twin study. Hypertens Res 2010; 34:173-9. [PMID: 21048779 DOI: 10.1038/hr.2010.194] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The familial aggregation of blood pressure (BP) may be partly due to the familial aggregation of obesity, caused by genetic and/or environmental factors that influence both. Gene-obesity interactions are expected to result in different heritability estimates for BP at different obesity levels. However, the latter hypothesis has never been tested. The present study included 1243 monozygotic and 833 dizygotic Han Chinese twins (mean±s.d. age: 37.81 ± 9.82; range: 19.1-81.4) from the Chinese National Twin Registry. Body mass index (BMI) was used as the index of general obesity. The outcome measures were systolic BP (SBP) and diastolic BP (DBP). Quantitative genetic modeling was performed using Mx software. The SBP and DBP heritabilities were 46 and 30%, respectively. The positive correlations of BMI with SBP (r=0.26) and with DBP (r=0.27) were largely due to genetic factors (approximately 85%). Genetic factors, which also influence BMI, account for 6 and 7% of the total variance for SBP and DBP, respectively. The gene-obesity interaction analysis showed that both common and unique environmental influences on SBP increased with increasing levels of BMI, resulting in a lower heritability at higher BMI levels, whereas for DBP the heritability remained unchanged at higher BMI levels. Our results suggest that higher BMIs may reduce SBP heritability through a larger impact of environmental effects. These conclusions may be valuable for gene-finding studies.
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Lee J, Chen L, Snieder H, Chen DF, Lee LM, Liu GF, Wu T, Tang X, Zhan SY, Cao WH, Lv J, Gao WJ, Hu YH. Heritability of Obesity-related Phenotypes and Association with Adiponectin Gene Polymorphisms in the Chinese National Twin Registry. Ann Hum Genet 2010; 74:146-54. [DOI: 10.1111/j.1469-1809.2010.00565.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Wu T, Snieder H, de Geus E. Genetic influences on cardiovascular stress reactivity. Neurosci Biobehav Rev 2009; 35:58-68. [PMID: 19963006 DOI: 10.1016/j.neubiorev.2009.12.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Revised: 11/23/2009] [Accepted: 12/01/2009] [Indexed: 01/01/2023]
Abstract
Individual differences in the cardiovascular response to stress play a central role in the reactivity hypothesis linking frequent exposure to psychosocial stress to adverse outcomes in cardiovascular health. To assess the importance of genetic factors, a meta-analysis was performed on all published twin studies that assessed heart rate (HR) or blood pressure (BP) reactivity to the cold pressor test or various mental stress tasks. For reactivity to mental stress, the pooled heritability estimate ranged from 0.26 to 0.43. Reactivity to the cold pressor test yielded heritability estimates from 0.21 to 0.55. An ensuing review of genetic association studies revealed a number of genes, mostly within the sympathoadrenal pathway, that may account for part of the heritability of cardiovascular stress reactivity. Future progress in gene finding, that should include measures of sympathetic and vagal stress reactivity, may help uncover the molecular pathways from genetic variation to stress reactivity.
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Affiliation(s)
- Ting Wu
- Unit of Genetic Epidemiology and Bioinformatics, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Harris AHS, Reeder R, Hyun JK. Common statistical and research design problems in manuscripts submitted to high-impact psychiatry journals: what editors and reviewers want authors to know. J Psychiatr Res 2009; 43:1231-4. [PMID: 19435635 DOI: 10.1016/j.jpsychires.2009.04.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/09/2009] [Accepted: 04/17/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Journal editors and statistical reviewers are often in the difficult position of catching serious problems in submitted manuscripts after the research is conducted and data have been analyzed. We sought to learn from editors and reviewers of major psychiatry journals what common statistical and design problems they most often find in submitted manuscripts and what they wished to communicate to authors regarding these issues. Our primary goal was to facilitate communication between journal editors/reviewers and researchers/authors and thereby improve the scientific and statistical quality of research and submitted manuscripts. METHOD Editors and statistical reviewers of 54 high-impact psychiatry journals were surveyed to learn what statistical or design problems they encounter most often in submitted manuscripts. Respondents completed the survey online. The authors analyzed survey text responses using content analysis procedures to identify major themes related to commonly encountered statistical or research design problems. RESULTS Editors and reviewers (n=15) who handle manuscripts from 39 different high-impact psychiatry journals responded to the survey. The most commonly cited problems regarded failure to map statistical models onto research questions, improper handling of missing data, not controlling for multiple comparisons, not understanding the difference between equivalence and difference trials, and poor controls in quasi-experimental designs. CONCLUSIONS The scientific quality of psychiatry research and submitted reports could be greatly improved if researchers became sensitive to, or sought consultation on frequently encountered methodological and analytic issues.
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Affiliation(s)
- Alex H S Harris
- Center for Health Care Evaluation, VA Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, CA 94025, USA.
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Liu GF, Riese H, Spector TD, Mangino M, O'Dell SD, Stolk RP, Snieder H. Bivariate genetic modelling of the response to an oral glucose tolerance challenge: a gene x environment interaction approach. Diabetologia 2009; 52:1048-55. [PMID: 19288074 DOI: 10.1007/s00125-009-1325-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Accepted: 02/17/2009] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS Twin and family studies have shown the importance of genetic factors influencing fasting and 2 h glucose and insulin levels. However, the genetics of the physiological response to a glucose load has not been thoroughly investigated. METHODS We studied 580 monozygotic and 1,937 dizygotic British female twins from the Twins UK Registry. The effects of genetic and environmental factors on fasting and 2 h glucose and insulin levels were estimated using univariate genetic modelling. Bivariate model fitting was used to investigate the glucose and insulin responses to a glucose load, i.e. an OGTT. RESULTS The genetic effect on fasting and 2 h glucose and insulin levels ranged between 40% and 56% after adjustment for age and BMI. Exposure to a glucose load resulted in the emergence of novel genetic effects on 2 h glucose independent of the fasting level, accounting for about 55% of its heritability. For 2 h insulin, the effect of the same genes that already influenced fasting insulin was amplified by about 30%. CONCLUSIONS/INTERPRETATION Exposure to a glucose challenge uncovers new genetic variance for glucose and amplifies the effects of genes that already influence the fasting insulin level. Finding the genes acting on 2 h glucose independently of fasting glucose may offer new aetiological insight into the risk of cardiovascular events and death from all causes.
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Affiliation(s)
- G F Liu
- Department of Epidemiology, Unit of Genetic Epidemiology and Bioinformatics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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McCaffery JM, Duan QL, Frasure-Smith N, Barhdadi A, Lespérance F, Théroux P, Rouleau GA, Dubé MP. Genetic predictors of depressive symptoms in cardiac patients. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:381-8. [PMID: 18618671 PMCID: PMC2660383 DOI: 10.1002/ajmg.b.30824] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Numerous studies suggest that the prevalence of depression is greater among cardiac patients than in the general population. However, little attention has been paid to the possibility of genetic contributions to depressive symptoms in cardiac patients. We conducted a candidate gene study focusing on genes related to inflammation, platelet aggregation, endothelial function and omega-3 fatty acid metabolism as predictors of depressive symptoms among 977 participants with established cardiovascular disease. Results suggested that genetic variation related to endothelial dysfunction is predictive of depressive symptoms and that endothelial dysfunction may be a novel mechanism contributing to depressive symptoms among cardiac patients.
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Affiliation(s)
- Jeanne M. McCaffery
- Weight Control and Diabetes Research Center, Brown Medical School and The Miriam Hospital
| | | | - Nancy Frasure-Smith
- Department of Psychiatry and School of Nursing, McGill University; the Research Center, Montreal Heart Institute; the Department of Psychiatry, University of Montreal; and the Research Center, Centre Hospitalier de l’Université de Montréal
| | - Amina Barhdadi
- Department of Medicine, Université de Montréal and the Research Centre of the Montreal Heart Institute
| | | | | | - Guy A. Rouleau
- Department of Medicine, University of Montreal; and the Research Center, Centre Hospitalier de l’Université de Montréal
| | - Marie-Pierre Dubé
- Department of Medicine, Université de Montréal and the Research Centre of the Montreal Heart Institute
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Freedland KE, de Geus EJC, Golden RN, Kop WJ, Miller GE, Vaccarino V, Brumback B, Llabre MM, White VJ, Sheps DS. What's in a name? Psychosomatic medicine and biobehavioral medicine. Psychosom Med 2009; 71:1-4. [PMID: 19124618 DOI: 10.1097/psy.0b013e3181954848] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Ge D, Su S, Zhu H, Dong Y, Wang X, Harshfield GA, Treiber FA, Snieder H. Stress-induced sodium excretion: a new intermediate phenotype to study the early genetic etiology of hypertension? Hypertension 2008; 53:262-9. [PMID: 19104006 DOI: 10.1161/hypertensionaha.108.118117] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Impaired stress-induced pressure natriuresis, ie, an inadequate compensatory increase in urinary sodium excretion (U(Na)V) in response to a stress-induced blood pressure increase, may lead to the premature development of essential hypertension. To assess the heritability of baseline U(Na)V, stress U(Na)V, and the U(Na)V response to stress (Delta U(Na)V=stress U(Na)V- baseline U(Na)V), we studied 396 black and 494 white twins, including monozygotic and dizygotic twins of the same as well as the opposite sex (mean age: 17.6+/-3.3 years; range: 11.9 to 30.0 years). Bivariate genetic model fitting was performed to examine the extent to which genetic and environmental factors are common or specific to baseline and stress U(Na)V. Heritability estimates for Delta U(Na)V can be derived from these bivariate models. All of the bivariate analyses were performed separately in whites and blacks, because univariate models for baseline U(Na)V showed significant ethnic differences in heritability estimates. Best-fitting models showed that the heritability of stress U(Na)V was 0.42 in whites and 0.58 in blacks. Only 15% and 11% of the total variance could be attributed to genetic factors common to baseline and stress U(Na)V in whites and blacks, respectively. After removal of all of the shared influences with baseline U(Na)V, heritabilities for stress U(Na)V were 0.32 in whites and 0.57 in blacks. Heritability estimates for Delta U(Na)V were 0.36 in whites and 0.39 in blacks. In summary, this study establishes Delta U(Na)V and stress U(Na)V as heritable phenotypes that may be used to study the genetic etiology of early hypertension development.
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Affiliation(s)
- Dongliang Ge
- Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta, Georgia, USA
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21
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De Geus EJC, Kupper N, Boomsma DI, Snieder H. Bivariate genetic modeling of cardiovascular stress reactivity: does stress uncover genetic variance? Psychosom Med 2007; 69:356-64. [PMID: 17510291 DOI: 10.1097/psy.0b013e318049cc2d] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the existence of gene-by-stress interaction by assessing cardiovascular stress reactivity in monozygotic and dizygotic twins. METHODS We studied 160 adolescent (mean age 16.7 +/- 2.0 years; range 13-22 years) and 212 middle-aged twin pairs (mean age 44.2 +/- 6.7 years; range 34-63 years). Systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), pre-ejection period (PEP), and respiratory sinus arrhythmia (RSA) were measured at rest and during a choice reaction time and a mental arithmetic task. We used a bivariate analysis of the resting and mean stress levels to test for gene-by-stress interaction, which can be caused by the emergence of new genetic variance specific to stress or by stress-induced amplification of the existing genetic variance at rest. RESULTS Genetic factors significantly contributed to individual differences in resting SBP, DBP, HR, PEP, and RSA levels in the adolescent (heritability range 0.31-0.70) and middle-aged (heritability range 0.32-0.64) cohorts. The effect of these genetic factors was amplified by stress for all variables in the adolescent cohort, and for SBP in the middle-aged cohort. In addition, stress-specific genetic variation emerged for HR in both cohorts and for PEP and SBP in the adolescent cohort. Heritability of stress levels of SBP, DBP, HR, PEP, and RSA ranged from 0.54 to 0.74 in the adolescents and from 0.44 to 0.64 in the middle-aged cohort. CONCLUSIONS Stress uncovers genetic variance in BP, HR, and cardiac sympathovagal balance through the emergence of new stress-specific genetic effects and the amplification of existing genetic effects that also affect the resting values.
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Affiliation(s)
- Eco J C De Geus
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, Netherlands.
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