中国成年双生子人群冠心病分布特征

A descriptive analysis on coronary heart disease in adult twins in China

目的描述中国双生子登记系统(CNTR)成年双生子冠心病的分布特征,探索我国双生子人群中冠心病的分布规律,为遗传和环境对于冠心病的作用提供线索和依据。方法基于2010-2018年在CNTR进行登记的双生子,纳入≥18岁34583对双生子进行分析,描述冠心病的人群、地区分布特征,分别计算同卵双生子(MZ)和异卵双生子(DZ)的冠心病同病率,估算遗传度。结果研究对象年龄(34.2±12.4)岁,本研究双生子冠心病患病率为0.7%,女性、年龄较高、北方、肥胖者中冠心病患病率更高。同性别双生子对内分析发现,MZ冠心病同病率为25.3%,DZ为7.4%,MZ高于DZ且差异有统计学意义(P<0.001),冠心病的遗传度为19.3%(95%CI:11.8%~26.8%)。在不同性别、年龄、地区分层中,均有MZ的冠心病同病率大于DZ的趋势,女性、北方、18~30岁人群和≥60岁人群中,冠心病的遗传度更高。结论本研究双生子人群冠心病的分布存在人群和地区差异,冠心病受到遗传因素的影响,但在不同特征的人群中遗传效应大小可能不同。

Objective To describe the distribution characteristics of coronary heart disease in adult twins recruited from Chinese Twin Registry(CNTR),and provide clues and evidence for the effect of genetic and environmental influences on coronary heart disease.Methods By using the data of CNTR during 2010-2018,a total of 34583 twin pairs aged≥18 years who completed questionnaire survey and had related information were included in the current study to analyze the population and area distribution characteristics of coronary heart disease.Random effect models were used to compare the differences between groups.The concordane rate of coronary heart disease were calculated respectively in monozygotic(MZ)twin pairs and dizygotic(DZ)twin pairs to estimate the heritability.Results The twin pairs included in this analysis were aged(34.2±12.4)years.The overall prevalence rate of coronary heart disease in twin pairs was 0.7%.Twin pairs who were women,older,obese and lived in northern China had higher prevalence of coronary heart disease(P<0.05).Intra-pair analysis in the same-sex twin pairs found that the concordane rate of coronary heart disease was higher in MZ twin pairs(25.3%)than in DZ twins(7.4%),and the difference was statistically significant(P<0.001).The overall heritability of coronary heart disease was 19.3%(95%CI:11.8%-26.8%).Stratified by gender,age and area,the concordane rate was still higher in MZ twin pairs than in DZ pairs.Participants who were women,aged 18-30 years or≥60 years and lived in northern China had a higher heritability of coronary heart disease.Conclusion The distribution of coronary heart disease in twin pairs differed in populations and areas.The prevalence of coronary heart disease was affected by genetic factors,but the effect varied with age,gender and area.