Twin study

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Twin studies can help determine the proportion of cases of a disease that are due to inherited versus environmental factors.[1]

Classification

Hawkes proposed the following types of twin studies:[1]

Classical twin method

The classical twin method compares outcome concordance rates in monozygotic and dizygotic twins.

Co-twin control method

In the co-twin control method, discordant monozygotic are closely compared which creates matched pair control. In this design, a single pair of twins may sometimes suffice.

Biometrical genetic methods

Problems with twin studies

Prenatal environment

Twin studies assume that monozygous and dizygous twins have similar prenatal environments; however, the fetal environments of monozygous and dizygous twins may differ.[2][3]

As a separate problem, about one third of monozygotic twins are dichorionic. Dichorionic type twins have separate sets of fetal membranes due to their common ovum having divided at an early stage.[2] The importance of this can be shown in studies that find different rates of concordance between monozygotic twins that are monochorionic verus dichorionic.[4] Some experts propose that twin studies should exclude monozygotic monochorionic pairs and monozygous dichorionic pairs with different birthweights.[2]

Methods of recruiting twins for study

Twins should be recruited from regional and national registries such as the Swedish Twin Registry.[5]. Recruiting volunteer pairs may bias towards monozygotic concordance.[1]

References

  1. 1.0 1.1 1.2 Hawkes CH (1997). "Twin studies in medicine--what do they tell us?". QJM 90 (5): 311–21. PMID 9205666[e]
  2. 2.0 2.1 2.2 Phillips DI (1993). "Twin studies in medical research: can they tell us whether diseases are genetically determined?". Lancet 341 (8851): 1008–9. PMID 8096890[e]
  3. Sørensen TI (2002). "Contributions and potentials of Swedish twin research". J. Intern. Med. 252 (3): 181–3. PMID 12269999[e]
  4. Loos RJ, Beunen G, Fagard R, Derom C, Vlietinck R, Phillips DI (2001). "Twin studies and estimates of heritability". Lancet 357 (9266): 1445. PMID 11360946[e]
  5. Lichtenstein P, De Faire U, Floderus B, Svartengren M, Svedberg P, Pedersen NL (2002). "The Swedish Twin Registry: a unique resource for clinical, epidemiological and genetic studies". J. Intern. Med. 252 (3): 184–205. PMID 12270000[e]