Clustering of hypertension, diabetes, and obesity in adult male twins: same genes or same environments?

Am J Hum Genet. 1994 Sep;55(3):566-73.


We investigated the mediating role of genetic factors in the clustering of hypertension, diabetes, and obesity, using the twin registry maintained by the National Academy of Sciences--National Research Council. The study sample included 2,508 male twin pairs born between 1917 and 1927 who responded to a mailed questionnaire that covered demographic variables, cardiovascular risk factors, and health behaviors. The incidence of hypertension and diabetes in this cohort was ascertained from subjects' self-report of a physician diagnosis and/or the use of prescription medications. The body-mass index calculated from self-reports of height and weight was used as a measure of obesity. Descriptive analyses indicated probandwise concordance rates of 34.0%, 31.2%, and 32.7%, respectively, for the joint occurrences of hypertension and diabetes, hypertension and obesity, and diabetes and obesity in MZ twin pairs. Corresponding concordance rates in DZ twin pairs were 8.1%, 14.9%, and 2.8%. The probandwise concordance for the clustering of all three conditions in the same individuals was 31.6% in MZ pairs and 6.3% in DZ pairs (relative risk 5.0; X2(1) = 2.6; P < .15). Multivariate genetic modeling of the correlation in liabilities to develop these conditions suggested the presence of a common latent factor mediating the clustering of hypertension, diabetes, and obesity in this twin sample. This common factor was influenced by both genetic and environmental effects (59% 8 genetic, 41% environmental). The genetic influences on the common latent factor were due to dominant rather than additive sources; the environmental influences appeared to be specific rather than shared by co-twins.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Cluster Analysis
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / genetics*
  • Diseases in Twins / epidemiology
  • Diseases in Twins / genetics*
  • Environment
  • Genes, Dominant
  • Genetic Variation
  • Humans
  • Hypertension / epidemiology
  • Hypertension / genetics*
  • Male
  • Middle Aged
  • Military Personnel
  • Models, Genetic*
  • Multivariate Analysis
  • Obesity / epidemiology
  • Obesity / genetics*
  • Prevalence
  • Risk
  • Twins, Dizygotic
  • Twins, Monozygotic
  • United States / epidemiology