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. 2014 Jun;275(6):631-9.
doi: 10.1111/joim.12177. Epub 2014 Jan 3.

Genetic factors may play a prominent role in the development of coronary heart disease dependent on important environmental factors

C Song  1 , Z Chang, P K E Magnusson, E Ingelsson, N L Pedersen
Affiliations
Free PMC article

Genetic factors may play a prominent role in the development of coronary heart disease dependent on important environmental factors

C Song et al. J Intern Med. 2014 Jun.
Free PMC article

Abstract

Objective: The aim of the study was to examine whether various lifestyle factors modify genetic influences on coronary heart disease (CHD).

Design: The effect of lifestyle factors [including smoking, sedentary lifestyle, alcohol intake and body mass index (BMI)] on risk of CHD was evaluated via Cox regression models in a twin study of gene-environment interaction. Using structure equation modelling, we estimated genetic variance of CHD dependent on lifestyle factors.

Subjects: In total, 51 065 same-sex twins from 25 715 twin pairs born before 1958 and registered in the Swedish Twin Registry were eligible for this study. During the 40-year follow-up, 7264 incident CHD events were recorded.

Results: Smoking, sedentary lifestyle and above average BMI were significantly associated with increased CHD incidence. The heritability of CHD decreased with increasing age, as well as with increasing levels of BMI, in both men and women.

Conclusions: The difference in the genetic component of CHD as a function of BMI suggests that genetic factors may play a more prominent role for disease development in the absence of important environmental factors. Increased knowledge of gene-environment interactions will be important for a full understanding of the aetiology of CHD.

Keywords: coronary heart disease; gene-environment interaction; heritability; modifiable lifestyle.

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Figures

Figure 1
Figure 1
Genetic variance (A), nonshared environmental variance (E) and heritability of CHD as a function of age in men (a) and women (b). Each unit on the x-axis represents age. Heritability of CHD, as a proportion of the total variance, is shown in the figure for selected ages (40, 50, 60, 70 and 80 years). CHD, coronary heart disease.
Figure 2
Figure 2
Variance components of CHD as a function of BMI in men. Genetic (A) and nonshared environmental (E) variance components of CHD versus BMI at the mean age at baseline are shown. Heritability of CHD, as a proportion of the total variance, is shown for BMI values of 17, 25 and 33 kg m−2. BMI, body mass index; CHD, coronary heart disease.
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