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. 2022 Oct 4;19(19):12708.
doi: 10.3390/ijerph191912708.

Comparison of Concordance of Peptic Ulcer Disease, Non-Adenomatous Intestinal Polyp, and Gallstone Disease in Korean Monozygotic and Dizygotic Twins: A Cross-Sectional Study

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Comparison of Concordance of Peptic Ulcer Disease, Non-Adenomatous Intestinal Polyp, and Gallstone Disease in Korean Monozygotic and Dizygotic Twins: A Cross-Sectional Study

Hyo Geun Choi et al. Int J Environ Res Public Health. .

Abstract

Epidemiological studies have suggested the role of multiple genetic and environmental factors in the development of non-neoplastic gastrointestinal (GI) diseases; however, little information is available on these factors in the Korean population. Therefore, this cross-sectional study explored the effect of these factors by analyzing the concordance of several benign GI disorders in 525 monozygotic twins compared to that in 122 dizygotic twins aged >20 years from the Healthy Twin Study data of the Korean Genome and Epidemiology Study (2005-2014). Chi-square test, Wilcoxon rank-sum, and binomial and multinomial logistic regression models were used for statistical analysis. There was lack of concordance of gastric/duodenal ulcers and cholelithiasis/cholangitis between monozygotic twins compared to that in dizygotic twins, suggesting that environmental factors may mediate those concordant disease expressions in monozygotic twins. The concordance of intestinal polyps in monozygotic twins was 32% lower than that in dizygotic twins (p = 0.028), indicating that the effect of genetic factors on the risk for intestinal polyp development may be low. In conclusion, the lack or low concordance of several benign GI diseases between monozygotic and dizygotic twin groups suggests the relative importance of environmental factors, indicating that these are preventable diseases.

Keywords: cholangitis; cholelithiasis; dizygotic twins; duodenal ulcer; environmental factor; gastric ulcer; genetic influence; intestinal polyp; monozygotic twins.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The study design of the present study. The 1050 monozygotic twins and 244 dizygotic twins were compared for the concordance of several common non-neoplastic gastrointestinal diseases including peptic ulcer disease, non-adenomatous intestinal polyp, and gallstone disease between twins.
Figure 2
Figure 2
Forest plots for odds ratios (OR) (95% confidence intervals) (CI) of coincidence of gastric/duodenal ulcers, non-adenomatous intestinal polyp, cholelithiasis/cholangitis according to crude, model 1 (adjusting sex, age, income, obesity, education, physical activity, frequency of alcohol consumption, smoking habit, marital status, sleep time, and medication history), and model 2 (model 1 plus history of each disease (gastric/duodenal ulcer, intestinal polyp, and cholelithiasis/cholangitis)) analyses.
Figure 3
Figure 3
Forest plots for odds ratios (OR) (95% confidence intervals) (CI) of whether the incidence of gastric/duodenal ulcers, non-adenomatous intestinal polyp, and cholelithiasis/cholangitis was more common in monozygotic or dizygotic twins.

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