Document Type : Original Article(s)

Authors

1 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The Isfahan Twin Cohort (ITC) aims to provide a comprehensive understanding of the interplay between genetics and environment in the development of Non-Communicable Diseases (NCDs). As a type of specialized epidemiological investigation, twin studies are designed to quantify the contribution of genetics to a particular phenotype when confronted with environmental factors. In this context, the present study aims to present a detailed overview of the ITC methodology.
Methods: The ITC is a prospective longitudinal study started in 2020. Data collection, including the demographics, socioeconomic status, health-related habits, medical history, and zygosity of the participants, was performed using validated questionnaires. Moreover, anthropometric measurements and blood pressure assessments were performed by a trained nurse. Also, fasting blood and morning urine samples were collected during a morning visit, and biochemical investigations were conducted at the central laboratory of the Isfahan Cardiovascular Research Institute. The participants underwent follow-up telephone interviews biannually, in which brief questionnaires were filled out on the changes in the lifestyle factors of the participants, such as diet, physical activity, psychological factors, and smoking habits. The second and final follow-up visit will include complete assessments, including blood and biological sample collections, similar to the baseline assessment. 
Results: The ITR has registered a total of 112 (n=224) monozygotic and 291 (n=582) dizygotic twin pairs during two years. The age range of the participants is 1 month to 56 years. Until November 2020 / 2021, the registered twins were categorized by age and included 48 pairs (n=96) in the infant group (monozygotic: 7 pairs, dizygotic: 41 pairs); 283 pairs (n=566) in the early childhood, late childhood, and adolescent groups (monozygotic: 74 pairs, dizygotic: 209 pairs); and 72 pairs (n=144) in the adult group (monozygotic: 31 pairs, dizygotic: 41 pairs). 
Conclusions: The cohort is being prospectively followed with plans to investigate the clinical utility of the newly developed biomarkers and gene-environmental interactions in the future.
 

Highlights

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Keywords

1.    Hur Y-M, Craig JM. Twin registries worldwide: An important resource for scientific research. Twin Research and Human Genetics. 2013;16(1):1-12.
2.    Skytthe A, Ohm Kyvik K, Vilstrup Holm N, Christensen KJSJoPH. The Danish twin registry. 2011;39(7_suppl):75-8.
3.    Lichtenstein P, Sullivan PF, Cnattingius S, Gatz M, Johansson S, Carlström E, et al. The Swedish Twin Registry in the third millennium: an update. 2006;9(6):875-82.
4.    Nilsen T, Brandt I, Harris JRJTR, Genetics H. The Norwegian twin registry. 2019;22(6):647-50.
5.    Kaprio J, Boomsma DIJTR, Genetics H. Cohorts. 2020;23(2):114-5.
6.    Hopper JL, Foley DL, White PA, Pollaers VJTR, Genetics H. Australian Twin Registry: 30 years of progress. 2013;16(1):34-42.
7.    Sumathipala A, Siribaddana S, Hotopf M, McGuffin P, Glozier N, Ball H, et al. The Sri Lankan twin registry: 2012 update. 2013;16(1):307-12.
8.    Verdi S, Abbasian G, Bowyer RC, Lachance G, Yarand D, Christofidou P, et al. TwinsUK: the UK adult twin registry update. 2019;22(6):523-9.
9.    Kaprio J, Boomsma DI. Cohorts. Twin Research and Human Genetics. 2020;23(2):114-5.
10.    Wagner K-H, Brath H. A global view on the development of non communicable diseases. Preventive medicine. 2012;54:S38-S41.
11.    Organization WH. Noncommunicable diseases country profiles 2018. 2018.
12.    Mulligan J-A, Walker D, Fox-Rushby J. Economic evaluations of noncommunicable disease interventions in developing countries: a critical review of the evidence base. Cost Effectiveness and Resource Allocation. 2006;4(1):1-10.
13.    Guo S-W. Does higher concordance in monozygotic twins than in dizygotic twins suggest a genetic component? Human heredity. 2001;51(3):121-32.
14.    Galton F. Inquiries into human faculty and its development: Macmillan; 1883.
15.    Palmer B. Double inanity: Twin studies are pretty much useless. Slate Magazine. 2011;24.
16.    Liew SHM, Elsner H, Spector TD, Hammond CJ. The first ‘classical’twin study? Analysis of refractive error using monozygotic and dizygotic twins published in 1922. Twin Research and Human Genetics. 2005;8(3):198-200.
17.    Hannon E, Knox O, Sugden K, Burrage J, Wong CC, Belsky DW, et al. Characterizing genetic and environmental influences on variable DNA methylation using monozygotic and dizygotic twins. PLoS genetics. 2018;14(8):e1007544.
18.    Gharipour M, Javanmard SH, Mansourian M, Sabri M, Khosravi E, Dianatkhah M, et al. Isfahan Twins Registry (ITR): An Invaluable Platform for Epidemiological and Epigenetic Studies: Design and Methodology of ITR. Twin Research and Human Genetics. 2019;22(6):579-82.
19.    Mohammadifard N, Sajjadi F, Maghroun M, Alikhasi H, Nilforoushzadeh F, Sarrafzadegan NJAa. Validation of a simplified food frequency questionnaire for the assessment of dietary habits in Iranian adults: Isfahan Healthy Heart Program, Iran. 2015;11(2):139.
20.    Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic review. International Journal of Behavioral Nutrition and Physical Activity. 2011;8(1):1-11.
21.    Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi SJH, outcomes qol. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. 2003;1(1):1-5.
22.    Fayers P, Bottomley A, Cancer EQoLGJEJo. Quality of life research within the EORTC—the EORTC QLQ-C30. 2002;38:125-33.
23.    Song Y-M, Lee D-H, Lee MK, Lee K, Lee HJ, Hong EJ, et al. Validity of the zygosity questionnaire and characteristics of zygosity-misdiagnosed twin pairs in the Healthy Twin Study of Korea. Twin Research and Human Genetics. 2010;13(3):223-30.
24.    Sarraf-Zadegan N, Sadri G, Malek-Afzali H, Baghaei M, Mohammadi-Fard N, Shahrokhi S, et al. Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience. Acta cardiologica. 2003;58(4):309-20.
25.    Willett WC, Dietz WH, Colditz GAJNEJoM. Guidelines for healthy weight. 1999;341(6):427-34.
26.    Heart N, Lung, Institute B, Obesity NAAftSo. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults: The Institute; 2000.
27.    James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). 2014;311(5):507-20.
28.    MWer S, Dykes D, Polesky H. A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic acids res. 1988;16(3):1215.
29.    Asbury K, Moran N, Plomin R. Do MZ twins have discordant experiences of friendship? A qualitative hypothesis-generating MZ twin differences study. PloS one. 2017;12(7):e0180521.
30.    Li Y, Liu Y, Cui J, Zhao H, Liu Y, Huang L. Cohort Studies on Chronic Noncommunicable Diseases Treated With Traditional Chinese Medicine: A Bibliometric Analysis. Frontiers in pharmacology. 2021;12:364.
31.    Tong C, Wen L, Xia Y, Leong P, Wang L, Fan X, et al. Protocol for a longitudinal twin birth cohort study to unravel the complex interplay between early-life environmental and genetic risk factors in health and disease: the Chongqing Longitudinal Twin Study (LoTiS). BMJ open. 2018;8(2):e017889.
32.    Organization WH. Global action plan for the prevention and control of noncommunicable diseases 2013-2020: World Health Organization; 2013.
33.    Budreviciute A, Damiati S, Sabir DK, Onder K, Schuller-Goetzburg P, Plakys G, et al. Management and prevention strategies for noncommunicable diseases (NCDs) and their risk factors. Frontiers in public health. 2020;8:788.
34.    Sharp GC, Relton CL. Epigenetics and noncommunicable diseases. Future Medicine; 2017.