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Published on: August 15, 2019
Contribution of Mendelian disorders to common chronic disease: opportunities for recognition, intervention, and
Maren T Scheuner1, Paula W Yoon, Muin J Khoury
1Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90095-1772,USA. scheuner@ucla.edu
Insights
Recognizing Mendelian disorders, genetic conditions with clear inheritance patterns, is key for individuals with family histories of chronic diseases. Identifying these disorders aids in diagnosis and risk assessment.
Area of Science:
- Genetics
- Medical Genetics
- Genomic Medicine
Background:
- Mendelian disorders can present as strong familial risks for common chronic diseases.
- Improved recognition of these disorders can enhance healthcare for at-risk individuals.
- The Online Mendelian Inheritance in Man (OMIM) database is a key resource for identifying genetic conditions.
Purpose of the Study:
- To identify Mendelian disorders associated with 17 common chronic diseases.
- To describe patterns of inheritance and disease combinations within these disorders.
- To assess the availability of genetic testing and management guidelines.
Main Methods:
- Reviewed the OMIM database for Mendelian disorders linked to 17 common chronic diseases.
- Selected disorders reported in multiple families with adult-onset disease.
- Utilized GeneTests/Reviews and other sources to determine genetic testing and guideline availability.
Main Results:
- Identified 188 Mendelian disorders from 2,592 OMIM entries.
- Most selected disorders (67.7%) were autosomal dominant.
- Genetic testing is available for 55% and management guidelines for 33.9% of identified disorders.
Conclusions:
- Significant clinical heterogeneity exists in Mendelian disorders presenting as familial chronic diseases.
- Recognizing inheritance patterns and disease combinations aids diagnosis.
- While genetic testing is often available, evidence-based management guidelines are needed for many conditions.
Abstract:
Recognizing Mendelian disorders should improve health care for persons with strong familial risks for common chronic diseases. The Online Mendelian Inheritance in Man (OMIM) database was reviewed to identify Mendelian disorders featuring 17 common chronic diseases, including 9 cardiovascular conditions, diabetes, and 7 common cancers. Mendelian disorders were selected if any one of the 17 diseases was reported in more than two families manifesting in adulthood. Patterns of chronic diseases and modes of inheritance associated with these Mendelian disorders are described. The GeneTests/Reviews database and other websites were reviewed to determine availability of genetic testing and management and prevention recommendations for the selected disorders. Of 2,592 (OMIM) entries reviewed, 188 Mendelian disorders were selected. Most (67.7%) are autosomal dominant disorders. Almost half (45.8%) feature combinations of the chronic diseases under study. At least one gene is known for 68.8% of the selected disorders, and clinical genetic testing is available for 55% of disorders. Guidelines for management and prevention are available for 33.9% of these, ranging from recommendations for supportive care to guidelines for managing affected persons and screening relatives. Significant clinical heterogeneity exists for Mendelian disorders that might present as strong family histories of common chronic diseases. Recognition of the different combinations of diseases within a pedigree, including mode of inheritance and heritable disease risk factors, facilitates diagnosis of these Mendelian disorders. Genetic testing is available for most disorders, which can further clarify the genetic risk, and for some, recommendations for management and prevention are available. However, evidence-based guidelines are needed.
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