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Nature versus nurture in gout: a twin study
Eswar Krishnan1, Christina N Lessov-Schlaggar, Ruth E Krasnow
1Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA. e.krishnan@stanford.edu
The American Journal of Medicine
|February 28, 2012
Summary
Gout risk is primarily environmental, not genetic, despite hyperuricemia having a genetic basis. This finding impacts how gout is prevented and treated.
Area of Science:
- Genetics
- Rheumatology
- Epidemiology
Background:
- Gouty arthritis (gout) is a prevalent inflammatory condition.
- The genetic contribution to gout risk is not well understood.
Purpose of the Study:
- To investigate the heritability of hyperuricemia and gout.
- To differentiate genetic and environmental influences on gout risk.
Main Methods:
- Heritability analysis conducted on 514 all-male twin pairs from the NHLBI twin study.
- Structural equation models and maximum likelihood methods were employed for statistical analysis.
- Bivariate logistic regressions identified covariates for adjustment.
Main Results:
- Hyperuricemia concordance was significantly higher in monozygotic (53%) versus dizygotic (24%) twins.
- Gout prevalence did not differ between monozygotic and dizygotic twins.
- Gout risk was substantially influenced by shared environmental factors, not genetics; hyperuricemia risk was significantly influenced by genetics.
Conclusions:
- Hyperuricemia is a heritable trait.
- Environmental factors, not genetics, are the primary drivers of gout risk (excluding rare genetic disorders).
- Findings suggest new avenues for gout prevention and treatment strategies.
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