Juan R. Ordoñana

The Murcia Twin Registry: A Population-Based Registry of Adult Multiples in Spain

The Murcia Twin Registry (MTR) was created in 2006, under the auspices of the University of Murcia and the regional Health Authority, aiming to develop a research resource in Spain intended to stimulate current research and new investigation on the analysis of genetic factors related to health and health-related behaviors. The MTR development strategy was designed as a step-by-step process. Initially, it was focused on womens health but nowadays it includes males and opposite-sex twins. The database comprises 2,281 participants born between 1940 and 1966 in the region of Murcia, in Spain. There have been three waves of data collection and today the MTR databases include questionnaire and anthropometric data as well as biological samples. The current main areas of research interest are health and health-related behaviors, including lifestyle, health promotion, and quality of life. Future short-term development points to the completion of the biobank and continuing the collection of longitudinal data.

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

To investigate the contribution of symptoms of depression to future episodes of low back pain (LBP).

Biological pathways, candidate genes, and molecular markers associated with quality-of-life domains: an update

Background There is compelling evidence of a genetic foundation of patient-reported quality of life (QOL). Given the rapid development of substantial scientific advances in this area of research, the current paper updates and extends reviews published in 2010.ObjectivesThe objective was to provide an updated overview of the biological pathways, candidate genes, and molecular markers involved in fatigue, pain, negative (depressed mood) and positive (well-being/happiness) emotional functioning, social functioning, and overall QOL.MethodsWe followed a purposeful search algorithm of existing literature to capture empirical papers investigating the relationship between biological pathways and molecular markers and the identified QOL domains.ResultsMultiple major pathways are involved in each QOL domain. The inflammatory pathway has the strongest evidence as a controlling mechanism underlying fatigue. Inflammation and neurotransmission are key processes involved in pain perception, and the catechol-O-methyltransferase (COMT) gene is associated with multiple sorts of pain. The neurotransmitter and neuroplasticity theories have the strongest evidence for their relationship with depression. Oxytocin-related genes and genes involved in the serotonergic and dopaminergic pathways play a role in social functioning. Inflammatory pathways, via cytokines, also play an important role in overall QOL.ConclusionsWhereas the current findings need future experiments and replication efforts, they will provide researchers supportive background information when embarking on studies relating candidate genes and/or molecular markers to QOL domains. The ultimate goal of this area of research is to enhance patients’ QOL.

Relationship Between Level of Education and Breastfeeding Duration Depends on Social Context: Breastfeeding Trends Over a 40-Year Period in Spain

This article presents trends of breastfeeding in Spain from the 1960s to the end of the century, analyzing the relationship between level of education and breastfeeding duration. A sample of 666 adult women provided data about breastfeeding practices for children born between 1958 and 2002. Joinpoint regression models for breastfeeding duration for the firstborn child throughout these years show a U-shaped curve, with a sharp decrease at the beginning of the 1970s (−17.2%) and a gradual increase toward the end of the century (1.9%). However, the trend for women with primary studies shows a constant decrease throughout the whole period (−7.4%), while higher education levels relate to a positive trend from the 1970s onward (3.4%). The authors conclude that in the Spanish context, maternal level of education is not associated with breastfeeding duration in the same direction or with the same magnitude across time. Factors related to breastfeeding should be studied, taking into account social context.

The Concordance and Heritability of Type 2 Diabetes in 34,166 Twin Pairs From International Twin Registers: The Discordant Twin (DISCOTWIN) Consortium

Twin pairs discordant for disease may help elucidate the epigenetic mechanisms and causal environmental factors in disease development and progression. To obtain the numbers of pairs, especially monozygotic (MZ) twin pairs, necessary for in-depth studies while also allowing for replication, twin studies worldwide need to pool their resources. The Discordant Twin (DISCOTWIN) consortium was established for this goal. Here, we describe the DISCOTWIN Consortium and present an analysis of type 2 diabetes (T2D) data in nearly 35,000 twin pairs. Seven twin cohorts from Europe (Denmark, Finland, Norway, the Netherlands, Spain, Sweden, and the United Kingdom) and one from Australia investigated the rate of discordance for T2D in same-sex twin pairs aged 45 years and older. Data were available for 34,166 same-sex twin pairs, of which 13,970 were MZ, with T2D diagnosis based on self-reported diagnosis and medication use, fasting glucose and insulin measures, or medical records. The prevalence of T2D ranged from 2.6% to 12.3% across the cohorts depending on age, body mass index (BMI), and national diabetes prevalence. T2D discordance rate was lower for MZ (5.1%, range 2.9-11.2%) than for same-sex dizygotic (DZ) (8.0%, range 4.9-13.5%) pairs. Across DISCOTWIN, 720 discordant MZ pairs were identified. Except for the oldest of the Danish cohorts (mean age 79), heritability estimates based on contingency tables were moderate to high (0.47-0.77). From a meta-analysis of all data, the heritability was estimated at 72% (95% confidence interval 61-78%). This study demonstrated high T2D prevalence and high heritability for T2D liability across twin cohorts. Therefore, the number of discordant MZ pairs for T2D is limited. By combining national resources, the DISCOTWIN Consortium maximizes the number of discordant MZ pairs needed for in-depth genotyping, multi-omics, and phenotyping studies, which may provide unique insights into the pathways linking genes to the development of many diseases.

An initiative in Spain for the study of women's health: the Murcia Twin Registry.

The present article describes the initial steps taken in setting up a twin registry in Spain. The Murcia Twin Registry (MTR) will focus initially on perimenopausal womens health. It will be administered and managed by the University of Murcia and the Murcia Health Council and will start with a database of 452 pairs of female twins born between 1940 and 1965 in the region of Murcia, Spain. Once the MTR is established and has gained some experience, our goal is to expand the age range and include males and opposite-sex twins. The current main areas of research interest are menopause, preventive behaviors, lifestyle and health as well as quality of life.

Genetics and the environment affect the relationship between depression and low back pain: a co-twin control study of Spanish twins.

Abstract Although the co-occurrence of low back pain (LBP) and depression is common, the nature of this association remains unclear. We aimed to investigate whether symptoms of depression are associated with LBP after adjusting for various confounders, including genetics. We used cross-sectional data from 2148 twins from the Murcia Twin Registry, Spain. All twins answered questions about lifetime prevalence of LBP (outcome variable) and symptoms of depression, collected through two instruments, deriving 3 measures: (1) self-report feelings of depression and anxiety; (2) state depression, and (3) trait depression. First, associations were investigated using logistic regression analysis of the total sample. We performed subsequent matched within-pair twin case–control analyses with all complete twin pairs discordant for LBP regardless of zygosity, and separately for dizygotic and monozygotic pairs. This sequential analysis allows for more precise estimates of the relationship between variables, as in each step, the impact of early shared environment and genetics is further considered. Symptoms of depression and anxiety were associated with higher prevalence of LBP in the total sample analysis (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.31-2.05), and this relationship was stronger in the subsequent case–control analysis (OR, 1.74; 95% CI, 1.13-2.69) and dizygotic case–control analysis (OR, 2.39; 95% CI, 1.39-4.08) but disappeared when the analysis was conducted for monozygotic twins (OR, 0.92; 95% CI, 0.42-2.05). A similar pattern was found for state and trait depression. The depression–LBP relationship disappears when high levels of control for confounding factors are applied and seems to be driven by genetic or environmental factors that influence both conditions.

Circadian system heritability as assessed by wrist temperature: A twin study

Previous research shows that wrist temperature (WT) is a good marker to assess the circadian system health in different circumstances. However, no studies have been performed in order to know the genetic component of this circadian marker. For this purpose, the aim was to determine, using classical twin models, the relative genetic and environmental influences on WT. The study was performed in 53 pairs of female twins (28 monozygotic (MZ) and 25 dizygotic (DZ)), with a body mass index 25.9 ± 3.78 and mean age 52 ± 6 years. The sample was selected from the Murcia Twin Register. Circadian patterns were studied by analyzing WT during one week every 10 min “Circadianware®”. Genetic influences to WT variability were estimated by comparing correlations of MZ and DZ twin pairs and fitting genetic structural equation models to measured variables. MZ twins showed higher intra-pair correlations than DZ twins for most of the parameters. Genetic factors were responsible for between 46% and 70% of variance (broad sense heritability) in parameters such as mean temperature, mesor, acrophase, Rayleigh test, percentage of rhythmicity and five hours of maximum temperature. The pattern of correlations and the genetic models point to moderate to high heritability for most of the WT parameters, suggesting a relevant genetic influence. The presence of these genetic factors points to endogenicity as the main cause of the coincidence of the WT rhythms. However, some WT parameters are still dependent on environment to a relevant extent and, hence, more amenable to change through external interventions.

Age and gender effects on the prevalence of poor sleep quality in the adult population.

OBJECTIVE Sleep quality has a significant impact on health and quality of life and is affected, among other factors, by age and sex. However, the prevalence of problems in this area in the general population is not well known. Therefore, our objective was to study the prevalence and main characteristics of sleep quality in an adult population sample. METHODS 2,144 subjects aged between 43 and 71 years belonging to the Murcia (Spain) Twin Registry. Sleep quality was measured by self-report through the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models were used to analyse the results. RESULTS The prevalence of poor sleep quality stands at 38.2%. Univariate logistic regression analyses showed that women were almost twice as likely as men (OR: 1.88; 95% confidence interval [95%CI]: 1.54 to 2.28) to have poor quality of sleep. Age was directly and significantly associated with a low quality of sleep (OR: 1.05; 95%CI: 1.03 to 1.06). CONCLUSIONS The prevalence of poor sleep quality is high among adults, especially women. There is a direct relationship between age and deterioration in the quality of sleep. This relationship also appears to be more consistent in women.

Heritability of initiation and duration of breastfeeding behavior

Breastfeeding is considered the best and most natural way of feeding infants during the first months of life. Breastfeeding has multiple short- and long-term benefits for the health of the mother and babies, and from an evolutionist standpoint, it would be a behavior worth preserving throughout time. The aim of the present study was to explore the relative influence of genetic and environmental factors in this behavior. Three hundred and ninety pairs of adult female twins provided information about whether they breastfed their children and for how long. Three variables were analyzed: initiation and duration for the first baby, and mean duration for the complete offspring. Polychoric correlations were consistently higher for monozygotic twins, supporting a role for genetic factors (0.50 [corrected] vs. 0.22 for initiation; 0.44 vs. 0.22 for duration in the first newborn; and 0.52 vs. 0.31 for duration on average). Model-fitting analyses found that in the best-fitting model, variance was explained by additive genetic and non-shared environmental factors, with estimated heritabilities ranging from 0.44 to 0.54 [corrected] in the measures studied. The rest of the variance would be due to unique environmental factors. We conclude that genetic factors have a significant impact on the complex behavior of breastfeeding.