Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

Constance Jensina Ulff-Møller; Anders Jørgen Svendsen; Louise Nørgaard Viemose; Søren Jacobsen

doi:10.1016/j.semarthrit.2017.06.007

Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

Constance Jensina Ulff-Møller, Anders Jørgen Svendsen, Louise Nørgaard Viemose, Søren Jacobsen

Department of Clinical Medicine

16 Citations (Scopus)

Abstract

OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.

METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.

RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95% CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0% (95% CI: 7.15-59.1) and 7.7% (95% CI: 1.37-33.3), and pairwise concordance rates of 14.3% (95% CI: 2.57-51.3) and 7.7% (95% CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3).

CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.

Original language	English
Journal	Seminars in Arthritis and Rheumatism
Volume	47
Issue number	4
Pages (from-to)	538-544
ISSN	0049-0172
DOIs	https://doi.org/10.1016/j.semarthrit.2017.06.007
Publication status	Published - Feb 2018

Keywords

Adult
Autoimmune Diseases/epidemiology
Comorbidity
Denmark/epidemiology
Diseases in Twins/epidemiology
Female
Genetic Predisposition to Disease
Humans
Lupus Erythematosus, Systemic/epidemiology
Male
Middle Aged
Prevalence
Registries

Access to Document

10.1016/j.semarthrit.2017.06.007

Cite this

@article{f352a15fec1e49df87d58f08b8bb6ddc,

title = "Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort",

abstract = "OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95% CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0% (95% CI: 7.15-59.1) and 7.7% (95% CI: 1.37-33.3), and pairwise concordance rates of 14.3% (95% CI: 2.57-51.3) and 7.7% (95% CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3).CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.",

keywords = "Adult, Autoimmune Diseases/epidemiology, Comorbidity, Denmark/epidemiology, Diseases in Twins/epidemiology, Female, Genetic Predisposition to Disease, Humans, Lupus Erythematosus, Systemic/epidemiology, Male, Middle Aged, Prevalence, Registries",

author = "Ulff-M{\o}ller, {Constance Jensina} and Svendsen, {Anders J{\o}rgen} and Viemose, {Louise N{\o}rgaard} and S{\o}ren Jacobsen",

year = "2018",

month = feb,

doi = "10.1016/j.semarthrit.2017.06.007",

language = "English",

volume = "47",

pages = "538--544",

journal = "Seminars in Arthritis and Rheumatism",

issn = "0049-0172",

publisher = "W.B.Saunders Co.",

number = "4",

}

TY - JOUR

T1 - Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

AU - Ulff-Møller, Constance Jensina

AU - Svendsen, Anders Jørgen

AU - Viemose, Louise Nørgaard

AU - Jacobsen, Søren

PY - 2018/2

Y1 - 2018/2

N2 - OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95% CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0% (95% CI: 7.15-59.1) and 7.7% (95% CI: 1.37-33.3), and pairwise concordance rates of 14.3% (95% CI: 2.57-51.3) and 7.7% (95% CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3).CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.

AB - OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95% CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0% (95% CI: 7.15-59.1) and 7.7% (95% CI: 1.37-33.3), and pairwise concordance rates of 14.3% (95% CI: 2.57-51.3) and 7.7% (95% CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3).CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.

KW - Adult

KW - Autoimmune Diseases/epidemiology

KW - Comorbidity

KW - Denmark/epidemiology

KW - Diseases in Twins/epidemiology

KW - Female

KW - Genetic Predisposition to Disease

KW - Humans

KW - Lupus Erythematosus, Systemic/epidemiology

KW - Male

KW - Middle Aged

KW - Prevalence

KW - Registries

U2 - 10.1016/j.semarthrit.2017.06.007

DO - 10.1016/j.semarthrit.2017.06.007

M3 - Journal article

C2 - 28755788

SN - 0049-0172

VL - 47

SP - 538

EP - 544

JO - Seminars in Arthritis and Rheumatism

JF - Seminars in Arthritis and Rheumatism

IS - 4

ER -

Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

Abstract

Keywords

Access to Document

Fingerprint

Cite this