genetic background in this twin sampleThe vast majority of monozygotic MZ twin pairs Even during the first few months however MZ twinsOoki Asaka 1993 Wilson 1979 and remain soAfter adolesc ID: 949801
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(MZ) twin pairs; when found, however, suchof obesity. We analyzed the growth patterns offor obesity. Screening 5 consecutive birth cohorts(1975Ð1979) of 22- to 27-year-old Finnish twins (theFinnTwin16 study), we found 14 obesity discordant genetic background in this twin sample.The vast majority of monozygotic (MZ) twin pairs Even during the first few months, however, MZ twins(Ooki & Asaka, 1993; Wilson, 1979) and remain soAfter adolescence, MZ intrapair correlations for 421 Growth Patterns in Young AdultMonozygotic Twin Pairs Discordant Received 16 June, 2004; accepted 16 July, 2004.Address for correspondence: Kirsi H. Pietilinen, Department ofPublic Health, PO Box 41, FIN Ð 00014 University of Helsinki,inland. E-mail: kirsi.pietilainen@helsinki.fi K W W S V G R L R U J W Z L Q 3 X E O L V K H G R Q O L Q H E \ & D P E U L G J H 8 Q L Y H U V L W \ 3 U H V V This study was directed at identifying criticalology. This was approached by searching for MZfactors, age, gender, and a close matching of child-between the co-twins are likely to arise from environ-plausibly, epigenetic mechanisms such as DNA methy-the DNA sequence and accordingly, influence growthand development. In this paper, the growth patterns FinnTwin16 cohort (Kaprio et al., 2002; Rose et al.,resulting in 5561 responses (2733 full pairs). Therespectively. All respondent twins were surveyed againBased on responses to items on current weight andwere recruited to the current study. Zygosity had been5 female pairs) participated in the clinical studies. Themeasured differences in BMI ranged from 3.8
to 10.1were also invited. Two male and two femalerespectively. This clinically smallCushingÕs disease or other major endocrinological dis-(K. P.). The twins were considered psychologicallyorigin. Parity or marital status could have possiblydescribed on a pair-to-pair basis. Further, in most(more) was leaner, but in one pair, the co-twin whosmoked more was heavier. The mean age of the dis-esting laboratory, National Public Health Institute,Helsinki, Finland, by the genotyping of multiple,vWA (12 alleles), FGA (20 alleles), AMEL (2 alleles),alleles), D5S818 (11 alleles), D13S317 (9 alleles),before their written informed consent was obtained. 422October 2004 Kirsi H. Pietilinen, Aila Rissanen, Maria Laamanen, Anna-Kaisa Lindholm, Harri Markkula, Hannele Yki-Jrvinen, and Jaakko Kaprio K W W S V G R L R U J W Z L Q 3 X E O L V K H G R Q O L Q H E \ & D P E U L G J H 8 Q L Y H U V L W \ 3 U H V V barefoot and in underwear. Weight was measured toeight was measured to[meters] squared) was used as a measure of relativeweight throughout the growth periods. In addition,the Ponderal Index (recorded birth weight [kilograms]divided by length at birth [meters] cubed) was calcu-Obstetric and delivery records were used to obtain= 15 pairs), gestational agesand workplaces. In addition, all the other records thatcare were collected. In some cases, health cards werestored at the city archives, and the records weretwin families. In males and in one female pair,(range 3Ð18). From 1 to 9.9 years, there were onones performed during the study. Thus, a total of anThe Pediator-program
(Tilator Oy Ltd., 2004) wasthe time of the study. Other measurements were notindividual were linearly interpolated between twofrom 0 to 23Ð25. Birthday 0 corresponds to the full-Stata (Vidmar et al., 2004). Creating the gender-specific, which is why we report the results (SVYMEAN, SVYTEST [Wald test] for equality ofals were derived. Use of nonparametric analyses inThe paired Wilcoxon test was used to compareBMI when studied at the metabolic ward. Thedant groups. The one-sample Wilcoxon test wascomputed to test whether the twin individualsÕ meanmean ±standard error (wise. A Heights, Weights, and Body Mass Indices at birth 25.5 tively. Males and females did not significantly differfrom each other. Compared to singletons in thetion (Cole et al., 1998), the twins in the current study-scores at birth for the males0.3 for BMIs respectively.than the referents (Wald test 423October 2004 Growth in MZ Twin Pairs Discordant and Concordant for Obesity K W W S V G R L R U J W Z L Q 3 X E O L V K H G R Q O L Q H E \ & D P E U L G J H 8 Q L Y H U V L W \ 3 U H V V (Wald test in BMIsDiscordant and concordant pairs. details in Table 1. Figure 2 shows the twinsÕ growthyoung adults (Table 1), the leaner co-twin was 221 co-twin BMI difference in the discordant pairs wasery, and was not significant (0.1 age of 6 months. From then on, no weight differenceswere apparent until the end of puberty. The adipositykg more than the leaner co-twins (quently, the weight differences gradually increased,In the pairs that were concordant for obesity asadolescence (Table 1, Figure 1). At exam
ination (agein weight and BMI, respectively, and the overweight.07) difference in weight and BMI respectively.0.4 for BMI inthe co-twins that were leaner and heavier, respectively, 424October 2004 Kirsi H. Pietilinen, Aila Rissanen, Maria Laamanen, Anna-Kaisa Lindholm, Harri Markkula, Hannele Yki-Jrvinen, and Jaakko Kaprio ) of Heights, Weights, and BMIs of the Leaner and Heavier Co-twins in Twin Pairs Discordant for Adult BMI Pairs discordant for obesity as young adultsPairs concordant for obesity as young adultsLeanerHeavierLeanerHeavierco-twinco-twinco-twinco-twin alue*Mean (Mean(Length at birth, cm947.2(0.6).9047.1(0.6)945.8(1.2).9545.7(1.1)Length at full-term birthday, cm48.8(0.7).4449.1(0.6)949.4(0.8).3148.4(1.0)10168.4(3.0).17169.1(2.9)9171.6(2.1).44171.0(2.5)10168.8(3.0).28169.4(2.8)9173.6(2.3).14173.1(2.5)10169.0(2.9).41169.4(2.9)9173.8(2.4).48173.0(2.8)eight at birth, kg92.5(0.1).0662.7(0.1)92.6(0.2).592.4(0.2)eight at full-term birthday, kg2.8(0.1).113.0(0.1)93.3(0.1).863.2(0.2)1067.1(2.6).0369.7(2.2)964.5(2.3).3765.5(2.4)1072.9(2.9).00584.3(2.7)971.0(3.1).0472.8(3.6)1073.5(2.7).00589.9(2.7)973.6(4.3).0475.9(4.8)23.3(0.7).0225.5(0.8)926.0(0.8).1125.0(0.7)11.0(0.3).0112.0(0.4)911.9(0.5).2611.5(0.5)BMI at full-term birthday, kg/m11.8(0.3).0412.5(0.3)913.5(0.3).7713.6(0.4)1023.7(1.0).0924.5(1.0)921.9(0.7).2122.4(0.8)1025.5(0.6).00529.4(0.5)923.5(0.9).0524.3(1.0) 1025.7(0.6).00531.4(0.5)924.3(1.2).00825.3(1.3)Note:* Leaner vs. heavier co-twin (paired Wilcoxon test).Interpolated to reflect body size at a given birthday.0.4 years for the discordant and for the concordant twins, respectively. K W W S V
G R L R U J W Z L Q 3 X E O L V K H G R Q O L Q H E \ & D P E U L G J H 8 Q L Y H U V L W \ 3 U H V V 425October 2004 Growth in MZ Twin Pairs Discordant and Concordant for Obesity Height for ageWeight for ageBMI for agel concordant twins ( Heavier co-twins 5 15 20 25 -1 0 1 2Age, y 5 15 20 25 -1 0 1 2 5 15 20 25 -1 0 1 Height for ageWeight for ageBMI for age 0 5 15 20 25 -1 0 1 2Age, y 5 15 20 25 -1 0 1 2Age, y 5 15 20 25 -1 0 1 2Age, y Height for ageHeight for ageWeight for ageWeight for ageBMI for ageBMI for age ). Both genders were combined after gender-specific calcula- WeightBody mass index 0 20 30 40 60 80 100 120 140 160 180Age, y 20 30 40 60 80 100Age, y 20 30 10 20 WeightBody mass indexl concordant twins ( 20 30 40 60 80 100 120 140 160 180Age, y 20 30 40 60 80 100Age, y 20 30 10 20 30Age, y/Leaner co-twins Heavier co-twins Height, cm and females were very similar. K W W S V G R L R U J W Z L Q 3 X E O L V K H G R Q O L Q H E \ & D P E U L G J H 8 Q L Y H U V L W \ 3 U H V V The concordant co-twins were comparable with each-scores for birth length were Ð2.1 after 6 months. However, both the co-twins of theoverweight concordant pairs had the weight-for-ageand BMI-for-age shown). The growth of discordant pairs was indistin-in weight-for-age (= .005) and BMI-for-age (The twin pairs were born on average at gestationalco-twins within each group (data not shown). Of thewith twin individualÕs size at birth (length = .65; BMI In this study, we found 14 MZ twin pairs discordanttwins. Of these rare pairs
, 10 participated in clinicalage of 18 years. In all but one pair, the heavier co-leaner counterparts. However, the differences wanedcence. Interestingly, both the leaner and the heavierDietz (1994) has introduced three critical periodsNotably, in our study, the same periods could be high-heavier at birth, both co-twins weighed more than theContrary to the present sample, data from previ-1998; Loos et al., 2001b; Loos et al., 2002; Wilson,adulthood. Why then were the weights of the presentdance only reappear after adolescence? It is possiblepredisposed to obesity. Such periodical increases incordant co-twins was subsequently following moreing lean or the one gaining more weight. Further, it is 426October 2004 Kirsi H. Pietilinen, Aila Rissanen, Maria Laamanen, Anna-Kaisa Lindholm, Harri Markkula, Hannele Yki-Jrvinen, and Jaakko Kaprio K W W S V G R L R U J W Z L Q 3 X E O L V K H G R Q O L Q H E \ & D P E U L G J H 8 Q L Y H U V L W \ 3 U H V V ated with decreased levels of physical activity (Brown& Trost, 2003). Combined with adopting obesity-2000; Lissner et al., 2000). In the present FinnTwin16cohort, the prevalence of overweight (BMI 6.7% to 15.2% in females respectively. Cross-sec-follow-up time in adulthood were mainly determined(Korkeila et al., 1995). In the current study, both thediscordant and the concordant pairs lived togethernot differentiate the groups from each other.study of 35- to 60-year-old MZ pairs (ously more dissimilar in behaviors than typical MZpairs. Hypothetically, the discordant pairs might alsoexposures (Vangipuram et al., 2004) c
ontributing tothe differences in the development of obesity. Further,tions are unlikely. Rather, we propose that whileUsually, phenotypic variation is surprisingly lowenvironmental conditions (Waddington, 1942). Thisdevelopmental constancy, known as canalization, maybe compromised by mutations releasing variation thatobesity, screening and phenotyping such twins intwin pairs discordant for obesity that the co-twinsÕ This work was supported by the National Institute ofEuropean Union Fifth Framework Program (QLRT-1999-00916, QLG2-CT-2002-01254) and HelsinkiUniversity Central Hospital grants. K.P. was sup-ported by a PhD studentship from the HelsinkiAhokas, Juho Vainio, Finnish Cultural, FinnishErjastiina Heikkinen, Toini Heikkinen, KaukoHeikkil, Eila Voipio, Katja Tuominen, MaaritSari Mkimattila, Mirja Tiikkainen, and Ilkka Sipil national Journal of Obesity, 20,Ball, K., Brown, W., & Crawford, D. (2002). Who doesnot gain weight? Prevalence and predictors of weight 427October 2004 Growth in MZ Twin Pairs Discordant and Concordant for Obesity K W W S V G R L R U J W Z L Q 3 X E O L V K H G R Q O L Q H E \ & D P E U L G J H 8 Q L Y H U V L W \ 3 U H V V of Obesity, 26,Berg, K. (1988). Variability gene effect on cholesterol atBrown, W. J., & Trost, S. G. (2003). Life transitions andAmerican Journal of Preventive Medicine, 25,Cole, T. J., Freeman, J. V., & Preece, M. A. (1998).fitted by maximum penalized likelihood. Dietz, W. H. (1994). Critical periods in childhood for thedevelopment of obesity. French, S. A., Harnack, L., & Jeffery, R. W. (2000). FastPrevention
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