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  Healthy Twin Study in Korea

 

 

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  1. Project  Overview

     

The "Healthy Twin" study was launched by the support of Korean NIH in year 2005. The study stemmed from the huge "Korean Twin and Family Registry", which included more than 200 thousand twin pairs and 4 million individuals with known family relationships.

If you need more information, you can download an article (Sung et al 2002) on the  baseline information about former Korean Twin and family registry, and an article (Sung et al 2006) on the study design of Healthy Twin.

   

Part 2

 2. Protocols of the "Healthy Twin" Study

    1) Questionnaire

          - Contents of Questionnaire version 1 &2

    Subject/Item

    No. of items

    Contents (Original version)

    Validation

    Target respondent

    Changes by the Version

    (ver 1 and ver2)

    F/U

    Quest

    original

    Korean

    Zygosity screening

    5

    (Australian, Finnish, Swedish twin study)

    +

    -

    Twin

    No

    Family members

    5

    Asking total family and biological relationship

    Twin

    V1 twins only -> V2 : All

    No

    Birth and development,

    handednessof twin

    20

    (Australian, Finnish, Swedish twin study)

    +

    Twin

    No

    Life time residence

    3

    Area of residence since birth (both twin)

    Twin

    No

    Perinatal history

    8

    (Australian, Finnish, Swedish twin study)

    twin's mother

    No

    Demographics

    6

    For 35 disease entities

    All

    No

    Past medical history

    35

    For 35 disease entities

    All

    V2 +retinal diseases, benign tumor of breasts

    Yes

    family history of disease and total family members

    35

    For 17 disease entities

    All

    V2 +thyroid diseases, retina/cataract/glaucoma

    Yes

    Occupation & shift work

    4

    All

    V2 +regular or temporary position

    Yes

    Job Stress

    25

    Karasek

    +

    All

    V2 +difficulty-reward model

    f/u Q: difficulty-reward model only

    Yes/No

    Depression Scale

    20

    All

    Medication

    8

    NSAIDs and vitamins

    All

    V2 +Antibiotics & prescribed Rx during 6 Months

    Yes

    smoking & ETS with FTND

    17

    +

    +

    All

    Yes

    Alcohol intake with AUDIT

    14

    +

    +

    All

    Yes

    Facial flushing

    2

    Do you flush with small amount of alcohol?

    +

    +

    All

    Only V2 and f/u Q

    Yes

    socio-economic position

    4

    Categorical income level / household No. / education level / marital status

    All

    Yes

    Physical activity

    19

    IPAQ long form

    +

    +

    All

    Short form in f/u quest. ->

    Yes

    lifetime weight change

    11

    Harvard

    All

    No

    Sleeping and snoring

    2

    Total duration of sleeping / snoring

    +

    +

    All

    No

    anxieity sensitivity

    36

    the expanded anxiety sensitivity index

    +

    +

    All

    No

    State/trait anxiety level

    40

    state trait anxiety inventory

    +

    +

    All

    No

    Presbyopia screening

    4

    -

    All

    Only in V2 & f/u Q

    Yes

    Personality

    140

    temperament and character inventory (TCI)

    +

    +

    All

    No

    Broiled and fried food

    9

    Preference&frequency of burnt/fried food

    All

    Yes

    food frequency table

    108

    Standardized food items with photographic amount exhibitions

    +

    All

    Yes

    eating behavior inventory

    33

    All

    Yes

    female reproductive history

    20

    All Women

    Yes

    sexual activity

    10

     

    Women taking Pap

    Yes

The language used in this questionnaire is Korean (current Korean version, which is the version 2 of above table), and you can also download the english version (original english version test batteries and some translations).

The language used in this questionnaire is Korean(Korean version), and you can also download the english version.

 

2-2

2) Measurements and Biorepositories 

 

      Clinical measurements

    Electrocardiogram, pulmonaryfunction test, chest X-ray, body composition analysis (Impedance),

    body fat measurement (DEXA), bone density (DEXA, whole body only)

      Physical Examination

    Physical examination, bloodpressure, height, weight, sitting height,

    arm span, head circumference, waist circumference, hip circumference

    Blood pressure, vital signs and whole body physical exams

      Cancer Screening

    1.mammography AND cytology of cervix uteri (pap smear)

    2. endoscopies: recommend national cancer screening programs over age 40 (with incentive)

    3. PSA (over age 40)

      Blood Tests and others

    Fasting plasma glucose, fastingplasma insulin,

    total cholesterol, HDL cholesterol, LDL cholesterol (directmeasure), triglyceride,

    high sensitivity C reactive protein (hs-CRP), totalprotein, albumin,

    gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine amino transferase (ALT),

    creatinine, calcium, uric acid,

    complete blood cell count (CBC) with differential count HbA1C (since mid 2006), Routine urinalysis (7 items)

      Biological Specimens

      (# of aliquots)

    DNA extract (>total 100¥ìg, -5¥ìg, 5¥ìg, others #3),

    Buffy coat with RNA preparation (2) (fixed by RNAlater ®, 2005)

    immortalized B-Cell line (>106 cells each, #3 about 90% success),

     

     serum (0.5ml, #3),

    plasma (0.5ml #2~3),

    packed red blood cell (1ml, #1)

    stool samples (3~5g, #1, starting from 2007) -> Commode stool kit (since 2009)

    12-hour urine (conical tubes #4~5),

    cervical smear and DNA extracts (mainly for HPV)

 

   3) Genotyping

         

          - STR (16 forensic markers, ABI) : for all

          - Affymetrix genechip version 6 (1M SNPs) : done 1870 individuals 

 

 

3. Update (participants)

       - age-sex distribution by twins and families (as of Dec 2008)

     

     

     

    Age

    Men

    Women

    Twin

    indivs

    Family

    Total

    Twin

    family

    sum

    Twin

    family

    sum

    MZ

    DZ

    MZ+DZ

    MZ

    DZ

    MZ+DZ

    20~29

    10

    -

    10

    86

    96

    37

    2

    39

    90

    119

    49

    176

    225

    30~39

    221

    64

    285

    138

    423

    379

    82

    461

    214

    675

    746

    352

    1,098

    40~49

    98

    16

    114

    115

    229

    179

    40

    219

    187

    406

    333

    302

    635

    50~59

    46

    22

    68

    89

    157

    48

    10

    58

    202

    260

    126

    291

    417

    60~69

    2

    -

    2

    166

    168

    2

    -

    2

    199

    201

    4

    365

    369

    70~79

    -

    -

    ¡¡-

    43

    43

    2

    -

    2

    65

    67

    2

    108

    110

    over 80

    -

    -

    -¡¡

    4

    4

    -

    -

      -

    2

    2

    -

    6

    6

    Total

    377

    102

    479

    641

    1,120

    647

    134

    781

    959

    1,740

    1,260

    1,600

    2,860

     

          - age-sex distribution of follow-up participants by twins and families (as of March 2010)

     

     

     

    Age

    Men

    Women

    Twin

    indivs

    Family

    Total

    Twin

    family

    sum

    Twin

    family

    sum

    MZ

    DZ

    MZ+DZ

    MZ

    DZ

    MZ+DZ

    20~29

    2

    -

    2

    17

    19

    9

    -

    9

    10

    19

    11

    27

    38

    30~39

    75

    21

    96

    43

    139

    144

    26

    170

    77

    247

    266

    120

    386

    40~49

    36

    11

    47

    45

    92

    90

    14

    104

    73

    177

    151

    118

    269

    50~59

    16

    4

    20

    35

    55

    17

    4

    21

    71

    92

    41

    106

    147

    60~69

    2

    -

    2

    48

    50

    -

    -

    -

    79

    79

    2

    127

    129

    70~79

    -

    -

    ¡¡-

    11

    11

    -

    -

    -

    25

    25

    -

    36

    36

    over 80

    -

    -

    -¡¡

    2

    2

    -

    -

      -

    -

    0

    -

    2

    2

    Total

    131

    36

    167

    201

    368

    260

    44

    304

    335

    639

    471

    536

    1,007

     

     

4. Publication List

     

    1. Sung J, Cho SI, Lee K, Ha M, Choi EY, Choi JS, Kim H, Kim J, Hong KS, KimY, Yoo KY, Park C, Song YM.

        Healthy Twin: a twin-family study of  Korea--protocols and current status.

        Twin Res Hum Genet 2006;9(6):844-848.

     

    2. Sung J, Cho SI, Song YM, Lee K, Choi EY, Ha M, Kim J, Kim H, Kim Y, ShinEK, Kim YH, Yoo KY, Park C, Kimm K.

        Do we need more twin studies? The HealthyTwin Study, Korea.

        Int J Epidemiol 2006;35(2):488-490.

     

    3. Lee K, Song YM, Sung J.

        Which Obesity Indicators Are Better Predictors of Metabolic Risk?: Healthy Twin Study.

        Obesity (Silver Spring) 2008: 16(4):834-40.

     

    4. Sung J, Lee K, Song YM.

        Relationship of eating behavior to long-term weight change and body mass index: The Healthy Twin study.

        Eating and Weight Disorders (EWD) 2009; 14(2-3):e98-105

     

    5. Sung J, Song YM, Stone J, Lee K, Jeong JI, Kim SS.

        Genetic influences on mammographic density in Korean twin and family: the Healthy Twin Study.

        Breask Cancer Res Treat 2010; [Epub ahead of print]

     

    6. Sung J, Song YM, Stone J, Lee K, Kim SY.

        Association of body size measurement and mammographic density in Korean women: the Healthy Twin Study.

        Cancer Epidemiology, Biomarker and Prevention 2010; 19(6): 1523-31

     

    7. Sung J, Lee K, Song YM, Lee MK, Lee DH.

        Heritability of Eating Behavior assessed Using the DEBQ (Dutch Eating Behavior Questionnaire) and Weight-related Traits:

        The Healthy Twin study.