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.