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The Association Between Prolonged Fatigue and Cardiovascular Disease in World War II Veteran Twins

Published online by Cambridge University Press:  21 February 2012

Annette L. Fitzpatrick*
Affiliation:
Department of Epidemiology, University of Washington, Seattle, Washington, United States of America. fitzpal@u.washington.edu
Terry Reed
Affiliation:
Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, United States of America.
Jack Goldberg
Affiliation:
Vietnam Era Twin Registry, Seattle VA Epidemiologic Research and Information Center, Seattle, Washington and Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.
Dedra Buchwald
Affiliation:
Department of Medicine, University of Washington, Seattle, Washington, United States of America.
*
*Address for correspondence: Annette L. Fitzpatrick, Department of Epidemiology, University of Washington, Building 29, Suite 310, 6200 NE 74th Street, Seattle, WA, 98115, USA.

Abstract

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Reports of fatigue preceding cardiac events have recently been confirmed by large prospective studies. To assess for genetic confounding, we investigated prolonged fatigue and cardiovascular disease (CVD) in a cohort of World War II veteran twins. We examined data from a questionnaire mailed to members of the National Academy of Sciences–National Research Council (NAS–NRC) World War II Twins Registry in 1998 and 1999 which included questions on demographics, medical conditions and symptoms of fatigue. Data from twins discordant for prolonged fatigue lasting a month or more were analyzed using conditional logistic regression. Among 1955 twin pairs, 157 monozygotic and 174 dizygotic pairs (mean age 74 years) were discordant for prolonged fatigue. An association was found between prolonged fatigue and a history of myocardial infarction or coronary artery surgery adjusting for age, socioeconomic status, smoking, alcohol use and depression (OR [Odds Ratio]: 2.2; 95% CI: 1.3–4.0). When analyses were performed separately by zygosity, the association was slightly larger for monozygotic (OR: 3.3; 95% CI: 1.2–9.1) than dizygotic twins (OR: 1.9; 95% CI: 0.9–4.0). These data corroborate the association of fatigue with CVD and suggest that it is not influenced by a common genetic factor. Further studies are needed to clarify the relationship and to better understand the biologic mechanisms.

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