Disease risk factors

Risk factors include age, increased peripheral body fat, and greater exposure to menstruation (i.e. short cycles, long duration of flow and reduced parity), whereas smoking, exercise, and oral contraceptive use (current and recent) may be protective [1]. There is no evidence, however, that the natural history of the disease can be influenced by controlling these factors. Genetic predisposition is likely as endometriosis occurs 6-9 times more commonly in the 1st degree relatives of affected women than in controls, and in an analysis of >3000 Australian twin pairs, 51% of the variance of the latent liability to the disease was attributable to additive genetic influences [8]. Disease her-itability is also apparent in non-human primates, which develop the disease spontaneously. These data imply that endometriosis is inherited as a complex genetic trait like diabetes or asthma, which means that a number of genes interact with each other to confer disease susceptibility but the phenotype probably emerges only in the presence of environmental risk factors. Recently, a genome-wide linkage study in 1176 affected sister pair families has identified a significant susceptibility locus for endometriosis on chromosome 10q26 and another region of suggestive linkage on chromosome 20p13 [9].

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