Association of ACE I/D polymorphism and recurrent miscarriages in an Italian population with a pre-modern reproductive pattern.

Angiotensin I-converting enzyme (ACE), in addition to its role in the renin angiotensin system, has a physiological function in the fibrinolysis pathway, the accurate control of which is critical for the normal development of pregnancy. Recently, the ACE I/D polymorphism was found to be associated with recurrent spontaneous miscarriages (RM). The present study analysed the relationship between ACE I/D polymorphism and the number of spontaneous miscarriages, the number of pregnancies and the number of children in a sample of 88 Italian women born before 1930, with a pre-modern reproductive behaviour. The ACE DD genotype was more prevalent among women with RM (p = 0.02). However, the women carrying the DD genotype not only had the highest number of miscarriages (p = 0.03), but also the highest number of pregnancies with an eventual complete fertility (children no = 4.4), similar to that of women carrying the other ACE genotypes. In contrast, published data on contemporary women with RM seem to indicate that the DD genotype could now be associated with a reduced reproductive success compared to the other ACE genotypes. It is suggested that this phenomenon may be the effect of the interaction between ACE genotypes and contemporary reproductive behaviours (delay in childbearing, below-replacement fertility).

Estrogen receptor alpha polymorphisms and fertility in populations with different reproductive patterns.

The estrogen receptor (ER) plays an important role in mediating estrogen action on target tissues. ER-alpha, the most abundant, is found in all human reproductive tissues and studies on alpha-ER knockout mice have highlighted its role in reproduction. ER-alpha gene (ESR1) polymorphisms have been associated with a variety of disorders including human infertility. In this study, we examined the association of ESR1 PvuII and XbaI polymorphisms with fertility in two populations with different reproductive patterns and precisely in a sample of healthy Italian men and women (n=178) and in a sample of healthy African-Ecuadorian women (n=57). ESR1 xx and ppxx genotypes among the Italian men were found to be associated with an above-median number of children (P=0.01 and P=0.004, respectively). ESR1 pp genotype among the Italian women showed a tendency to be associated with a lower number of abortions (P=0.04), whereas ESR1 pp and ppxx genotypes among African-Ecuadorian women were associated with a higher number of children (P=0.02 and P=0.03, respectively). These results are consistent with previous observations indicating a role of ESR1 genotypes in human infertility and give insight into the complex interactions between genotypes and reproductive behaviours in human populations.

Apolipoprotein E polymorphism and fertility: a study in pre-industrial populations.

Human apolipoprotein E is the most important supplier of the cholesterol precursor for steroid hormone production in steroidogenic tissues and therefore could play a role in the regulation of steroid hormone function and influence human reproduction. This hypothesis has been confirmed by studies describing a differential fertility associated with common apolipoprotein (APOE) genotypes in two European populations. In the present investigation the impact of APOE genetic variation on fertility was studied in two Ecuadorian populations, African-Ecuadorians (57 women) and Cayapa Indians (27 women). In addition some biodemographic variables concerning women's fertility were investigated (124 African-Ecuadorian women; 40 Cayapa women) to better understand the APOE-fertility relationships in these pre-industrial populations. General fertility rates in both populations were very high (6.5 and 6.2 for the African-Ecuadorians and for the Cayapa respectively). When considering only women near the end of reproductive life (>/=40 years), a more marked difference was observed between the two groups (9.1 versus 7.7, P=0.09). In both communities, the highest number of children was found to be associated with the e*4/e*3 genotype; the e*4/e*3 genotype frequency (0.50) in the African-Ecuadorian women with 9-17 children was about three times that of the women with 0-8 children (0.14) (P=0.02). The present findings are at variance with those observed in European populations, where e*3/e*3 was the genotype associated with the highest reproductive efficiency. A possible explanation for this inconsistency could be due to the different functional properties associated with the e*3 and e*4 alleles and to genotype interactions with environmental factors including reproductive strategies.

Changes in twinning rate: Italy 1950-1996.

BACKGROUND: In the wide-ranging debate about the potential monitors of population fertility, twinning rate has been considered a candidate. In the developed countries, a decline in spontaneous twinning rate began around 1950 and continued until the late 1970s. The decrease in mean maternal age at delivery and the number of children per family have been considered as possible reasons for the decrease. The rise in twinning rates, which began in the 1980s, is probably due to the spread of assisted reproduction, at least for older mothers. METHODS: The temporal trend in twinning rate and the relationship with maternal age at delivery and birth order in the Italian population were analysed. RESULTS: The recent increase in twinning rate can be mainly attributed to the recourse to assisted reproduction techniques, as demonstrated by the twinning frequency among older primiparae. The twinning rate recently observed in young mothers approximates to the value of the 1950s, which is assumed to represent a 'natural' fertility condition. CONCLUSIONS: On the assumption that twinning is an indicator of fertility, and hence of population fitness, the present data seem to suggest that natural fertility has been slightly increasing in the Italian population.

Absence of selection on birth weight in modern Italy.

The effect of stabilizing and directional selection on birth weight has been analyzed for Italian births from 1954 to 1994, a period of rapid improvement in environmental conditions. The population of newborns was subdivided according to gestational age, one of the main covariates of birth weight. In the last cohort of births, no selection at all (neither stabilizing nor directional) was found in full-term babies, which represent more than 95% of total deliveries. Preterm babies are still selected against, even if at lower rates than in the past. It can therefore be claimed that improved and widely available prenatal and neonatal care has dramatically changed the selection patterns previously associated with birth weight in the majority of the Italian population. The mortality rates associated with birth-weight variations lying in a wide interval (2.5 kg-4.5 kg) are nowadays very similar, and both stabilizing and directional selection have practically disappeared.

Sex differential patterns in perinatal deaths in Italy.

In industrialized countries, male excess is generally found in early deaths, despite the overall decrease in mortality. We studied the association between sex and some factors generally considered crucial for babies' survival, such as mother's age and education, birth order, and gestational age, in order to gain insight into the causes underlying the persisting higher vulnerability of male sex in early life. The analysis was performed on babies dying during the perinatal period. These were subdivided into those who were stillborn and those who died during the first week of extrauterine life. A higher male excess among babies dying during the neonatal period than among those who were stillborn was always found in all classes of all factors. The finding of such generalized male overmortality in the early extrauterine period of life, together with the patterns shown by the temporal sex ratio in stillbirths and in early deaths, supports the hypothesis of a postponement of male risk from late fetal into neonatal life.

Sex ratio at reproductive age: changes over the last century in the Italian population.

The radical improvement in living conditions experienced in Italy during the last century caused a reduction in male extra-mortality during the prereproductive years. As a consequence, a progressive increase in the sex ratio at the beginning of the reproductive age (15-19 years) occurred, so that in recent times the sex ratio in the young adult population has approached the almost constant value of 1.06 observed at birth. We calculated that the sex composition would be the same in newborns and in young adults in about one generation: obviously, we have to assume that the sex differentials in mortality and migration are constant over time. The 1:1 equilibrium between sexes, which maximizes reproductive success, occurred in the 15-19 age group at the beginning of the century and shifted to the 30-35 age group in the 1990s. We compared the 1993-1995 sex ratios in different age groups in European Union countries and observed that in Italy as well as in other Mediterranean countries the numerical equality between sexes is reached at 30-35 years of age, while in north-central Europe it is reached later, approximately at the end of reproductive life.

Natural selection and reproductive behavior in Italy, 1930-1993.

We studied the relaxation of natural selection affecting the newborn population in Italy between 1930 and 1993 due to the decrease in the stillbirth (mortality) rate and the simultaneous changes in women's reproductive behavior (strategies). Results show that, apart from a drastic overall reduction, the stillbirth rate has varied among different groups of neonates. The present stillbirth rate of less than 5 per thousand, observed in 8 of the 20 phenotypic classes defined on the basis of maternal age at delivery and neonate birth order, most likely represents an unavoidable biological or genetic cost. A 9 per thousand stillbirth rate, about twice the potential minimum, exists among neonates born to women delivering at advanced age (> or = 35): the risk they face at the first or, in adverse living conditions, the fourth pregnancy could, however, be decreased by a policy aimed at countering the tendency to delay maternity and improving antenatal care in economically disadvantaged areas of the country.

Natural selection in industrialized countries: a study of three generations of Italian newborns.

We have studied the impact of natural selection on the Italian population, analysing the relationship between stillbirth and three related variables: birth weight, birth order and maternal age. A progressive relaxation of selection with time has been demonstrated by the reduction of the Haldane index calculated with respect to the three variables.

Heterogeneous effects of natural selection on the Italian newborns.

We have studied the impact of natural selection through stillbirth on the Italian population, taking into account the socio-economic heterogeneity of the country. The results suggest that older age at delivery and lower cultural level of the mothers, indicators of critical biological and socio-economic conditions, even at present increase stillbirth risk. Moreover, in the less favourable environment of the southern regions, selection is still sex-specific.

Genetic fitness in Huntington's Disease and Spinocerebellar Ataxia 1: a population genetics model for CAG repeat expansions.

An analysis of genetic fitness was performed in Huntington's Disease (HD) and Spinocerebellar Ataxia 1 (SCA1) families. Two partially overlapping samples were used: clinically defined HD and SCA1 patients from families ascertained in definite geographical areas, and molecularly typed carriers of HD and SCA1 mutations (CAG trinucleotide expansions). In both cases, a control group of normal relatives was used. HD and SCA1 patients born before 1915-20 had more children than normal controls. Carriers of HD and SCA1 mutations, all in the low/medium expansion range (37-49 and 47-54 CAG repeats respectively), had a higher number of children than controls up to more recent times (1935-1950). The reproduction of heterozygotes for large expansions could be analysed only in subjects born after 1950 and provided indirect evidence of a lower than normal number of children. The above results fit a model based on a differential fitness according to the degree of expansion. Such a model predicts that 1) up to relatively recently the frequency of alleles in the low/medium range has been maintained or even increased by the increased fitness of their carriers, as well as by new mutations, and 2) the frequency of large expansions, part of which are lost at each generation, is maintained through further expansions of alleles in the low/medium expansion range. The implications of such a model on linkage disequilibrium and the possible spread of these diseases in future generations are discussed.

Early selection and sex composition in Italy: a study at the regional level.

We have chosen four Italian regions with different degrees of industrialization and socioeconomic levels to study environmental differences in the sex ratio. The improvement in living and sanitary conditions during the last century has led to a progressive reduction in early male extramortality, and the sex ratio at birth has been almost unchanged at least to the first year of life and probably up to reproductive age. To investigate whether socioeconomic, cultural, or biological factors still influence the sex ratio at birth, we studied the stillbirth rate and the relations between newborn viability and sex composition as a function of maternal age and educational level. Our results suggest that in less favorable environments early selection against male newborns is almost twice that against female newborns when the mothers are the least favored for socioeconomic status, cultural level, and biological conditions (older than 39 years).

Factors affecting the sex ratio in humans: multivariate analysis of the Italian population.

Several studies have shown that the human secondary sex ratio is affected by a wide range of biological and environmental factors. Here, we describe a partitioning of the sex ratio variability as observed in the Italian population over the last two generations. This period has seen drastic changes in the environmental conditions of Italy. As a consequence, demographic and biological variables that can affect the sex ratio have also changed dramatically. In an attempt to isolate any specific effect, we used a stepwise multiple regression to analyze the covariation over time of the sex ratio and of relevant parameters, such as stillbirth rate, maternal age, firstborn proportion, and birth order. The results show that a quadratic function of the firstborn proportion and mother's age is a fairly good predictor of sex ratio values.

Sex ratio and selection by early mortality in humans: fifty-year analysis in different ethnic groups.

We studied the sex ratio (M/F) in representative populations of the main human ethnic groups, namely, US whites, US blacks, and Japanese. The data cover a period of over 50 years. For intra-ethnic comparison, we included analogous data on Italians. The populations studied show heterogeneous patterns: the US white and Italian populations are the most similar, with no drastic variations in live-birth sex ratio throughout the period. Comparison of sex ratio data for live-borns and 1-year-old infants yields a similar pattern in all groups; the differences between the two sex ratio values are constantly reducing. It can be hypothesized that in the near future the sex ratio observed at birth will be maintained up to reproductive age. If this value is stabilized by natural selection, as is likely, new relationships between the sex ratio and selection are expected to evolve in the populations of developed countries.

Sex ratio and natural selection in humans: a comparative analysis of two Caucasian populations.

In the course of the last century industrialized countries have experienced significant changes in mortality rates. Since the sex ratio of a population may be considered a function of, among other factors, differential mortality in the two sexes, it is expected to correlate with changes in sex-specific mortality rates. In this paper secular changes in the sex ratio at birth and after the action of relevant components of early selection (stillbirth, mortality within the first month and within the first year of life) have been studied in the Italian and in the USA White populations. The results can be summarized as follows. (i) In the past, extra male-specific mortality appeared to reduce the relatively large values of the sex ratio observed at birth, and this held true in both populations. (ii) In more recent times, male-specific mortality has been decreasing in all age groups, and the sex ratios before and after the action of early selection now tend to identical values. Therefore, it can be envisaged that in the near future the sex ratio observed at birth will be maintained up to the reproductive age. If the reproductive value is stabilized by natural selection, as is likely, new relationships between sex ratio and selection may be expected to develop in a relatively short time.

Effects of environmental changes on natural selection active on human polygenic traits.

During the last century, industrialized countries experienced such an improvement in socioeconomic conditions and in sanitation that it is likely that the selective forces active on human metric traits have been modified. Perinatal mortality as a function of birth weight is one of the clearest examples of natural selection in humans. Here, trends over time of stabilizing and directional selection associated with birth weight have been analyzed in Japan from 1969 to 1989. The population of newborns has been subdivided according to gestational age, which is one of the main covariates of birth weight. The results show that in full-term babies both stabilizing and directional selection are coming to an end, whereas in babies born after 8 months of gestation these selective forces are still active, even if at much lower levels than in the past. The peculiar results found in the 7-month-gestation population are probably due to grossly abnormal cases of immaturity.

Natural selection associated with birth weight. VI. Towards the end of the stabilizing component.

The secular trend for stabilizing selection on birth weight has been analysed in Italy from 1954 to 1985 in order to study changes in the forces of natural selection which have occurred as a consequence of progress in health care. In previous papers we demonstrated a very rapid relaxation of stabilizing selection on birth weight. In this paper we show that in the last few years this kind of selection has been coming to an end for the vast majority of Italian newborns.

Effects of environmental changes on the phenotypic expression of human polygenic traits.

The very large increase in adult stature during the last century is well documented for many countries and this phenomenon has been associated with the rapid improvement of environmental conditions. In the case of Italy, data relative to its regions and drawn from the military records of the last century showed a rapid normalization (i.e. elimination of both negative skewness and hyperkurtosis) of the distribution (1874-1938), followed by acceleration of the average increase (1938-57), which is now approaching a plateau (1957-64). Two different interactions between genotype and environment are hypothesized: the curve normalization is interpreted as being due to the elimination of extremely unfavourable conditions which inhibit growth, while the rapid stature increase is possibly due to the achievement of an environmental threshold, such as to permit a complete expression of the genetic potential. In fact, under the multifactorial model, a perfectly normal distribution is expected, unless there is differential selection before age 18.

Genetic heterogeneity in Sardinia: 15 polymorphisms examined in 11 isolates.

Blood group systems ABO, RH, MNS, KEL, FY, LU and P, red cell enzymes ACP1, PGM1, PGM2, ADA, DIA and PHI, serum markers GC, HP, IGHG1, IGHG3 and IGK were examined in about 900 individuals sampled in 11 Sardinian isolates. The genetic differentiation turned out to be relatively high and the relevance of selected and neutral genes has been evaluated.