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Nature or nurture? Definitions The expression of many common diseases such as cardiovascular disease, hypertension, diabetes, asthma, psychiatric disorders, and certain cancers is determined by genetic background, environmental factors, and lifestyle. Polygenic: multiple genes are thought to contribute to the phenotype. Complex genetic traits may be influenced by modifying genes that are not linked to the main gene involved in the pathogenesis of the trait. This type of gene-gene interaction, or epistasis, plays an important role in polygenic traits that require the simultaneous presence of variations in multiple genes in order to result in a pathologic phenotype. Polygenic Inheritance: a pattern responsible for many features that seem simple on the surface. Many traits such as height, shape, weight, color, and metabolic rate are governed by the cumulative effects of many genes. Polygenic traits are not expressed as absolute or discrete characters, as was the case with Mendel's pea plant traits. Instead, polygenic traits are recognizable by their expression as a gradation of small differences (a continuous variation). The results form a bell shaped curve, with a mean value and extremes in either direction. Multifactorial: multiple genes are assumed to interact with environmental factors.