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Bell-Hensley A, Beard DC, Feeney K, Zheng H, Jiang Y, Zhang X, Liu J, Gabel H, McAlinden A. Skeletal abnormalities in mice with Dnmt3a missense mutations. Bone 2024; 183:117085. [PMID: 38522809 PMCID: PMC11057337 DOI: 10.1016/j.bone.2024.117085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024]
Abstract
Overgrowth and intellectual disability disorders in humans are typified by length/height and/or head circumference ≥ 2 standard deviations above the mean as well as intellectual disability and behavioral comorbidities, including autism and anxiety. Tatton-Brown-Rahman Syndrome is one type of overgrowth and intellectual disability disorder caused by heterozygous missense mutations in the DNA methyltransferase 3A (DNMT3A) gene. Numerous DNMT3A mutations have been identified in Tatton-Brown-Rahman Syndrome patients and may be associated with varying phenotype severities of clinical presentation. Two such mutations are the R882H and P904L mutations which result in severe and mild phenotypes, respectively. Mice with paralogous mutations (Dnmt3aP900L/+ and Dnmt3aR878H/+) exhibit overgrowth in their long bones (e.g., femur, humerus), but the mechanisms responsible for their skeletal overgrowth remain unknown. The goal of this study is to characterize skeletal phenotypes in mouse models of Tatton-Brown-Rahman Syndrome and identify potential cellular mechanisms involved in the skeletal overgrowth phenotype. We report that mature mice with the Dnmt3aP900L/+ or Dnmt3aR878H/+ mutation exhibit tibial overgrowth, cortical bone thinning, and weakened bone mechanical properties. Dnmt3aR878H/+ mutants also contain larger bone marrow adipocytes while Dnmt3aP900L/+ mutants show no adipocyte phenotype compared to control animals. To understand the potential cellular mechanisms regulating these phenotypes, growth plate chondrocytes, osteoblasts, and osteoclasts were assessed in juvenile mutant mice using quantitative static histomorphometry and dynamic histomorphometry. Tibial growth plates appeared thicker in mutant juvenile mice, but no changes were observed in osteoblast activity or osteoclast number in the femoral mid-diaphysis. These studies reveal new skeletal phenotypes associated with Tatton-Brown-Rahman Syndrome in mice and provide a rationale to extend clinical assessments of patients with this condition to include bone density and quality testing. These findings may be also informative for skeletal characterization of other mouse models presenting with overgrowth and intellectual disability phenotypes.
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Affiliation(s)
- Austin Bell-Hensley
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Diana C Beard
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA
| | - Kathryn Feeney
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Hongjun Zheng
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Yunhao Jiang
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Xiyun Zhang
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA
| | - Jin Liu
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Harrison Gabel
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA.
| | - Audrey McAlinden
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA; Department of Cell Biology & Physiology, Washington University in St. Louis, St. Louis, MO, USA; Shriners Hospital for Children - St. Louis, St. Louis, MO, USA.
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2
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Scharf A, Bezerra FF, Zembrzuski VM, Fonseca ACPDA, Gusmão L, Faerstein E. Investigation of associations of European, African, Amerindian genomic ancestries and MC4R, FTO, FAIM2, BDNF loci with obesity-related traits in Rio de Janeiro, Brazil. AN ACAD BRAS CIENC 2023; 95:e20220052. [PMID: 36921152 DOI: 10.1590/0001-3765202320220052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/02/2022] [Indexed: 03/12/2023] Open
Abstract
A complex web of causation is involved in adiposity, including environmental, social and genetic factors. We aimed to investigate associations between genetic factors such as ancestry and single nucleotide polymorphisms, and obesity-related traits in a sampled Brazilian population. A sample of 501 unrelated adults participating in 2013 at the longitudinal Pró-Saúde Study (EPS) in Rio de Janeiro, Brazil was selected. We analysed 46 AIM-InDels (insertion/deletion) as genetic ancestry markers and four single nucleotide polymorphisms located in the genes MC4R (rs17782313), FTO (rs9939609), FAIM2 (rs7138803) and BDNF (rs4074134), previously described as associated with obesity. The selected obesity-related markers were anthropometric parameters such as body mass index, waist circumference and waist-to-hip ratio, and body composition measurements namely body fat percentage, android fat mass and gynoid fat mass. The sample showed greater European ancestry (57.20%), followed by African (28.80%) and lastly Amerindian (14%). Our results suggest that the rs4074134 (BDNF) CC genotype was directly associated with gynoid fat mass, whereas body fat percentage, android fat mass and the anthropometric parameters seem not to be associated with neither ancestry nor the four polymorphisms in this population sample, most likely due to a stronger role of social, behavioural and environmental determinants.
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Affiliation(s)
- Allan Scharf
- State University of Rio de Janeiro (UERJ), DNA Diagnostic Laboratory, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
| | - Flávia F Bezerra
- State University of Rio de Janeiro (UERJ), Institute of Nutrition, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
| | - Verônica M Zembrzuski
- Oswaldo Cruz Foundation (FIOCRUZ), Human Genetics Laboratory, Oswaldo Cruz Institute, Brasil Avenue, 4365, 21040-360 Rio de Janeiro, RJ, Brazil
| | - Ana Carolina P DA Fonseca
- Oswaldo Cruz Foundation (FIOCRUZ), Human Genetics Laboratory, Oswaldo Cruz Institute, Brasil Avenue, 4365, 21040-360 Rio de Janeiro, RJ, Brazil.,Oswaldo Cruz Foundation (FIOCRUZ), Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Brasil Avenue, 4365, 21040-360 Rio de Janeiro, RJ, Brazil
| | - Leonor Gusmão
- State University of Rio de Janeiro (UERJ), DNA Diagnostic Laboratory, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
| | - Eduardo Faerstein
- State University of Rio de Janeiro (UERJ), Institute of Social Medicine, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
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Cagliyan E, Ozmen S, Timur HT, Ozgozen ME, Semiz GG. Morbidly obese pregnant woman with congenital leptin deficiency: Follow-up and obstetric outcome. J Obstet Gynaecol Res 2022; 48:2964-2967. [PMID: 35909242 DOI: 10.1111/jog.15379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022]
Abstract
Congenital leptin deficiency is a rare congenital genetic disease. It is characterized by early-onset, severe morbid obesity. The disease occurs due to mutations in the LEP gene. Obesity is a severe consequence of the disease. It also causes reproductive and obstetric complications. In this study, we present a 26-year-old pregnant case who had been previously diagnosed with congenital leptin deficiency. The pregnancy made it more difficult to regulate the metabolic changes caused by the disease. Problems were held by a multidisciplinary approach, with the contribution of endocrinology and cardiology departments. The patient gave birth to a healthy girl at the 37th week of gestation. Spontaneous pregnancy resulting in a live birth is very uncommon in women with congenital leptin deficiency. The follow-up and treatment approaches during pregnancy and the obstetric outcome are presented with the literature.
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Affiliation(s)
- Erkan Cagliyan
- Department of Gynecology and Obstetrics, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Samican Ozmen
- Department of Gynecology and Obstetrics, T.C. Sağlık Bakanlığı Karacabey Devlet Hastanesi, Bursa, Turkey
| | - Hikmet T Timur
- Department of Gynecology and Obstetrics, T.C. Sağlık Bakanlığı Urla Devlet Hastanesi, Izmir, Turkey
| | - Mehmet E Ozgozen
- Department of Gynecology and Obstetrics, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Gokcen G Semiz
- Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey
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4
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Rushing A, Sommer EC, Zhao S, Po'e EK, Barkin SL. Salivary epigenetic biomarkers as predictors of emerging childhood obesity. BMC MEDICAL GENETICS 2020; 21:34. [PMID: 32059710 PMCID: PMC7023819 DOI: 10.1186/s12881-020-0968-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 02/06/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Epigenetics could facilitate greater understanding of disparities in the emergence of childhood obesity. While blood is a common tissue used in human epigenetic studies, saliva is a promising tissue. Our prior findings in non-obese preschool-aged Hispanic children identified 17 CpG dinucleotides for which differential methylation in saliva at baseline was associated with maternal obesity status. The current study investigated to what extent baseline DNA methylation in salivary samples in these 3-5-year-old Hispanic children predicted the incidence of childhood obesity in a 3-year prospective cohort. METHODS We examined a subsample (n = 92) of Growing Right Onto Wellness (GROW) trial participants who were randomly selected at baseline, prior to randomization, based on maternal phenotype (obese or non-obese). Baseline saliva samples were collected using the Oragene DNA saliva kit. Objective data were collected on child height and weight at baseline and 36 months later. Methylation arrays were processed using standard protocol. Associations between child obesity at 36 months and baseline salivary methylation at the previously identified 17 CpG dinucleotides were evaluated using multivariable logistic regression models. RESULTS Among the n = 75 children eligible for analysis, baseline methylation of Cg1307483 (NRF1) was significantly associated with emerging childhood obesity at 36-month follow-up (OR = 2.98, p = 0.04), after adjusting for child age, gender, child baseline BMI-Z, and adult baseline BMI. This translates to a model-estimated 48% chance of child obesity at 36-month follow-up for a child at the 75th percentile of NRF1 baseline methylation versus only a 30% chance of obesity for a similar child at the 25th percentile. Consistent with other studies, a higher baseline child BMI-Z during the preschool period was associated with the emergence of obesity 3 years later, but baseline methylation of NRF1 was associated with later obesity even after adjusting for child baseline BMI-Z. CONCLUSIONS Saliva offers a non-invasive means of DNA collection and epigenetic analysis. Our proof of principle study provides sound empirical evidence supporting DNA methylation in salivary tissue as a potential predictor of subsequent childhood obesity for Hispanic children. NFR1 could be a target for further exploration of obesity in this population.
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Affiliation(s)
- Amanda Rushing
- Louisiana State University Health Sciences Center, School of Medicine, 1901 Perdido Street, New Orleans, LA, 70112, USA
| | - Evan C Sommer
- Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, Nashville, TN, 37232-9225, USA
| | - Shilin Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, 571 Preston Research Building, 2220 Pierce Ave, Nashville, TN, 37232-6838, USA
| | - Eli K Po'e
- Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, Nashville, TN, 37232-9225, USA
| | - Shari L Barkin
- Department of Pediatrics, Vanderbilt University School of Medicine, 2200 Children's Way, Doctor's Office Tower 8232, Nashville, TN, 37232-9225, USA.
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Różdżyńska-Świątkowska A, Tylki-Szymańska A. The importance of anthropological methods in the diagnosis of rare diseases. J Pediatr Endocrinol Metab 2019; 32:311-320. [PMID: 30917104 DOI: 10.1515/jpem-2018-0433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/29/2019] [Indexed: 11/15/2022]
Abstract
Most of inborn errors of metabolism (IEMs) and rare endocrine-metabolic diseases (REMD) are rare diseases. According to the European Commission on Public Health, a rare disease is defined, based on its prevalence, as one affecting one in 2000 people. Many IEMs affect body stature, cause craniofacial abnormalities, and disturb the developmental process. Therefore, body proportion, dysmorphic characteristics, and morphological parameters must be assessed and closely monitored. This can be achieved only with the help of an anthropologist who has adequate tools. This is why the role of an anthropologist in collaboration with the physician in the diagnostic process is not to be underestimated. Clinical anthropologists contribute to assessing physical development and improve our understanding of the natural history of rare metabolic diseases. This paper presents anthropometric techniques and methods, such as analysis of demographic data, anthropometric parameters at birth, percentile charts, growth patterns, bioimpedance, somatometric profiles, craniofacial profiles, body proportion indices, and mathematical models of growth curves used in certain rare diseases. Contemporary anthropological methods play an important role in the diagnostic process of rare genetic diseases.
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Affiliation(s)
| | - Anna Tylki-Szymańska
- Department of Pediatric, Nutrition and Metabolic Diseases, Children's Memorial Health Institute, Warsaw, Poland
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Mirza N, Phan TL, Tester J, Fals A, Fernandez C, Datto G, Estrada E, Eneli I. A Narrative Review of Medical and Genetic Risk Factors among Children Age 5 and Younger with Severe Obesity. Child Obes 2018; 14:443-452. [PMID: 29791184 PMCID: PMC6157342 DOI: 10.1089/chi.2017.0350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Severe obesity defined as an age- and gender-specific body mass index ≥120% of the 95th percentile in children younger than 5 years is well recognized as a significant challenge for prevention and treatment. This article provides an overview of the prevalence, classification of obesity severity, patterns of weight gain trajectory, medical and genetic risk factors, and comorbid disorders among young children with an emphasis on severe obesity. Studies suggest rapid weight gain trajectory in infancy, maternal smoking, maternal gestational diabetes, and genetic conditions are associated with an increased risk for severe obesity in early childhood. Among populations of young children with severe obesity seeking care, co-morbid conditions such as dyslipidemia and fatty liver disease are present and families report behavioral concerns and developmental delays. Children with severe obesity by age 5 represent a vulnerable population of children at high medical risk and need to be identified early and appropriately managed.
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Affiliation(s)
- Nazrat Mirza
- Department of Pediatrics and Adolescent Medicine, Children's National Health System, and George Washington University, Washington, DC
| | - Thao-Ly Phan
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
- Division of Weight Management, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE
| | - June Tester
- Division of Endocrinology, UCSF Benioff Children's Hospital Oakland, Oakland, CA
| | - Angela Fals
- Center for Child and Family Wellness, Florida Hospital for Children, Orlando, FL
| | - Cristina Fernandez
- Creighton University and Children's Hospital and Medical Center, Omaha, NE
| | - George Datto
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
- Division of Weight Management, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Elizabeth Estrada
- Pediatric Endocrinology, University of North Carolina, Chapel Hill, NC
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, and Ohio State University, Columbus, OH
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7
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de Carvalho Marchesin J, Celiberto LS, Orlando AB, de Medeiros AI, Pinto RA, Zuanon JAS, Spolidorio LC, dos Santos A, Taranto MP, Cavallini DCU. A soy-based probiotic drink modulates the microbiota and reduces body weight gain in diet-induced obese mice. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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8
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Chen CP, Lin SP, Chern SR, Chen SW, Lai ST, Chuang TY, Chen LF, Wang W. A 17-year-old boy with Klinefelter syndrome presenting Marfan syndrome-like clinical features of tall stature, scoliosis, arachnodactyly and subluxation of bilateral elbow joints. Taiwan J Obstet Gynecol 2018; 57:608-610. [PMID: 30122589 DOI: 10.1016/j.tjog.2018.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Shuan-Pei Lin
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Early Childhood Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Schu-Rern Chern
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shih-Ting Lai
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tzu-Yun Chuang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Li-Feng Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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9
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Vergier J, Marquant E, Busa T, Reynaud R. [Investigation of tall stature in children: Diagnostic work-up, review of the main causes]. Arch Pediatr 2018; 25:163-169. [PMID: 29395883 DOI: 10.1016/j.arcped.2017.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 08/27/2017] [Accepted: 12/14/2017] [Indexed: 11/27/2022]
Abstract
Tall stature is not a common motive for medical consultation, even though by definition 2.5 % of children in the general population are concerned. It is usually defined as height greater than+2 standard deviations (SD) using the appropriate growth chart for age and gender, or a difference greater than +2 SD between actual height and target height. With a patient presenting tall stature, the physician has to determine whether it is a benign feature or a disease. Indeed, making the diagnosis is essential for hormonal disease or genetic overgrowth syndromes. The past medical history including parents' height, prenatal and birth data, physical examination along with anthropometry (height, weight, head circumference, body mass index), and growth chart evaluation with the detailed growth pattern are generally sufficient to make the diagnosis such as familial tall stature, obesity, or early puberty. Bone age estimation may be helpful for some specific etiologies and is also necessary to help predict final adult height. After exclusion of common causes, further investigation is required. Sudden growth acceleration often reveals endocrine pathology such as early puberty, hyperthyroidism, or acrogigantism. Tall stature accompanied by dysmorphic features, congenital malformations, developmental delay, or a family medical history may be related to genetic disorders such as Marfan, Sotos, or Wiedemann-Beckwith syndromes. We relate here the most frequent etiologies of overgrowth syndromes.
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Affiliation(s)
- J Vergier
- Service de pédiatrie multidisciplinaire, hôpital Timone Enfants, Assistance publique des hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - E Marquant
- Service de pédiatrie multidisciplinaire, hôpital Timone Enfants, Assistance publique des hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France
| | - T Busa
- Service de génétique médicale, hôpital Timone Enfants, Assistance publique des Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France
| | - R Reynaud
- Service de pédiatrie multidisciplinaire, hôpital Timone Enfants, Assistance publique des hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France
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10
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Kamien B, Ronan A, Poke G, Sinnerbrink I, Baynam G, Ward M, Gibson WT, Dudding-Byth T, Scott RJ. A Clinical Review of Generalized Overgrowth Syndromes in the Era of Massively Parallel Sequencing. Mol Syndromol 2018; 9:70-82. [PMID: 29593474 DOI: 10.1159/000484532] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 12/22/2022] Open
Abstract
The overgrowth syndromes are important to diagnose, not just for accurate genetic counseling, but also for knowledge surrounding cancer surveillance and prognosis. There has been a recent expansion in the number of genes associated with a mendelian overgrowth phenotype, so this review updates previous classifications of overgrowth syndromes. We also describe a clinical and molecular approach to the investigation of individuals presenting with overgrowth. This review aims to assist the clinical diagnosis of generalized overgrowth syndromes by outlining the salient features of well-known overgrowth syndromes alongside the many syndromes that have been discovered and classified more recently. We provide key clinical "handles" to aid clinical diagnosis and a list of genes to aid with panel design when using next generation sequencing, which we believe is frequently needed due to the overlapping phenotypic features seen between overgrowth syndromes.
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Affiliation(s)
- Benjamin Kamien
- Hunter Genetics, Perth, WA, Australia.,School of Medicine and Public Health, The University of Newcastle, Perth, WA, Australia.,School of Biomedical Sciences and Pharmacy, The University of Newcastle, Newcastle, NSW, Australia
| | - Anne Ronan
- Hunter Genetics, Perth, WA, Australia.,School of Medicine and Public Health, The University of Newcastle, Perth, WA, Australia
| | - Gemma Poke
- Department of Clinical Genetics, Capital & Coast District Health Board, Wellington, New Zealand
| | - Ingrid Sinnerbrink
- Department of Clinical Genetics, Nepean Hospital, Perth, WA, Australia.,Nepean Clinical School, University of Sydney, Penrith, NSW, Australia
| | - Gareth Baynam
- Genetic Services of Western Australia, Newcastle, NSW, Australia.,Western Australian Register of Developmental Anomalies, Perth, WA, Australia.,Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.,Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Spatial Sciences, Department of Science and Engineering, Curtin University, Perth, WA, Australia
| | - Michelle Ward
- Genetic Services of Western Australia, Newcastle, NSW, Australia
| | - William T Gibson
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Tracy Dudding-Byth
- Hunter Genetics, Perth, WA, Australia.,GrowUpWell Priority Research Center, Perth, WA, Australia.,School of Medicine and Public Health, The University of Newcastle, Perth, WA, Australia.,Hunter Medical Research Institute, Perth, WA, Australia
| | - Rodney J Scott
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Newcastle, NSW, Australia.,Molecular Pathology, Hunter Area Pathology Service, Perth, WA, Australia
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11
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A genotype-first approach identifies an intellectual disability-overweight syndrome caused by PHIP haploinsufficiency. Eur J Hum Genet 2017; 26:54-63. [PMID: 29209020 DOI: 10.1038/s41431-017-0039-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/19/2017] [Accepted: 10/17/2017] [Indexed: 11/08/2022] Open
Abstract
Genotype-first combined with reverse phenotyping has shown to be a powerful tool in human genetics, especially in the era of next generation sequencing. This combines the identification of individuals with mutations in the same gene and linking these to consistent (endo)phenotypes to establish disease causality. We have performed a MIP (molecular inversion probe)-based targeted re-sequencing study in 3,275 individuals with intellectual disability (ID) to facilitate a genotype-first approach for 24 genes previously implicated in ID.Combining our data with data from a publicly available database, we confirmed 11 of these 24 genes to be relevant for ID. Amongst these, PHIP was shown to have an enrichment of disruptive mutations in the individuals with ID (5 out of 3,275). Through international collaboration, we identified a total of 23 individuals with PHIP mutations and elucidated the associated phenotype. Remarkably, all 23 individuals had developmental delay/ID and the majority were overweight or obese. Other features comprised behavioral problems (hyperactivity, aggression, features of autism and/or mood disorder) and dysmorphisms (full eyebrows and/or synophrys, upturned nose, large ears and tapering fingers). Interestingly, PHIP encodes two protein-isoforms, PHIP/DCAF14 and NDRP, each involved in neurodevelopmental processes, including E3 ubiquitination and neuronal differentiation. Detailed genotype-phenotype analysis points towards haploinsufficiency of PHIP/DCAF14, and not NDRP, as the underlying cause of the phenotype.Thus, we demonstrated the use of large scale re-sequencing by MIPs, followed by reverse phenotyping, as a constructive approach to verify candidate disease genes and identify novel syndromes, highlighted by PHIP haploinsufficiency causing an ID-overweight syndrome.
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12
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Ozdemir AC, Wynn GM, Vester A, Weitzmann MN, Neigh GN, Srinivasan S, Rudd MK. GNB3 overexpression causes obesity and metabolic syndrome. PLoS One 2017; 12:e0188763. [PMID: 29206867 PMCID: PMC5716578 DOI: 10.1371/journal.pone.0188763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 11/13/2017] [Indexed: 11/19/2022] Open
Abstract
The G-protein beta subunit 3 (GNB3) gene has been implicated in obesity risk; however, the molecular mechanism of GNB3-related disease is unknown. GNB3 duplication is responsible for a syndromic form of childhood obesity, and an activating DNA sequence variant (C825T) in GNB3 is also associated with obesity. To test the hypothesis that GNB3 overexpression causes obesity, we created bacterial artificial chromosome (BAC) transgenic mice that carry an extra copy of the human GNB3 risk allele. Here we show that GNB3-T/+ mice have increased adiposity, but not greater food intake or a defect in satiety. GNB3-T/+ mice have elevated fasting plasma glucose, insulin, and C-peptide, as well as glucose intolerance, indicating type 2 diabetes. Fasting plasma leptin, triglycerides, cholesterol and phospholipids are elevated, suggesting metabolic syndrome. Based on a battery of behavioral tests, GNB3-T/+ mice did not exhibit anxiety- or depressive-like phenotypes. GNB3-T/+ and wild-type animals have similar activity levels and heat production; however, GNB3-T/+ mice exhibit dysregulation of acute thermogenesis. Finally, Ucp1 expression is significantly lower in white adipose tissue (WAT) in GNB3-T/+ mice, suggestive of WAT remodeling that could lead to impaired cellular thermogenesis. Taken together, our study provides the first functional link between GNB3 and obesity, and presents insight into novel pathways that could be applied to combat obesity and type 2 diabetes.
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Affiliation(s)
- Alev Cagla Ozdemir
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Grace M. Wynn
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Aimee Vester
- Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - M. Neale Weitzmann
- Division of Endocrinology, Metabolism, and Lipids, Emory University School of Medicine, Atlanta, GA, United States of America
- Atlanta VA Medical Center, Decatur, GA, United States of America
| | - Gretchen N. Neigh
- Department of Physiology, Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Anatomy & Neurobiology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Shanthi Srinivasan
- Atlanta VA Medical Center, Decatur, GA, United States of America
- Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, United States of America
| | - M. Katharine Rudd
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, United States of America
- * E-mail:
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Harcourt BE, Bullen DVR, Kao KT, Tassoni D, Alexander EJ, Burgess T, White SM, Sabin MA. Maternal inheritance of BDNF deletion, with phenotype of obesity and developmental delay in mother and child. Am J Med Genet A 2017; 176:194-200. [PMID: 29160031 DOI: 10.1002/ajmg.a.38539] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 09/28/2017] [Accepted: 10/08/2017] [Indexed: 12/21/2022]
Abstract
Childhood obesity is a significant world health problem. Understanding the genetic and environmental factors contributing to the development of obesity in childhood is important for the rational design of strategies for obesity prevention and treatment. Brain-derived neurotrophic factor (BDNF) plays an important role in the growth and development of the central nervous system, there is also an evidence that BDNF plays a role in regulation of appetite. Disruption of the expression of this gene in a child has been previously reported to result in a phenotype of severe obesity, hyperphagia, impaired cognitive function, and hyperactivity. We report a mother and child, both with micro-deletions encompassing the BDNF gene locus, who both have obesity and developmental delay, although without hyperactivity. This report highlights the maternal inheritance of a rare genetic cause of childhood obesity.
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Affiliation(s)
- Brooke E Harcourt
- Obesity Research, Murdoch Childrens Research Institute, Parkville, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Department of Endocrinology and Diabetes, The Royal Children's Hospital, Melbourne, Australia.,Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia
| | | | - Kung-Ting Kao
- Obesity Research, Murdoch Childrens Research Institute, Parkville, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Department of Endocrinology and Diabetes, The Royal Children's Hospital, Melbourne, Australia
| | | | - Erin J Alexander
- Obesity Research, Murdoch Childrens Research Institute, Parkville, Australia.,Department of Endocrinology and Diabetes, The Royal Children's Hospital, Melbourne, Australia
| | - Trent Burgess
- Victorian Clinical Genetic Services, The Royal Children's Hospital, Melbourne, Australia
| | - Susan M White
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Victorian Clinical Genetic Services, The Royal Children's Hospital, Melbourne, Australia.,Murdoch Childrens Research Institute, Parkville, Australia
| | - Matthew A Sabin
- Obesity Research, Murdoch Childrens Research Institute, Parkville, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Department of Endocrinology and Diabetes, The Royal Children's Hospital, Melbourne, Australia
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14
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Yu YH. Making sense of metabolic obesity and hedonic obesity. J Diabetes 2017; 9:656-666. [PMID: 28093902 DOI: 10.1111/1753-0407.12529] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/10/2017] [Accepted: 01/10/2017] [Indexed: 01/01/2023] Open
Abstract
Body weight is neither stationary nor does it change unidirectionally. Rather, body weight usually oscillates up and down around a set point. Two types of forces determine the direction of weight changes. Forces that push body weight away from the set point are defined as non-homeostatic and are governed by multiple mechanisms, including, but not limited to, hedonic regulation of food intake. Forces that restore the set point weight are defined as homeostatic, and they operate through mechanisms that regulate short-term energy balance driven by hunger and satiation and long-term energy balance driven by changes in adiposity. In the normal physiological state, the deviation of body weight from the set point is usually small and temporary, and is constantly corrected by homeostatic forces. Metabolic obesity develops when body weight set point is shifted to an abnormally high level and the obese body weight becomes metabolically defended. In hedonic obesity, the obese body weight is maintained by consistent overeating due to impairments in the reward system, although the set point is not elevated. Adaptive increases in energy expenditure are elicited in hedonic obesity because body weight is elevated above the set point. Neither subtype of obesity undergoes spontaneous resolution unless the underlying disorders are corrected. In this review, the need for both appropriate patient stratification and tailored treatments is discussed in the context of the new framework of metabolic and hedonic obesity.
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Affiliation(s)
- Yi-Hao Yu
- Department of Endocrinology, Greenwich Hospital and Northeast Medical Group, Yale-New Haven Health System, Greenwich, Connecticut, USA
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15
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Page LC, Shi M, Freemark M. Early-Onset Obesity Caused by Monogenic Disorders. CURRENT PEDIATRICS REPORTS 2017. [DOI: 10.1007/s40124-017-0132-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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16
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Han JY, Lee IG, Jang W, Shin S, Park J, Kim M. Identification of a novel de novo nonsense mutation of the NSD1 gene in monozygotic twins discordant for Sotos syndrome. Clin Chim Acta 2017; 470:31-35. [PMID: 28457852 DOI: 10.1016/j.cca.2017.04.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 04/27/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Sotos syndrome is a congenital overgrowth disorder characterized by facial gestalt, excessively rapid growth, acromegalic features and a non-progressive cerebral disorder with intellectual disability. METHODOLOGY The identical male twins showed somewhat different clinical, cognitive and behavioural phenotypes. Abnormal clinical manifestations including seizures, scoliosis, enlarged ventricles, and attention-deficit/hyperactivity disorder (ADHD) were found in the proband (first twin), but not in the sibling (second twin). We used diagnostic exome sequencing (DES) to identify a heterozygous de novo mutation of the NSD1 gene in monozygotic twins with Sotos syndrome. RESULTS DES revealed a novel nonsense mutation c.2596G>T (p.Glu866*) of the NSD1 gene in the proband, the first of monozygotic twins. Sanger sequencing analysis of the proband and his family members showed that this nonsense mutation was present in the proband and his sibling, but was absent in their parents, indicating that it occurred with de novo origin. CONCLUSION This finding expands the phenotypic spectrum associated with variable expression of the Sotos syndrome caused by NSD1 mutation, and it adds further support for postconceptual mutation, epigenetic change and/or an environmental factor involved in the cause of the Sotos syndrome.
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Affiliation(s)
- Ji Yoon Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Goo Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woori Jang
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soyoung Shin
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joonhong Park
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Myungshin Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Oelsner KT, Guo Y, To SBC, Non AL, Barkin SL. Maternal BMI as a predictor of methylation of obesity-related genes in saliva samples from preschool-age Hispanic children at-risk for obesity. BMC Genomics 2017; 18:57. [PMID: 28068899 PMCID: PMC5223358 DOI: 10.1186/s12864-016-3473-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 12/26/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The study of epigenetic processes and mechanisms present a dynamic approach to assess complex individual variation in obesity susceptibility. However, few studies have examined epigenetic patterns in preschool-age children at-risk for obesity despite the relevance of this developmental stage to trajectories of weight gain. We hypothesized that salivary DNA methylation patterns of key obesogenic genes in Hispanic children would 1) correlate with maternal BMI and 2) allow for identification of pathways associated with children at-risk for obesity. RESULTS Genome-wide DNA methylation was conducted on 92 saliva samples collected from Hispanic preschool children using the Infinium Illumina HumanMethylation 450 K BeadChip (Illumina, San Diego, CA, USA), which interrogates >484,000 CpG sites associated with ~24,000 genes. The analysis was limited to 936 genes that have been associated with obesity in a prior GWAS Study. Child DNA methylation at 17 CpG sites was found to be significantly associated with maternal BMI, with increased methylation at 12 CpG sites and decreased methylation at 5 CpG sites. Pathway analysis revealed methylation at these sites related to homocysteine and methionine degradation as well as cysteine biosynthesis and circadian rhythm. Furthermore, eight of the 17 CpG sites reside in genes (FSTL1, SORCS2, NRF1, DLC1, PPARGC1B, CHN2, NXPH1) that have prior known associations with obesity, diabetes, and the insulin pathway. CONCLUSIONS Our study confirms that saliva is a practical human tissue to obtain in community settings and in pediatric populations. These salivary findings indicate potential epigenetic differences in Hispanic preschool children at risk for pediatric obesity. Identifying early biomarkers and understanding pathways that are epigenetically regulated during this critical stage of child development may present an opportunity for prevention or early intervention for addressing childhood obesity. TRIAL REGISTRATION The clinical trial protocol is available at ClinicalTrials.gov ( NCT01316653 ). Registered 3 March 2011.
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Affiliation(s)
- Kathryn Tully Oelsner
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, Suite 601, MSC 617, Charleston, SC 29425 USA
| | - Yan Guo
- Center for Quantitative Research, School of Medicine, Vanderbilt University, 2220 Pierce Ave, 571 Preston Research Building, Nashville, TN USA
| | - Sophie Bao-Chieu To
- Department of Biological Sciences, Vanderbilt University, 1210 BSB, 465 21st Ave S, Nashville, TN USA
| | - Amy L. Non
- Department of Anthropology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
| | - Shari L. Barkin
- Department of Pediatrics, Vanderbilt University School of Medicine, 2200 Children’s Way, Doctor’s Office Tower 8232, Nashville, TN 37232-9225 USA
- Pediatric Obesity Research, Diabetes Research and Training Center, Vanderbilt University School of Medicine, 2200 Children’s Way, Doctor’s Office Tower 8232, Nashville, TN 37232-9225 USA
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De novo nonsense and frameshift variants of TCF20 in individuals with intellectual disability and postnatal overgrowth. Eur J Hum Genet 2016; 24:1739-1745. [PMID: 27436265 DOI: 10.1038/ejhg.2016.90] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 06/01/2016] [Accepted: 06/21/2016] [Indexed: 01/01/2023] Open
Abstract
Recently, germline variants of the transcriptional co-regulator gene TCF20 have been implicated in the aetiology of autism spectrum disorders (ASD). However, the knowledge about the associated clinical picture remains fragmentary. In this study, two individuals with de novo TCF20 sequence variants were identified in a cohort of 313 individuals with intellectual disability of unknown aetiology, which was analysed by whole exome sequencing using a child-parent trio design. Both detected variants - one nonsense and one frameshift variant - were truncating. A comprehensive clinical characterisation of the patients yielded mild intellectual disability, postnatal tall stature and macrocephaly, obesity and muscular hypotonia as common clinical signs while ASD was only present in one proband. The present report begins to establish the clinical picture of individuals with de novo nonsense and frameshift variants of TCF20 which includes features such as proportionate overgrowth and muscular hypotonia. Furthermore, intellectual disability/developmental delay seems to be fully penetrant amongst known individuals with de novo nonsense and frameshift variants of TCF20, whereas ASD is shown to be incompletely penetrant. The transcriptional co-regulator gene TCF20 is hereby added to the growing number of genes implicated in the aetiology of both ASD and intellectual disability. Furthermore, such de novo variants of TCF20 may represent a novel differential diagnosis in the overgrowth syndrome spectrum.
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Can Macrosomia or Large for Gestational Age Be Predictive of Mucopolysaccharidosis Type I, II and VI? Pediatr Neonatol 2016; 57:181-7. [PMID: 26522251 DOI: 10.1016/j.pedneo.2015.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/23/2015] [Accepted: 04/16/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The objective of the study was to compare mean values for birth body length and weight between patients with mucopolysaccharidosis (MPS) and the general population. METHODS A retrospective analysis of birth anthropometric data was performed for patients (n = 103) with MPS I, II, and VI. Two-tailed t tests were used to compare mean values for body length and weight at birth between patients with MPS and the general population. RESULTS Mean values for birth body length and weight for all studied groups were greater than in the general population. For body length the differences were statistically significant. When considered individually, 53% of patients were large for gestational age (LGA) and 30% were macrosomic. The highest percentage of LGA was observed in MPS II males and MPS VI females (55% and 56%, respectively), while the highest percentage of macrosomia was observed in MPS VI males (36%). CONCLUSION At the time of birth, MPS patients were larger than those in the general population. High birth weight and/or LGA can be suggestive of MPS disease and should raise suspicion aiding early disease recognition.
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Fideleff HL, Boquete HR, Suárez MG, Azaretzky M. Burden of Growth Hormone Deficiency and Excess in Children. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2015; 138:143-66. [PMID: 26940390 DOI: 10.1016/bs.pmbts.2015.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Longitudinal growth results from multifactorial and complex processes that take place in the context of different genetic traits and environmental influences. Thus, in view of the difficulties in comprehension of the physiological mechanisms involved in the achievement of normal height, our ability to make a definitive diagnosis of GH impairment still remains limited. There is a myriad of controversial aspects in relation to GH deficiency, mainly related to diagnostic controversies and advances in molecular biology. This might explain the diversity in therapeutic responses and may also serve as a rationale for new "nonclassical" treatment indications for GH. It is necessary to acquire more effective tools to reach an adequate evaluation, particularly while considering the long-term implications of a correct diagnosis, the cost, and safety of treatments. On the other hand, overgrowth constitutes a heterogeneous group of different pathophysiological situations including excessive somatic and visceral growth. There are overlaps in clinical and molecular features among overgrowth syndromes, which constitute the real burden for an accurate diagnosis. In conclusion, both GH deficiency and overgrowth are a great dilemma, still not completely solved. In this chapter, we review the most burdensome aspects related to short stature, GH deficiency, and excess in children, avoiding any details about well-known issues that have been extensively discussed in the literature.
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Affiliation(s)
- Hugo L Fideleff
- Department of Medicine, Endocrinology Unit, Hospital T. Alvarez, Buenos Aires, Argentina.
| | - Hugo R Boquete
- Department of Medicine, Endocrinology Unit, Hospital T. Alvarez, Buenos Aires, Argentina
| | - Martha G Suárez
- Department of Medicine, Endocrinology Unit, Hospital T. Alvarez, Buenos Aires, Argentina
| | - Miriam Azaretzky
- Department of Medicine, Endocrinology Unit, Hospital T. Alvarez, Buenos Aires, Argentina
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Jo WH, Jung MK, Kim KE, Chae HW, Kim DH, Kwon AR, Kim HS. XYY syndrome: a 13-year-old boy with tall stature. Ann Pediatr Endocrinol Metab 2015; 20:170-3. [PMID: 26512355 PMCID: PMC4623347 DOI: 10.6065/apem.2015.20.3.170] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/15/2015] [Accepted: 09/17/2015] [Indexed: 11/20/2022] Open
Abstract
When evaluating the underlying causes of tall stature, it is important to differentiate pathologic tall stature from familial tall stature. Various pathologic conditions leading to adult tall stature include excess growth hormone secretion, Marfan syndrome, androgen or estrogen deficiency, testicular feminization, and sex chromosome anomaly, such as Klinefelter syndrome and XYY syndrome. Men with 47,XYY syndrome can exhibit multiple phenotypes. A 13-year-old boy visited the hospital for evaluation of tall stature. The boy had no other physical abnormalities except tall stature. All biochemical and imaging studies were within the normal ranges. He was diagnosed with XYY syndrome in this chromosome study. When evaluating men with tall stature, XYY syndrome should be ruled out.
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Affiliation(s)
- Won Ha Jo
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Mo Kyung Jung
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Eun Kim
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Duk Hee Kim
- Department of Pediatrics, Sowha Children's Hospital, Seoul, Korea
| | - Ah Reum Kwon
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Abstract
Medical providers need to monitor growth at every visit. Weight status is influenced by genetics, medical conditions, socioeconomic status, and family environment. Screening for food security and psychosocial risk factors is an integral tool to identify families at risk for nutritional deficits and child maltreatment. Nutritional rehabilitation is best accomplished in an outpatient, multidisciplinary setting. Medical neglect should be considered in failure to thrive and obesity when there is a serious risk of harm from identified medical complications, additional or worsening medical complications occurring despite a multidisciplinary approach, and/or non-adherence with the treatment plan.
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Affiliation(s)
- Nancy S Harper
- Children's Physician Services of South Texas, Driscoll Children's Hospital, 3533 South Alameda, Corpus Christi, TX 78411, USA.
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Abstract
Referral for an assessment of tall stature is much less common than for short stature. Although the commonest cause is an underlying familial tendency to tallness, there are important disorders that should be considered at the initial assessment. Distinguishing these conditions from normal variations of growth is the key objective when managing the child and family. In some children, further targeted investigations will be needed and in rare instances intervention to limit final height may be appropriate. This article discusses a structured approach to the assessment and management of a child with tall stature.
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Affiliation(s)
- Justin H Davies
- Department of Paediatric Endocrinology, Southampton Children's Hospital, Southampton, UK
| | - Tim Cheetham
- Institute of Genetic Medicine, Newcastle University, c/o Department of Paediatric Endocrinology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
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Mutations in ZBTB20 cause Primrose syndrome. Nat Genet 2014; 46:815-7. [DOI: 10.1038/ng.3035] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/23/2014] [Indexed: 02/06/2023]
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Skinner MK, Manikkam M, Tracey R, Guerrero-Bosagna C, Haque M, Nilsson EE. Ancestral dichlorodiphenyltrichloroethane (DDT) exposure promotes epigenetic transgenerational inheritance of obesity. BMC Med 2013; 11:228. [PMID: 24228800 PMCID: PMC3853586 DOI: 10.1186/1741-7015-11-228] [Citation(s) in RCA: 270] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/27/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Ancestral environmental exposures to a variety of environmental factors and toxicants have been shown to promote the epigenetic transgenerational inheritance of adult onset disease. The present work examined the potential transgenerational actions of the insecticide dichlorodiphenyltrichloroethane (DDT) on obesity and associated disease. METHODS Outbred gestating female rats were transiently exposed to a vehicle control or DDT and the F1 generation offspring bred to generate the F2 generation and F2 generation bred to generate the F3 generation. The F1 and F3 generation control and DDT lineage rats were aged and various pathologies investigated. The F3 generation male sperm were collected to investigate methylation between the control and DDT lineage male sperm. RESULTS The F1 generation offspring (directly exposed as a fetus) derived from the F0 generation exposed gestating female rats were not found to develop obesity. The F1 generation DDT lineage animals did develop kidney disease, prostate disease, ovary disease and tumor development as adults. Interestingly, the F3 generation (great grand-offspring) had over 50% of males and females develop obesity. Several transgenerational diseases previously shown to be associated with metabolic syndrome and obesity were observed in the testis, ovary and kidney. The transgenerational transmission of disease was through both female (egg) and male (sperm) germlines. F3 generation sperm epimutations, differential DNA methylation regions (DMR), induced by DDT were identified. A number of the genes associated with the DMR have previously been shown to be associated with obesity. CONCLUSIONS Observations indicate ancestral exposure to DDT can promote obesity and associated disease transgenerationally. The etiology of disease such as obesity may be in part due to environmentally induced epigenetic transgenerational inheritance.
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Affiliation(s)
- Michael K Skinner
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA 99164-4236, USA.
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Millington GWM. Obesity, genetics and the skin. Clin Exp Dermatol 2013; 38:50-6; quiz 56. [PMID: 23252752 DOI: 10.1111/ced.12024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2012] [Indexed: 12/16/2022]
Abstract
The increasing problem of obesity in childhood is recognized as both a short-term and long-term serious public-health concern. Excess body weight may contribute to psychological morbidity; cancers; metabolic, cardiovascular and musculoskeletal disorders; and dermatological conditions. There is increasing recognition of the role of genetic factors in the aetiology of obesity. Although in the vast majority of cases these influences are polygenic, some obese children suffer from monogenic disorders, which may present with obesity alone. However, more often than not, they generally display other syndromic features. Some of these syndromes have a clear cutaneous phenotype, and these conditions will be the focus of this review.
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Affiliation(s)
- G W M Millington
- Department of Dermatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, UK.
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27
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Current world literature. Curr Opin Pediatr 2012; 24:547-53. [PMID: 22790103 DOI: 10.1097/mop.0b013e3283566807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Molin AM, Andrieux J, Koolen DA, Malan V, Carella M, Colleaux L, Cormier-Daire V, David A, de Leeuw N, Delobel B, Duban-Bedu B, Fischetto R, Flinter F, Kjaergaard S, Kok F, Krepischi AC, Le Caignec C, Ogilvie CM, Maia S, Mathieu-Dramard M, Munnich A, Palumbo O, Papadia F, Pfundt R, Reardon W, Receveur A, Rio M, Ronsbro Darling L, Rosenberg C, Sá J, Vallee L, Vincent-Delorme C, Zelante L, Bondeson ML, Annerén G. A novel microdeletion syndrome at 3q13.31 characterised by developmental delay, postnatal overgrowth, hypoplastic male genitals, and characteristic facial features. J Med Genet 2011; 49:104-9. [PMID: 22180640 PMCID: PMC3261728 DOI: 10.1136/jmedgenet-2011-100534] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Congenital deletions affecting 3q11q23 have rarely been reported and only five cases have been molecularly characterised. Genotype-phenotype correlation has been hampered by the variable sizes and breakpoints of the deletions. In this study, 14 novel patients with deletions in 3q11q23 were investigated and compared with 13 previously reported patients. METHODS Clinical data were collected from 14 novel patients that had been investigated by high resolution microarray techniques. Molecular investigation and updated clinical information of one cytogenetically previously reported patient were also included. RESULTS The molecular investigation identified deletions in the region 3q12.3q21.3 with different boundaries and variable sizes. The smallest studied deletion was 580 kb, located in 3q13.31. Genotype-phenotype comparison in 24 patients sharing this shortest region of overlapping deletion revealed several common major characteristics including significant developmental delay, muscular hypotonia, a high arched palate, and recognisable facial features including a short philtrum and protruding lips. Abnormal genitalia were found in the majority of males, several having micropenis. Finally, a postnatal growth pattern above the mean was apparent. The 580 kb deleted region includes five RefSeq genes and two of them are strong candidate genes for the developmental delay: DRD3 and ZBTB20. CONCLUSION A newly recognised 3q13.31 microdeletion syndrome is delineated which is of diagnostic and prognostic value. Furthermore, two genes are suggested to be responsible for the main phenotype.
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Affiliation(s)
- Anna-Maja Molin
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
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Argente J, Sotos JF. [Overgrowth with and without obesity: clinical and molecular principles]. An Pediatr (Barc) 2011; 76:161.e1-28. [PMID: 22098786 DOI: 10.1016/j.anpedi.2011.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 09/15/2011] [Indexed: 12/26/2022] Open
Abstract
Somatic overgrowth is a complex and heterogeneous pathology that is only partially understood, although developments in molecular biology have allowed the discovery of the aetiological basis of some of these conditions. The differential diagnosis of a patient with a possible variant of normality, a chromosomopathy, a dysmorphic syndrome, a metabolic or an endocrine disease is essential. The initial clinical evaluation should include a correct anamnesis and physical examination, as well as complementary laboratory and image analyses that will help to orient the diagnosis. This should include a full blood counts and complete biochemical analysis, determinations of IGF-I, IGFBP-3, free T4, TSH and homocystinuria, as well as a karyotype and an X-ray of the left hand and wrist. These results should be very beneficial in orienting the diagnosis. Additional molecular studies should be performed when a monogenic disease is suspected. Cardiological, ophthalmological, skeletal, psychological and psychiatric studies should be performed if the clinical information and previously mentioned complementary studies so indicate. In this review, the aetiological basis and the diagnostic-therapeutic principles in the most common causes of overgrowth, will be analysed.
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Affiliation(s)
- J Argente
- Servicios de Pediatría y Endocrinología, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Departamento de Pediatría, Universidad Autónoma de Madrid, CIBER de fisiopatología de la Obesidad y Nutrición, España.
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Abstract
The increased prevalence of obesity in childhood and adolescence highlights the need for effective treatment approaches. Initial assessments of these patients should include taking a careful history (investigating comorbidities, family history and potentially modifiable behaviors) and physical examination with BMI plotted on a BMI-for-age chart. The degree of investigation is dependent on the patient's age and severity of obesity, the findings on history and physical examination, and associated familial risk factors. There are several broad principles of conventional management: management of comorbidities; family involvement; taking a developmentally appropriate approach; the use of a range of behavior change techniques; long-term dietary change; increased physical activity; and decreased sedentary behaviors. Orlistat can be useful as an adjunct to lifestyle changes in severely obese adolescents and metformin can be used in older children and adolescents with clinical insulin resistance. Bariatric surgery should be considered in those who are severely obese, with recognition of the need for management in centers with multidisciplinary weight management teams and for surgery to be performed in tertiary institutions experienced in bariatric surgery. Finally, given the high prevalence and chronic nature of obesity, coordinated models of care for health-service delivery for the management of pediatric obesity are needed.
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Assessment and management of obesity in childhood and adolescence. NATURE REVIEWS. GASTROENTEROLOGY & HEPATOLOGY 2011. [PMID: 21970867 DOI: 10.1038/nrgastro.2011.165.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The increased prevalence of obesity in childhood and adolescence highlights the need for effective treatment approaches. Initial assessments of these patients should include taking a careful history (investigating comorbidities, family history and potentially modifiable behaviors) and physical examination with BMI plotted on a BMI-for-age chart. The degree of investigation is dependent on the patient's age and severity of obesity, the findings on history and physical examination, and associated familial risk factors. There are several broad principles of conventional management: management of comorbidities; family involvement; taking a developmentally appropriate approach; the use of a range of behavior change techniques; long-term dietary change; increased physical activity; and decreased sedentary behaviors. Orlistat can be useful as an adjunct to lifestyle changes in severely obese adolescents and metformin can be used in older children and adolescents with clinical insulin resistance. Bariatric surgery should be considered in those who are severely obese, with recognition of the need for management in centers with multidisciplinary weight management teams and for surgery to be performed in tertiary institutions experienced in bariatric surgery. Finally, given the high prevalence and chronic nature of obesity, coordinated models of care for health-service delivery for the management of pediatric obesity are needed.
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