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Mansour S, Alkhaaldi SMI, Sammanasunathan AF, Ibrahim S, Farhat J, Al-Omari B. Precision Nutrition Unveiled: Gene-Nutrient Interactions, Microbiota Dynamics, and Lifestyle Factors in Obesity Management. Nutrients 2024; 16:581. [PMID: 38474710 DOI: 10.3390/nu16050581] [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: 12/30/2023] [Revised: 02/05/2024] [Accepted: 02/18/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Obesity is a complex metabolic disorder that is associated with several diseases. Recently, precision nutrition (PN) has emerged as a tailored approach to provide individualised dietary recommendations. AIM This review discusses the major intrinsic and extrinsic components considered when applying PN during the management of obesity and common associated chronic conditions. RESULTS The review identified three main PN components: gene-nutrient interactions, intestinal microbiota, and lifestyle factors. Genetic makeup significantly contributes to inter-individual variations in dietary behaviours, with advanced genome sequencing and population genetics aiding in detecting gene variants associated with obesity. Additionally, PN-based host-microbiota evaluation emerges as an advanced therapeutic tool, impacting disease control and prevention. The gut microbiome's composition regulates diverse responses to nutritional recommendations. Several studies highlight PN's effectiveness in improving diet quality and enhancing adherence to physical activity among obese patients. PN is a key strategy for addressing obesity-related risk factors, encompassing dietary patterns, body weight, fat, blood lipids, glucose levels, and insulin resistance. CONCLUSION PN stands out as a feasible tool for effectively managing obesity, considering its ability to integrate genetic and lifestyle factors. The application of PN-based approaches not only improves current obesity conditions but also holds promise for preventing obesity and its associated complications in the long term.
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Affiliation(s)
- Samy Mansour
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Saif M I Alkhaaldi
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Ashwin F Sammanasunathan
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Saleh Ibrahim
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Joviana Farhat
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Basem Al-Omari
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
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Heald A, Qin R, Loureiro CM, Williams R, Devaney Dopson C, Gibson JM, Narayanan RP, Fachim H, McCay K, Ollier W. A study to investigate genetic factors associated with weight gain in people with diabetes: analysis of polymorphisms in four relevant genes. Adipocyte 2023; 12:2236757. [PMID: 37582184 PMCID: PMC10431742 DOI: 10.1080/21623945.2023.2236757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/26/2023] [Accepted: 07/11/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Weight change is often seen in people with diabetes. We investigated the effects of genes associated with weight change/glucose handling/insulin-signalling. MATERIALS/METHODS DNA from diabetes individuals and non-diabetes individuals, plus clinical data, were available from the DARE study (n = 379 individuals: T1D n = 111; T2D n = 222; controls n = 46). Weight gain was assessed by temporal change of Body Mass Index (BMI). Genotyping was performed for CAV1rs926198, LEPRrs1137101, BDNFrs6265 and FTOrs9939609. RESULTS No differences in genotype distributions were observed for the four SNPs in all groups un-stratified by weight gain. Following stratification differences in genotype distribution were observed. For those BMI relatively stable; controls showed a difference in genotype distributions versus T1D (CAV1rs926198, LEPRrs1137101). In T2D vs controls, significant differences were observed in genotype distribution for all four genes. For BMI increase, the only difference by category was LEPRrs1137101 (bothT1D/T2D vs controls). In BMI-stable groups, CAV1rs926198, T1D individuals showed lower T allele frequency (p=0.004) vs non-diabetes and for LEPRrs1137101 a higher G allele frequency versus controls (p=0.002). For T2D, CAV1rs926198, T allele frequency was lower in T2D than controls (p=0.005). For LEPR rs1137101, the G allele frequency was higher than in controls (p=0.004). In those with BMI increase, LEPRrs1137101 T1D individuals had higher G allele frequency versus controls (p=0.002) as did T2D vs controls (p=0.03). CONCLUSION Differences in allele frequency were seen between diabetes individuals and non-diabetes diagnosed at baseline in relation to the likelihood of BMI increase of >10%. It is established that the G allele of LEPRrs1137101 is associated with weight gain/obesity. However, this is the first report of CAV1rs926198 polymorphism being associated with weight stability/gain in diabetes.
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Affiliation(s)
- Adrian Heald
- Department of Endocrinology and Diabetes, Salford Royal Hospital, Salford, UK
| | - Rui Qin
- The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Camila M. Loureiro
- Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, Sao Paulo, Brazil
| | - Richard Williams
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | | | - J Martin Gibson
- Department of Endocrinology and Diabetes, Salford Royal Hospital, Salford, UK
- The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Ram Prakash Narayanan
- St Helens and Knowsley Hospitals NHS Trust, St Helens Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Helene Fachim
- Department of Endocrinology and Diabetes, Salford Royal Hospital, Salford, UK
- The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Kevin McCay
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - William Ollier
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
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Christiansen MR, Kilpeläinen TO, McCaffery JM. Abdominal Obesity Genetic Variants Predict Waist Circumference Regain After Weight Loss. Diabetes 2023; 72:1424-1432. [PMID: 37494631 DOI: 10.2337/db23-0131] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/23/2023] [Indexed: 07/28/2023]
Abstract
Although many individuals are able to achieve weight loss, maintaining this loss over time is challenging. We aimed to study whether genetic predisposition to general or abdominal obesity predicts weight regain after weight loss. We examined the associations between genetic risk scores for higher BMI and higher waist-to-hip ratio adjusted for BMI (WHRadjBMI) with changes in weight and waist circumference up to 3 years after a 1-year weight loss program in participants (n = 822 women, n = 593 men) from the Look AHEAD (Action for Health in Diabetes) study who had lost ≥3% of their initial weight. Genetic predisposition to higher BMI or WHRadjBMI was not associated with weight regain after weight loss. However, the WHRadjBMI genetic score did predict an increase in waist circumference independent of weight change. To conclude, a genetic predisposition to higher WHRadjBMI predicts an increase in abdominal obesity after weight loss, whereas genetic predisposition to higher BMI is not predictive of weight regain. These results suggest that genetic effects on abdominal obesity may be more pronounced than those on general obesity during weight regain. ARTICLE HIGHLIGHTS Nearly all individuals who intentionally lose weight experience weight regain. Individuals with a higher genetic risk for abdominal adiposity experience increased regain in waist circumference after weight loss. Genetic predisposition to higher BMI does not predict weight regain after weight loss.
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Affiliation(s)
- Malene Revsbech Christiansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Jeanne M McCaffery
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
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Rosenbaum M, Foster G. Differential mechanisms affecting weight loss and weight loss maintenance. Nat Metab 2023; 5:1266-1274. [PMID: 37612402 DOI: 10.1038/s42255-023-00864-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/13/2023] [Indexed: 08/25/2023]
Abstract
In most lifestyle, pharmacological and surgical interventions, weight loss occurs over an approximately 6- to 9-month period and is followed by a weight plateau and then weight regain. Overall, only about 15% of individuals can sustain a 10% or greater non-surgical, non-pharmacological, weight loss. A key question is the degree to which the genotypes, phenotypes and environmental correlates of success in weight loss and weight loss maintenance are continuous or dichotomous. This Perspective is a comparison of the interactions of weight loss and maintenance with genetic, behavioural, physiological and environmental homeostatic systems and a discussion of the implications of these findings for research in, and treatment of, obesity. Data suggest that weight loss and weight loss maintenance are physiologically and psychologically different in many ways. Consequently, individuals may require different interventions designed for temporarily sustaining a negative energy balance during weight loss versus permanently maintaining energy balance after weight loss.
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Affiliation(s)
- Michael Rosenbaum
- Columbia University Irving Medical Center, Departments of Pediatrics and Medicine, Division of Molecular Genetics and the Irving Center for Clinical and Translational Research (MR), New York, NY, USA.
| | - Gary Foster
- WW International, Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Weight and Eating Disorders Program (GF), New York, NY, USA
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Hafida S, Apovian C. Physiology of the Weight-Reduced State and Its Impact on Weight Regain. Endocrinol Metab Clin North Am 2022; 51:795-815. [PMID: 36244694 DOI: 10.1016/j.ecl.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Obesity is a chronic disease characterized by long duration, slow progression, and periods of remission and relapses. Despite the development of effective medical and surgical interventions and millions of people conducting tremendous personal efforts to manage their weight every year, recidivism remains a significant barrier to attaining long-term weight maintenance. This review aimed to explain the underlying physiology of the weight-reduced state including changes in energy balance, adipose tissue, genetic, environmental, and behavioral factors that may predispose individuals to weight regain following weight loss.
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Affiliation(s)
- Samar Hafida
- Division of Endocrinology, Diabetes, Nutrition and Weight Management, 72 East, Concord Street C3 (Room 321 A), Collamore Building, Boston, MA 02118, USA.
| | - Caroline Apovian
- Division of Endocrinology, Diabetes and Hypertension, Center for Weight Management and Wellness, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Suite RFB-2, Brigham and Women's at 221 Longwood, Boston, MA 02115, USA
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Antoine D, Guéant-Rodriguez RM, Chèvre JC, Hergalant S, Sharma T, Li Z, Rouyer P, Chery C, Halvick S, Bui C, Oussalah A, Ziegler O, Quilliot D, Brunaud L, Guéant JL, Meyre D. Low-frequency Coding Variants Associated With Body Mass Index Affect the Success of Bariatric Surgery. J Clin Endocrinol Metab 2022; 107:e1074-e1084. [PMID: 34718599 DOI: 10.1210/clinem/dgab774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT A recent study identified 14 low-frequency coding variants associated with body mass index (BMI) in 718 734 individuals predominantly of European ancestry. OBJECTIVE We investigated the association of 2 genetic scores (GS) with i) the risk of severe/morbid obesity, ii) BMI variation before weight-loss intervention, iii) BMI change in response to an 18-month lifestyle/behavioral intervention program, and iv) BMI change up to 24 months after bariatric surgery. METHODS The 14 low-frequency coding variants were genotyped or sequenced in 342 French adults with severe/morbid obesity and 574 French adult controls from the general population. We built risk and protective GS based on 6 BMI-increasing and 5 BMI-decreasing low-frequency coding variants that were polymorphic in our study. RESULTS While the risk GS was not associated with severe/morbid obesity status, BMI-decreasing low-frequency coding variants were significantly less frequent in patients with severe/morbid obesity than in French adults from the general population. Neither the risk nor the protective GS was associated with BMI before intervention in patients with severe/morbid obesity, nor did they affect BMI change in response to a lifestyle/behavioral modification program. The protective GS was associated with a greater BMI decrease following bariatric surgery. The risk and protective GS were associated with a higher and lower risk of BMI regain after bariatric surgery. CONCLUSION Our data indicate that in populations of European descent, low-frequency coding variants associated with BMI in the general population also affect the outcomes of bariatric surgery in patients with severe/morbid obesity.
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Affiliation(s)
- Darlène Antoine
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Rosa-Maria Guéant-Rodriguez
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Jean-Claude Chèvre
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Sébastien Hergalant
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Tanmay Sharma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Zhen Li
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
- Specialized Obesity Center and Endocrinology, Diabetology, department of Nutrition, Brabois Hospital, CHRU of Nancy, 54500 Vandoeuvre-Les-Nancy, France
| | - Pierre Rouyer
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Céline Chery
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Sarah Halvick
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Catherine Bui
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Abderrahim Oussalah
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - Olivier Ziegler
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
- Specialized Obesity Center and Endocrinology, Diabetology, department of Nutrition, Brabois Hospital, CHRU of Nancy, 54500 Vandoeuvre-Les-Nancy, France
- Department of Surgery, Endocrine and metabolic surgery, Multidisciplinary unit for obesity surgery (CVMC), University Hospital Centre of Nancy, Brabois Hospital, 54500 Nancy, France
| | - Didier Quilliot
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
- Specialized Obesity Center and Endocrinology, Diabetology, department of Nutrition, Brabois Hospital, CHRU of Nancy, 54500 Vandoeuvre-Les-Nancy, France
- Department of Surgery, Endocrine and metabolic surgery, Multidisciplinary unit for obesity surgery (CVMC), University Hospital Centre of Nancy, Brabois Hospital, 54500 Nancy, France
| | - Laurent Brunaud
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
- Department of Surgery, Endocrine and metabolic surgery, Multidisciplinary unit for obesity surgery (CVMC), University Hospital Centre of Nancy, Brabois Hospital, 54500 Nancy, France
| | - Jean-Louis Guéant
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
| | - David Meyre
- Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France
- FHU ARRIMAGE, department of Biochemistry-Molecular Biology-Nutrition, University Hospital Centre of Nancy, 54500 Nancy, France
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario L8S 4L8, Canada
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Association between the FTO rs9939609 single nucleotide polymorphism and dietary adherence during a 2-year caloric restriction intervention: Exploratory analyses from CALERIE™ phase 2. Exp Gerontol 2021; 155:111555. [PMID: 34543722 DOI: 10.1016/j.exger.2021.111555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/20/2021] [Accepted: 09/09/2021] [Indexed: 01/15/2023]
Abstract
Caloric restriction (CR) improves markers of aging in humans; but it is not known if the fat mass and obesity-associated gene (FTO) rs9939609 single nucleotide polymorphism (SNP), which is associated with appetite and energy intake, influences adherence to prolonged CR. Utilizing data from the two-year Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE™) phase 2 randomized controlled trial, we tested whether the FTO rs9939609 SNP was associated with adherence to CR in healthy adults without obesity. As secondary aims, we assessed whether the FTO rs9939609 SNP was associated with changes in body composition, biomarkers of aging, and eating behaviors. Participants were randomized into either a CR group that targeted a 25% reduction in energy intake compared to the habitual energy intake at baseline, or an ad libitum (AL) control group. Participants were genotyped for the FTO rs9939609 SNP. Dietary adherence was determined through changes in energy intake using doubly labeled water and changes in body composition at baseline, month 12, and month 24 in both the CR and AL condition. Weight, body composition, resting metabolic rate (RMR), adiponectin, insulin, leptin, and eating behaviors were measured at the same timepoints. A total of 144 participants (91 CR and 53 AL, age: 38.6 ± 7.1 years; body mass index: 25.3 ± 1.7 kg/m2) were studied. Of these, 27 were homozygous for the 'obesity-risk' A allele (AA), while 44 were homozygous for the T allele (TT) and 73 were heterozygotes (AT). By design, the CR group exhibited greater percent CR compared to the AL group during the trial (P < 0.01), but no genotype-by-treatment interaction was observed for change in energy intake or percent CR (P ≥ 0.40). The FTO rs9939609 SNP was also negligibly associated with change in most other endpoints (P ≥ 0.13), though AAs showed a reduction in RMR adjusted for body composition change over the 24 months relative to TTs (genotype-by-treatment interaction: P = 0.03). In a two-year CR intervention delivered to healthy individuals without obesity, the FTO rs9939609 SNP was not associated with adherence to CR and did not alter improvements in most aging biomarkers.
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Lee HH, McGeary JE, Dunsiger S, Baker L, Balasubramanyam A, Knowler WC, Williams DM. The Moderating Effects of Genetic Variations on Changes in Physical Activity Level and Cardiorespiratory Fitness in Response to a Life-Style Intervention: A Randomized Controlled Trial. Psychosom Med 2021; 83:440-448. [PMID: 34080585 PMCID: PMC9922170 DOI: 10.1097/psy.0000000000000930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Prior studies identified single nucleotide polymorphisms (SNPs) associated with physical activity (PA) level in a natural environment and intervention study: rs978656-DNAPTP6, rs10887741-PAPSS2, rs7279064-C18orf2, and rs6265-BDNF. Using the four SNPs' polygenic score (PGS), we examined whether PGS moderates a life-style intervention's effect on changes in PA level and cardiorespiratory fitness (CRF). METHODS This is a secondary analysis of Look AHEAD, a multicenter randomized controlled trial designed to test the health benefits of a life-style intervention among 2675 participants with overweight/obesity and type 2 diabetes (ages, 45-76 years). Using linear mixed-effects models, level of PA (Paffenbarger PA questionnaire) and treadmill-assessed CRF were each regressed on four SNPs' PGS, study time (baseline, year 1, and year 4), intervention arm, and interactions between the three. Models adjusted for age, sex, body mass index, ancestry principal components (population stratification), and study sites, with Bonferroni corrections for multiple testing (α < .005). Effect modification by age was examined. RESULTS PGS was not predictive of change in CRF or PA level in response to intervention. In analyses without PGS by intervention by time, the relationships between PGS and PA phenotypes were modified by age (p interaction = .048 for CRF and .058 for PA), such that a 1-unit increase in PGS was associated with 24 kcal · wk-1 more in moderate-intensity PA and 0.004 MET higher CRF only among older groups (age >55 years for CRF, >60 years for PA level). CONCLUSIONS The effects of the intervention on PA and CRF were not moderated by the four SNPs. Future studies with extended SNP list should confirm the findings on effect modification by age.
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Affiliation(s)
- Harold H. Lee
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - John E. McGeary
- Department of Psychiatry and Human Behavior, Brown Alpert Medical School
- Genomics Laboratory, Providence Veterans Affairs Medical Center
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health
- Centers for Behavioral and Preventive Medicine, Miriam Hospital
| | - Laura Baker
- Department of Internal Medicine, Wake Forest School of Medicine
| | - Ashok Balasubramanyam
- Department of Medicine - Endocrinology, Diabetes and Metabolism, Baylor College of Medicine
| | - William C. Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health
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Loos RJF, Burant C, Schur EA. Strategies to Understand the Weight-Reduced State: Genetics and Brain Imaging. Obesity (Silver Spring) 2021; 29 Suppl 1:S39-S50. [PMID: 33759393 PMCID: PMC8500189 DOI: 10.1002/oby.23101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 11/09/2022]
Abstract
Most individuals with obesity or overweight have difficulty maintaining weight loss. The weight-reduced state induces changes in many physiological processes that appear to drive weight regain. Here, we review the use of cell biology, genetics, and imaging techniques that are being used to begin understanding why weight regain is the normal response to dieting. As with obesity itself, weight regain has both genetic and environmental drivers. Genetic drivers for "thinness" and "obesity" largely overlap, but there is evidence for specific genetic loci that are different for each of these weight states. There is only limited information regarding the genetics of weight regain. Currently, most genetic loci related to weight point to the central nervous system as the organ responsible for determining the weight set point. Neuroimaging tools have proved useful in studying the contribution of the central nervous system to the weight-reduced state in humans. Neuroimaging technologies fall into three broad categories: functional, connectivity, and structural neuroimaging. Connectivity and structural imaging techniques offer unique opportunities for testing mechanistic hypotheses about changes in brain function or tissue structure in the weight-reduced state.
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Affiliation(s)
- Ruth J. F. Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Charles Burant
- Department of Internal Medicine, University of Washington, Seattle, Washington, USA
| | - Ellen A. Schur
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Aronne LJ, Hall KD, Jakicic JM, Leibel RL, Lowe MR, Rosenbaum M, Klein S. Describing the Weight-Reduced State: Physiology, Behavior, and Interventions. Obesity (Silver Spring) 2021; 29 Suppl 1:S9-S24. [PMID: 33759395 PMCID: PMC9022199 DOI: 10.1002/oby.23086] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
Although many persons with obesity can lose weight by lifestyle (diet and physical activity) therapy, successful long-term weight loss is difficult to achieve, and most people who lose weight regain their lost weight over time. The neurohormonal, physiological, and behavioral factors that promote weight recidivism are unclear and complex. The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop in June 2019, titled "The Physiology of the Weight-Reduced State," to explore the mechanisms and integrative physiology of adaptations in appetite, energy expenditure, and thermogenesis that occur in the weight-reduced state and that may oppose weight-loss maintenance. The proceedings from the first session of this workshop are presented here. Drs. Michael Rosenbaum, Kevin Hall, and Rudolph Leibel discussed the physiological factors that contribute to weight regain; Dr. Michael Lowe discussed the biobehavioral issues involved in weight-loss maintenance; Dr. John Jakicic discussed the influence of physical activity on long-term weight-loss maintenance; and Dr. Louis Aronne discussed the ability of drug therapy to maintain weight loss.
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Affiliation(s)
- Louis J. Aronne
- Weill Cornell Medicine Comprehensive Weight Control Center, New York, New York, USA
| | - Kevin D. Hall
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - John M. Jakicic
- Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rudolph L. Leibel
- Departments of Pediatrics and Medicine, Division of Molecular Genetics, Columbia University, New York, New York, USA
| | - Michael R. Lowe
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Michael Rosenbaum
- Departments of Pediatrics and Medicine, Division of Molecular Genetics, Columbia University, New York, New York, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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11
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Holzapfel C, Sag S, Graf-Schindler J, Fischer M, Drabsch T, Illig T, Grallert H, Stecher L, Strack C, Caterson ID, Jebb SA, Hauner H, Baessler A. Association between Single Nucleotide Polymorphisms and Weight Reduction in Behavioural Interventions-A Pooled Analysis. Nutrients 2021; 13:nu13030819. [PMID: 33801339 PMCID: PMC7998423 DOI: 10.3390/nu13030819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/24/2022] Open
Abstract
Knowledge of the association between single nucleotide polymorphisms (SNPs) and weight loss is limited. The aim was to analyse whether selected obesity-associated SNPs within the fat mass and obesity-associated (FTO), transmembrane protein 18 (TMEM18), melanocortin-4 receptor (MC4R), SEC16 homolog B (SEC16B), and brain-derived neurotrophic factor (BDNF) gene are associated with anthropometric changes during behavioural intervention for weight loss. genetic and anthropometric data from 576 individuals with overweight and obesity from four lifestyle interventions were obtained. A genetic predisposition score (GPS) was calculated. Our results show that study participants had a mean age of 48.2 ± 12.6 years and a mean baseline body mass index of 33.9 ± 6.4 kg/m2. Mean weight reduction after 12 months was −7.7 ± 10.9 kg. After 12 months of intervention, the MC4R SNPs rs571312 and rs17782313 were significantly associated with a greater decrease in body weight and BMI (p = 0.012, p = 0.011, respectively). The investigated SNPs within the other four genetic loci showed no statistically significant association with changes in anthropometric parameters. The GPS showed no statistically significant association with weight reduction. In conclusion there was no consistent evidence for statistically significant associations of SNPs with anthropometric changes during a behavioural intervention. It seems that other factors play a more significant in weight management than the investigated SNPs.
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Affiliation(s)
- Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, 80992 Munich, Germany; (J.G.-S.); (T.D.); (L.S.); (H.H.)
- Correspondence: ; Tel.: +49-89-28924923; Fax: +49-89-28924922
| | - Sabine Sag
- Clinic of Internal Medicine II, University Hospital of Regensburg, 93053 Regensburg, Germany; (S.S.); (M.F.); (C.S.); (A.B.)
| | - Johanna Graf-Schindler
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, 80992 Munich, Germany; (J.G.-S.); (T.D.); (L.S.); (H.H.)
| | - Marcus Fischer
- Clinic of Internal Medicine II, University Hospital of Regensburg, 93053 Regensburg, Germany; (S.S.); (M.F.); (C.S.); (A.B.)
| | - Theresa Drabsch
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, 80992 Munich, Germany; (J.G.-S.); (T.D.); (L.S.); (H.H.)
| | - Thomas Illig
- Hannover Unified Biobank, Hannover Medical School, 30625 Hannover, Germany;
| | - Harald Grallert
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Lynne Stecher
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, 80992 Munich, Germany; (J.G.-S.); (T.D.); (L.S.); (H.H.)
| | - Christina Strack
- Clinic of Internal Medicine II, University Hospital of Regensburg, 93053 Regensburg, Germany; (S.S.); (M.F.); (C.S.); (A.B.)
| | - Ian D. Caterson
- Boden Collaboration, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia;
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK;
| | - Hans Hauner
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, 80992 Munich, Germany; (J.G.-S.); (T.D.); (L.S.); (H.H.)
- ZIEL Institute for Food and Health, Else Kröner-Fresenius-Center of Nutritional Medicine, School of Life Sciences, Technical University of Munich, 85354 Freising-Weihenstephan, Germany
| | - Andrea Baessler
- Clinic of Internal Medicine II, University Hospital of Regensburg, 93053 Regensburg, Germany; (S.S.); (M.F.); (C.S.); (A.B.)
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12
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Abstract
Obesity is associated with an increased risk of various diseases and mortality. Although nearly 50 % of adults have been reported trying to lose weight, the prevalence of obesity has increased. One factor that hinders weight loss-induced decrease in obesity prevalence is weight regain. Although behavioural, psychological and physiological factors associated with weight regain have been reviewed, the information regarding the relationship between weight regain and genetics has not been previously summarised. In this paper, we comprehensively review the association between genetic polymorphisms and weight regain in adults and children with obesity after weight loss. Based on this information, identification of genetic polymorphism in patients who undergo weight loss intervention might be used to estimate their risks of weight regain. Additionally, the genetic-based risk estimation may be used as a guide for physicians and dietitians to provide each of their patients with the most appropriate strategies for weight loss and weight maintenance.
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13
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Salem ESB, Vonberg AD, Borra VJ, Gill RK, Nakamura T. RNAs and RNA-Binding Proteins in Immuno-Metabolic Homeostasis and Diseases. Front Cardiovasc Med 2019; 6:106. [PMID: 31482095 PMCID: PMC6710452 DOI: 10.3389/fcvm.2019.00106] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/17/2019] [Indexed: 12/16/2022] Open
Abstract
The increasing prevalence of worldwide obesity has emerged as a major risk factor for type 2 diabetes (T2D), hepatosteatosis, and cardiovascular disease. Accumulating evidence indicates that obesity has strong inflammatory underpinnings tightly linked to the development of metabolic diseases. However, the molecular mechanisms by which obesity induces aberrant inflammation associated with metabolic diseases are not yet clearly defined. Recently, RNAs have emerged as important regulators of stress responses and metabolism. RNAs are subject to changes in modification status, higher-order structure, and cellular localization; all of which could affect the affinity for RNA-binding proteins (RBPs) and thereby modify the RNA-RBP networks. Proper regulation and management of RNA characteristics are fundamental to cellular and organismal homeostasis, as well as paramount to health. Identification of multiple single nucleotide polymorphisms (SNPs) within loci of fat mass- and obesity-associated protein (FTO) gene, an RNA demethylase, through genome-wide association studies (GWAS) of T2D, and functional assessments of FTO in mice, support the concept that disruption in RNA modifications leads to the development of human diseases including obesity and metabolic disorder. In obesity, dynamic alterations in modification and localization of RNAs appear to modulate the RNA-RBP networks and activate proinflammatory RBPs, such as double-stranded RNA (dsRNA)-dependent protein kinase (PKR), Toll-like receptor (TLR) 3 and TLR7, and RNA silencing machinery. These changes induce aberrant inflammation and the development of metabolic diseases. This review will describe the current understanding of the underlying causes of these common and altered characteristics of RNA-RBP networks which will pave the way for developing novel approaches to tackle the pandemic issue of obesity.
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Affiliation(s)
- Esam S B Salem
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Andrew D Vonberg
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Vishnupriya J Borra
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Rupinder K Gill
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Takahisa Nakamura
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Department of Metabolic Bioregulation, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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14
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Lamiquiz-Moneo I, Mateo-Gallego R, Bea AM, Dehesa-García B, Pérez-Calahorra S, Marco-Benedí V, Baila-Rueda L, Laclaustra M, Civeira F, Cenarro A. Genetic predictors of weight loss in overweight and obese subjects. Sci Rep 2019; 9:10770. [PMID: 31341224 PMCID: PMC6656717 DOI: 10.1038/s41598-019-47283-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 07/03/2019] [Indexed: 12/24/2022] Open
Abstract
The aim of our study was to investigate a large cohort of overweight subjects consuming a homogeneous diet to identify the genetic factors associated with weight loss that could be used as predictive markers in weight loss interventions. We retrospectively recruited subjects (N = 788) aged over 18 years with a Body Mass Index (BMI) between 25 and 40 kg/m2 who were treated at our lipid unit for at least one year from 2008 to 2016, and we also recruited a control group (168 patients) with normal BMIs. All participants received counselling from a nutritionist that included healthy diet and physical activity recommendations. We genotyped 25 single nucleotide variants (SNVs) in 25 genes that were previously associated with obesity and calculated genetic scores that were derived from 25 SNVs. The risk allele in CADM2 showed a higher frequency in overweight and obese subjects than in controls (p = 0.007). The mean follow-up duration was 5.58 ± 2.68 years. Subjects with lower genetic scores showed greater weight loss during the follow-up period. The genetic score was the variable that best explained the variations in weight from the baseline. The genetic score explained 2.4% of weight change variance at one year and 1.6% of weight change variance at the end of the follow-up period after adjusting for baseline weight, sex, age and years of follow-up.
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Affiliation(s)
- Itziar Lamiquiz-Moneo
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Rocío Mateo-Gallego
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain. .,Universidad de Zaragoza, Zaragoza, Spain.
| | - Ana M Bea
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Blanca Dehesa-García
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Sofía Pérez-Calahorra
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Victoria Marco-Benedí
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Lucía Baila-Rueda
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Martín Laclaustra
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - Fernando Civeira
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain.,Universidad de Zaragoza, Zaragoza, Spain
| | - Ana Cenarro
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
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15
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Abstract
One of the biggest challenges in the management of obesity is the prevention of weight regain after successful weight loss. Weight regain after weight loss has large interindividual variation. Although many factors probably contribute to this variation, we hypothesize that variability in biological responses associated with weight loss-induced shrinking of subcutaneous adipocytes has an important role. In this Review, we show that weight loss-induced variations in cellular stress, extracellular matrix remodelling, inflammatory responses, adipokine secretion and lipolysis seem to be associated with the amount of weight that is regained after successful weight loss. Weight regain could therefore, at least in part, depend on a combination of these factors. Further research on the causality of these associations could aid the development of effective strategies to prevent weight regain after successful weight loss.
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Affiliation(s)
- Marleen A van Baak
- NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, Netherlands.
| | - Edwin C M Mariman
- NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, Netherlands
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16
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Genome-wide gene-based analyses of weight loss interventions identify a potential role for NKX6.3 in metabolism. Nat Commun 2019; 10:540. [PMID: 30710084 PMCID: PMC6358625 DOI: 10.1038/s41467-019-08492-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 01/07/2019] [Indexed: 12/31/2022] Open
Abstract
Hundreds of genetic variants have been associated with Body Mass Index (BMI) through genome-wide association studies (GWAS) using observational cohorts. However, the genetic contribution to efficient weight loss in response to dietary intervention remains unknown. We perform a GWAS in two large low-caloric diet intervention cohorts of obese participants. Two loci close to NKX6.3/MIR486 and RBSG4 are identified in the Canadian discovery cohort (n = 1166) and replicated in the DiOGenes cohort (n = 789). Modulation of HGTX (NKX6.3 ortholog) levels in Drosophila melanogaster leads to significantly altered triglyceride levels. Additional tissue-specific experiments demonstrate an action through the oenocytes, fly hepatocyte-like cells that regulate lipid metabolism. Our results identify genetic variants associated with the efficacy of weight loss in obese subjects and identify a role for NKX6.3 in lipid metabolism, and thereby possibly weight control. Individuals show large variability in their capacity to lose weight and maintain this weight. Here, the authors perform GWAS in two weight loss intervention cohorts and identify two genetic loci associated with weight loss that are taken forward for Bayesian fine-mapping and functional assessment in flies.
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17
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Arena R, Ozemek C, Laddu D, Campbell T, Rouleau CR, Standley R, Bond S, Abril EP, Hills AP, Lavie CJ. Applying Precision Medicine to Healthy Living for the Prevention and Treatment of Cardiovascular Disease. Curr Probl Cardiol 2018; 43:448-483. [DOI: 10.1016/j.cpcardiol.2018.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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18
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Hagman E, Hecht L, Marko L, Azmanov H, Groop L, Santoro N, Caprio S, Weiss R. Predictors of responses to clinic-based childhood obesity care. Pediatr Diabetes 2018; 19:1351-1356. [PMID: 30225917 DOI: 10.1111/pedi.12774] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/03/2018] [Accepted: 09/09/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVE Lifestyle modification is the therapy of choice for childhood obesity, yet the response rate is variable and may be affected by genetic factors. We aimed to investigate predictors of poor response to lifestyle modification obesity treatment in children. METHODS A prospective cohort study of 434 youths (64.5% females) between 4 and 20 years of age undergoing a standard care of lifestyle modification obesity management for 35.9 ± 20.8 months at Yale Childhood Obesity Clinic, USA. The primary outcome was a "poor response," defined as the quintile with the largest increase in BMI Z-score over time. The secondary outcome was the endpoint BMI Z-score. Covariates investigated were sex, baseline pubertal status and degree of obesity, race, biochemical profile, and family history of overweight. A subsample (n = 214) had FTO genotyping (SNP rs8050136) tested. RESULTS Males (hazard ratio [HR] = 5.35, 95% confidence interval [CI] [3.32-8.61], P < 0.0001) and pubertal adolescents (HR = 2.78, [1.40-5.50], P = 0.003) compared to prepubertal children were more prone to respond poorly. Baseline degree of obesity was associated with relative protection from responding poorly (HR per BMI Z-score unit = 0.32, [0.17-0.61], P = 0.0006). Carriers of the FTO obesity-predisposing allele (AA genotype) were protected from responding poorly compared to non-carriers (CC genotype) (HR = 0.33, [0.12-0.88], P = 0.028). CONCLUSIONS Boys and pubertal adolescents are more prone to respond poorly to standard obesity care while those with greater baseline degree of obesity and carriers of the FTO obesity-predisposing allele are not.
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Affiliation(s)
- Emilia Hagman
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel.,Department of Clinical Science, Intervention and Technology, Karolinska Insitutet, Stockholm, Sweden
| | - Lior Hecht
- Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel
| | - Limor Marko
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
| | - Henny Azmanov
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
| | - Leif Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
| | - Nicola Santoro
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | - Sonia Caprio
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | - Ram Weiss
- Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel.,Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
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19
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Wang T, Xu M, Bi Y, Ning G. Interplay between diet and genetic susceptibility in obesity and related traits. Front Med 2018; 12:601-607. [DOI: 10.1007/s11684-018-0648-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/26/2018] [Indexed: 01/28/2023]
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20
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Goodarzi MO. Genetics of obesity: what genetic association studies have taught us about the biology of obesity and its complications. Lancet Diabetes Endocrinol 2018; 6:223-236. [PMID: 28919064 DOI: 10.1016/s2213-8587(17)30200-0] [Citation(s) in RCA: 259] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/24/2017] [Accepted: 05/24/2017] [Indexed: 01/01/2023]
Abstract
Genome-wide association studies (GWAS) for BMI, waist-to-hip ratio, and other adiposity traits have identified more than 300 single-nucleotide polymorphisms (SNPs). Although there is reason to hope that these discoveries will eventually lead to new preventive and therapeutic agents for obesity, this will take time because such developments require detailed mechanistic understanding of how an SNP influences phenotype (and this information is largely unavailable). Fortunately, absence of functional information has not prevented GWAS findings from providing insights into the biology of obesity. Genes near loci regulating total body mass are enriched for expression in the CNS, whereas genes for fat distribution are enriched in adipose tissue itself. Gene by environment and lifestyle interaction analyses have revealed that our increasingly obesogenic environment might be amplifying genetic risk for obesity, yet those at highest risk could mitigate this risk by increasing physical activity and possibly by avoiding specific dietary components. GWAS findings have also been used in mendelian randomisation analyses probing the causal association between obesity and its many putative complications. In supporting a causal association of obesity with diabetes, coronary heart disease, specific cancers, and other conditions, these analyses have clinical relevance in identifying which outcomes could be preventable through weight loss interventions.
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Affiliation(s)
- Mark O Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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21
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Sumithran P, Purcell K, Kuyruk S, Proietto J, Prendergast LA. Combining biological and psychosocial baseline variables did not improve prediction of outcome of a very-low-energy diet in a clinic referral population. Clin Obes 2018; 8:30-38. [PMID: 29119687 DOI: 10.1111/cob.12229] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/13/2017] [Accepted: 09/29/2017] [Indexed: 12/31/2022]
Abstract
Consistent, strong predictors of obesity treatment outcomes have not been identified. It has been suggested that broadening the range of predictor variables examined may be valuable. We explored methods to predict outcomes of a very-low-energy diet (VLED)-based programme in a clinically comparable setting, using a wide array of pre-intervention biological and psychosocial participant data. A total of 61 women and 39 men (mean ± standard deviation [SD] body mass index: 39.8 ± 7.3 kg/m2 ) underwent an 8-week VLED and 12-month follow-up. At baseline, participants underwent a blood test and assessment of psychological, social and behavioural factors previously associated with treatment outcomes. Logistic regression, linear discriminant analysis, decision trees and random forests were used to model outcomes from baseline variables. Of the 100 participants, 88 completed the VLED and 42 attended the Week 60 visit. Overall prediction rates for weight loss of ≥10% at weeks 8 and 60, and attrition at Week 60, using combined data were between 77.8 and 87.6% for logistic regression, and lower for other methods. When logistic regression analyses included only baseline demographic and anthropometric variables, prediction rates were 76.2-86.1%. In this population, considering a wide range of biological and psychosocial data did not improve outcome prediction compared to simply-obtained baseline characteristics.
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Affiliation(s)
- P Sumithran
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - K Purcell
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - S Kuyruk
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - J Proietto
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - L A Prendergast
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
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22
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Recent progress in genetics, epigenetics and metagenomics unveils the pathophysiology of human obesity. Clin Sci (Lond) 2017; 130:943-86. [PMID: 27154742 DOI: 10.1042/cs20160136] [Citation(s) in RCA: 227] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/24/2016] [Indexed: 12/19/2022]
Abstract
In high-, middle- and low-income countries, the rising prevalence of obesity is the underlying cause of numerous health complications and increased mortality. Being a complex and heritable disorder, obesity results from the interplay between genetic susceptibility, epigenetics, metagenomics and the environment. Attempts at understanding the genetic basis of obesity have identified numerous genes associated with syndromic monogenic, non-syndromic monogenic, oligogenic and polygenic obesity. The genetics of leanness are also considered relevant as it mirrors some of obesity's aetiologies. In this report, we summarize ten genetically elucidated obesity syndromes, some of which are involved in ciliary functioning. We comprehensively review 11 monogenic obesity genes identified to date and their role in energy maintenance as part of the leptin-melanocortin pathway. With the emergence of genome-wide association studies over the last decade, 227 genetic variants involved in different biological pathways (central nervous system, food sensing and digestion, adipocyte differentiation, insulin signalling, lipid metabolism, muscle and liver biology, gut microbiota) have been associated with polygenic obesity. Advances in obligatory and facilitated epigenetic variation, and gene-environment interaction studies have partly accounted for the missing heritability of obesity and provided additional insight into its aetiology. The role of gut microbiota in obesity pathophysiology, as well as the 12 genes associated with lipodystrophies is discussed. Furthermore, in an attempt to improve future studies and merge the gap between research and clinical practice, we provide suggestions on how high-throughput '-omic' data can be integrated in order to get closer to the new age of personalized medicine.
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23
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Livingstone KM, Celis-Morales C, Papandonatos GD, Erar B, Florez JC, Jablonski KA, Razquin C, Marti A, Heianza Y, Huang T, Sacks FM, Svendstrup M, Sui X, Church TS, Jääskeläinen T, Lindström J, Tuomilehto J, Uusitupa M, Rankinen T, Saris WHM, Hansen T, Pedersen O, Astrup A, Sørensen TIA, Qi L, Bray GA, Martinez-Gonzalez MA, Martinez JA, Franks PW, McCaffery JM, Lara J, Mathers JC. FTO genotype and weight loss: systematic review and meta-analysis of 9563 individual participant data from eight randomised controlled trials. BMJ 2016; 354:i4707. [PMID: 27650503 PMCID: PMC6168036 DOI: 10.1136/bmj.i4707] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials. DESIGN Systematic review and random effects meta-analysis of individual participant data from randomised controlled trials. DATA SOURCES Ovid Medline, Scopus, Embase, and Cochrane from inception to November 2015. ELIGIBILITY CRITERIA FOR STUDY SELECTION Randomised controlled trials in overweight or obese adults reporting reduction in body mass index, body weight, or waist circumference by FTO genotype (rs9939609 or a proxy) after dietary, physical activity, or drug based interventions. Gene by treatment interaction models were fitted to individual participant data from all studies included in this review, using allele dose coding for genetic effects and a common set of covariates. Study level interactions were combined using random effect models. Metaregression and subgroup analysis were used to assess sources of study heterogeneity. RESULTS We identified eight eligible randomised controlled trials for the systematic review and meta-analysis (n=9563). Overall, differential changes in body mass index, body weight, and waist circumference in response to weight loss intervention were not significantly different between FTO genotypes. Sensitivity analyses indicated that differential changes in body mass index, body weight, and waist circumference by FTO genotype did not differ by intervention type, intervention length, ethnicity, sample size, sex, and baseline body mass index and age category. CONCLUSIONS We have observed that carriage of the FTO minor allele was not associated with differential change in adiposity after weight loss interventions. These findings show that individuals carrying the minor allele respond equally well to dietary, physical activity, or drug based weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015015969.
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Affiliation(s)
- Katherine M Livingstone
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE4 5PL, UK Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Victoria, Australia
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE4 5PL, UK BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - George D Papandonatos
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | - Bahar Erar
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | - Jose C Florez
- Diabetes Unit and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA Programs in Metabolism and Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Kathleen A Jablonski
- George Washington University Department of Epidemiology and Biostatistics The Biostatistics Center, Rockville, MD, USA
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain CIBER Fisiopatologia de la Obesidad y Nutricion and PREDIMED Network from Instituto de Salud Carlos III Spanish Government, Spain
| | - Amelia Marti
- CIBER Fisiopatologia de la Obesidad y Nutricion and PREDIMED Network from Instituto de Salud Carlos III Spanish Government, Spain Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Tao Huang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA Epidemiology Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Frank M Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mathilde Svendstrup
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Section on Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Danish Diabetes Academy, Odense, Denmark
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Timothy S Church
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Tiina Jääskeläinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland Department of Medical and Clinical Genetics, University of Helsinki, Finland
| | - Jaana Lindström
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Tuomilehto
- Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Wim H M Saris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Maastricht, Netherlands
| | - Torben Hansen
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Section on Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Section on Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Copenhagen University, Rolighedsvej 30, Frederiksberg C, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Section on Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Denmark
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - George A Bray
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Miguel A Martinez-Gonzalez
- CIBER Fisiopatologia de la Obesidad y Nutricion and PREDIMED Network from Instituto de Salud Carlos III Spanish Government, Spain Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
| | - J Alfredo Martinez
- CIBER Fisiopatologia de la Obesidad y Nutricion and PREDIMED Network from Instituto de Salud Carlos III Spanish Government, Spain Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain Food Science and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Paul W Franks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital Malmö, Malmö, Sweden
| | - Jeanne M McCaffery
- The Miriam Hospital and the Alpert School of Medicine, Brown University, Providence, USA
| | - Jose Lara
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE4 5PL, UK Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
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Abstract
It is known that our physiology changes throughout the day and that several physiological hormones display circadian rhythmicity. The alteration of this normal pattern is called chronodisruption (CD). In recent years, it has been demonstrated that CD is related to obesity. Although several factors may be causing CD, one important aspect to consider is the failure in our internal clock. Indeed, studies performed in mutant animals have demonstrated that mutations in clock genes are related to obesity. In human subjects, mutations are rare (<1 % of the population). Nevertheless, it is rather common to have genetic variations in one SNP, which underlie differences in our vulnerability to disease. Several SNP in clock genes are related to obesity and weight loss. Taking into account that genetics is behind CD, as has already been demonstrated in twins’ models, the question is: Are we predestinated? We will see along these lines that nutrigenetics and epigenetics answer: ‘No, we are not predestinated’. Through nutrigenetics we know that our behaviours may interact with our genes and may decrease the deleterious effect of one specific risk variant. From epigenetics the message is even more positive: it is demonstrated that by changing our behaviours we can change our genome. Herein, we propose modifying ‘what, how, and when we eat’ as an effective tool to decrease our genetic risk, and as a consequence to diminish CD and decrease obesity. This is a novel and very promising area in obesity prevention and treatment.
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The FTO gene is associated with a paradoxically favorable cardiometabolic risk profile in frail, obese older adults. Pharmacogenet Genomics 2016; 26:154-160. [PMID: 26709911 DOI: 10.1097/fpc.0000000000000201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Fat mass and obesity-associated (FTO) gene polymorphisms have been reported to be associated with differences in BMI, obesity, and type 2 diabetes. However, previous studies have been predominantly conducted in younger individuals across a spectrum of body weights, whereas little information is available on the older population. We examined the association of FTO gene polymorphisms with cardiometabolic risks among adults who were both obese (BMI≥30 kg/m) and older (age≥65 years). METHODS A total of 165 frail, obese older adults were genotyped for FTO (rs9939609 and rs8050136) single nucleotide polymorphisms and studied for associations with body weight and body composition, components and prevalence of the metabolic syndrome, insulin response to an oral glucose tolerance test, and levels of adipocytokines (e.g. leptin) and vitamin D. RESULTS Carriers of the A allele (CA/AA) of the FTO single nucleotide polymorphism rs8050136 had lower body weight, BMI, body fat, and trunk fat than those without the A allele (CC genotype; all P's<0.05). Moreover, genotype CA/AA was associated with lower levels of triglycerides and higher levels of high-density lipoprotein-cholesterol and carriers of this genotype showed a trend toward a lower waist circumference, resulting in a lower prevalence of metabolic syndrome than in CC genotype carriers. The insulin area under the curve during the oral glucose tolerance test was lower for genotype CA/AA. Despite the lower insulin levels, the glucose area under the curve was unchanged, resulting in a higher insulin sensitivity index. Leptin levels were also lower and adiponectin and 25-hydroxyvitamin levels tended to be higher for genotype CA/AA than for genotype CC. No differences were observed for rs9939609. CONCLUSION Unlike the results from studies in younger individuals, the risk A allele may confer a favorable cardiometabolic risk profile in obese older adults, suggesting selective survival of obese adults into old age. If confirmed in a larger sample of surviving obese older adults, these findings may have implications in the clinical approach to obesity in this population.
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Xiang L, Wu H, Pan A, Patel B, Xiang G, Qi L, Kaplan RC, Hu F, Wylie-Rosett J, Qi Q. FTO genotype and weight loss in diet and lifestyle interventions: a systematic review and meta-analysis. Am J Clin Nutr 2016; 103:1162-70. [PMID: 26888713 PMCID: PMC4807705 DOI: 10.3945/ajcn.115.123448] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 01/20/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Studies have suggested that the fat mass and obesity-associated (FTO) genotype is associated with individual variability in weight loss in response to diet/lifestyle interventions, but results are inconsistent. OBJECTIVE We aimed to provide a summary of the literature evaluating the relation between the FTO genotype and weight loss in response to diet/lifestyle interventions. DESIGN A search of English-language articles in the PubMed and Embase databases (through 30 April 2015) was performed. Eligible studies were diet/lifestyle weight-loss intervention studies conducted in adults that reported changes in body weight or body mass index (BMI) by the FTO variant rs9939609 (or its proxy). Differences in weight loss between FTO genotypes across studies were pooled with the use of fixed-effect models. RESULTS A meta-analysis of 10 studies (comprising 6951 participants) that reported the results of additive genetic models showed that individuals with the FTO TA genotype and AA genotype (those with the obesity-predisposing A allele) had 0.18-kg (95% CI: -0.09-, 0.45-kg;P= 0.19; NS) and 0.44-kg (95% CI: 0.09-, 0.79-kg;P= 0.015) greater weight loss, respectively, than those with the TT genotype. A meta-analysis of 14 studies (comprising 7700 participants) that reported the results of dominant genetic models indicated a 0.20-kg (-0.43-, 0.04-kg) greater weight loss in the TA/AA genotype than in the TT genotype (P= 0.10). In addition, differences in weight loss between the AA genotype and TT genotype were significant in studies with a diet intervention only, adjustment for baseline BMI or body weight, and several other subgroups. However, the relatively small number of studies limited these stratified analyses, and there was no statistically significant difference between subgroups. CONCLUSIONS This meta-analysis suggests that individuals carrying the homozygous FTO obesity-predisposing allele may lose more weight through diet/lifestyle interventions than noncarriers. Our data provide evidence for genetic variability in response to diet/lifestyle interventions on weight loss, although clinical applications of these findings need further investigations.
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Affiliation(s)
- Lingwei Xiang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Hongyu Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - An Pan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bhakti Patel
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Guangda Xiang
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuhan, China; and
| | - Lu Qi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Frank Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY;
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Han J. Rare Syndromes and Common Variants of the Brain-Derived Neurotrophic Factor Gene in Human Obesity. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2016; 140:75-95. [DOI: 10.1016/bs.pmbts.2015.12.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Papandonatos GD, Pan Q, Pajewski NM, Delahanty LM, Peter I, Erar B, Ahmad S, Harden M, Chen L, Fontanillas P, Wagenknecht LE, Kahn SE, Wing RR, Jablonski KA, Huggins GS, Knowler WC, Florez JC, McCaffery JM, Franks PW. Genetic Predisposition to Weight Loss and Regain With Lifestyle Intervention: Analyses From the Diabetes Prevention Program and the Look AHEAD Randomized Controlled Trials. Diabetes 2015; 64:4312-21. [PMID: 26253612 PMCID: PMC4657576 DOI: 10.2337/db15-0441] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/04/2015] [Indexed: 12/22/2022]
Abstract
Clinically relevant weight loss is achievable through lifestyle modification, but unintentional weight regain is common. We investigated whether recently discovered genetic variants affect weight loss and/or weight regain during behavioral intervention. Participants at high-risk of type 2 diabetes (Diabetes Prevention Program [DPP]; N = 917/907 intervention/comparison) or with type 2 diabetes (Look AHEAD [Action for Health in Diabetes]; N = 2,014/1,892 intervention/comparison) were from two parallel arm (lifestyle vs. comparison) randomized controlled trials. The associations of 91 established obesity-predisposing loci with weight loss across 4 years and with weight regain across years 2-4 after a minimum of 3% weight loss were tested. Each copy of the minor G allele of MTIF3 rs1885988 was consistently associated with greater weight loss following lifestyle intervention over 4 years across the DPP and Look AHEAD. No such effect was observed across comparison arms, leading to a nominally significant single nucleotide polymorphism×treatment interaction (P = 4.3 × 10(-3)). However, this effect was not significant at a study-wise significance level (Bonferroni threshold P < 5.8 × 10(-4)). Most obesity-predisposing gene variants were not associated with weight loss or regain within the DPP and Look AHEAD trials, directly or via interactions with lifestyle.
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Affiliation(s)
| | - Qing Pan
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Nicholas M Pajewski
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Linda M Delahanty
- Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Boston, MA Department of Medicine, Harvard Medical School, Boston, MA
| | - Inga Peter
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Bahar Erar
- Center for Statistical Sciences, Brown University, Providence, RI
| | - Shafqat Ahmad
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Skåne University Hospital Malmö, Malmö, Sweden
| | | | - Ling Chen
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | - Pierre Fontanillas
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | | | - Lynne E Wagenknecht
- Look AHEAD Coordinating Center, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Steven E Kahn
- Division of Metabolism, Endocrinology & Nutrition, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA
| | - Rena R Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital and The Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Gordon S Huggins
- Center for Translational Genomics, Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA
| | - William C Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Jose C Florez
- Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Boston, MA Department of Medicine, Harvard Medical School, Boston, MA Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | - Jeanne M McCaffery
- Weight Control and Diabetes Research Center, The Miriam Hospital and The Warren Alpert Medical School of Brown University, Providence, RI
| | - Paul W Franks
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Skåne University Hospital Malmö, Malmö, Sweden Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Misra A. Prevention of diabetes: more answers, more questions. Lancet Diabetes Endocrinol 2015; 3:831-2. [PMID: 26377053 DOI: 10.1016/s2213-8587(15)00331-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 08/27/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Anoop Misra
- Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India; Diabetic Foundation (India), New Delhi, India; National Diabetes Obesity and Cholesterol Foundation, New Delhi, India.
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Prospective association of a genetic risk score and lifestyle intervention with cardiovascular morbidity and mortality among individuals with type 2 diabetes: the Look AHEAD randomised controlled trial. Diabetologia 2015; 58:1803-13. [PMID: 25972230 PMCID: PMC4507276 DOI: 10.1007/s00125-015-3610-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/07/2015] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS Both obesity and genetics contribute to cardiovascular disease (CVD). We examined whether a genetic risk score (GRS) prospectively predicted cardiovascular morbidity and mortality among overweight/obese individuals with type 2 diabetes and whether behavioural weight loss could diminish this association. METHODS Look AHEAD (Action for Health in Diabetes) is a randomised controlled trial to determine the effects of intensive lifestyle intervention (ILI), including weight loss and physical activity, relative to diabetes support and education, on cardiovascular outcomes among overweight/obese individuals with type 2 diabetes. Of the participants, 4,016 provided consent for genetic analyses and had DNA samples passing quality control procedures. These secondary data analyses focused on whether a GRS derived from 153 single nucleotide polymorphisms (SNPs) associated with coronary artery disease in the most recent genome-wide association study predicted cardiovascular morbidity and mortality over a median of 9.6 years of follow-up, and whether ILI would diminish this association. RESULTS The GRS significantly predicted the primary composite endpoint of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalisation for angina in the full sample (HR, 95% CI per 1 SD increase in GRS: 1.19 [1.10, 1.28]) and among individuals with no known history of CVD at baseline (HR 1.18 [95% CI 1.07, 1.30]). In no case did ILI significantly alter this association. CONCLUSIONS/INTERPRETATION A GRS comprised of SNPs significantly predicts cardiovascular morbidity and mortality over 9.6 years of follow-up in Look AHEAD. Lifestyle intervention did not alter the genetic association. CLINICAL TRIAL REGISTRATION NCT00017953; NCT01270763.
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Huggins GS, Berger S, McCaffery JM. Can Genetics Modify the Influence of Healthy Lifestyle on Lipids in the Context of Obesity and Type 2 Diabetes? CURRENT CARDIOVASCULAR RISK REPORTS 2015. [DOI: 10.1007/s12170-015-0464-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Terranova CO, Brakenridge CL, Lawler SP, Eakin EG, Reeves MM. Effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab 2015; 17:371-8. [PMID: 25523815 DOI: 10.1111/dom.12430] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/19/2014] [Accepted: 12/14/2014] [Indexed: 12/13/2022]
Abstract
AIMS To provide a systematic review and meta-analysis of recent evidence on the effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes. METHODS A search of the literature from January 2003 to July 2013 was conducted (PubMed, Embase, CINAHL and Web of Science). The studies considered eligible were randomized controlled trials evaluating weight loss interventions (diet and physical activity, with or without behavioural strategies) of ≥12 weeks duration, compared with usual care or another comparison intervention. Ten studies were included for review. Some heterogeneity was present in the sample, therefore, random-effects models were used to calculate pooled effects. RESULTS Intervention duration ranged from 16 weeks to 9 years, with all but one delivered via individual or group face-to-face sessions. From six studies comparing lifestyle intervention with usual care the pooled effect on weight (n = 5795) was -3.33 kg [95% confidence interval (CI) -5.06, -1.60 kg], and on glycated haemoglobin (HbA1c; n = 5784) was -0.29% (95% CI -0.61, 0.03%), with both attenuated in sensitivity analyses. The pooled within-group effect on weight (n = 3063) from all 10 lifestyle intervention groups was -5.33 kg (95% CI -7.33, -3.34 kg), also attenuated in sensitivity analyses. None of the participant or intervention characteristics examined explained the heterogeneity. Only one study assessed whether intervention effects were maintained after the end of the intervention. CONCLUSIONS Lifestyle-based weight loss intervention trials in type 2 diabetes achieve, on average, modest reductions in weight and HbA1c levels, but results were heavily influenced by one trial. Evidence-based approaches for improving the effectiveness of lifestyle-based interventions in type 2 diabetes are needed, along with future studies reporting on maintenance and cost-effectiveness.
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Affiliation(s)
- C O Terranova
- Cancer Prevention Research Centre, School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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Fat-mass and obesity-associated gene polymorphisms and weight gain after risperidone treatment in first episode schizophrenia. Behav Brain Funct 2014; 10:35. [PMID: 25278160 PMCID: PMC4282200 DOI: 10.1186/1744-9081-10-35] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 09/07/2014] [Indexed: 01/08/2023] Open
Abstract
Background Obesity induced by antipsychotics severely increases the risk of many diseases and significantly reduces quality of life. Genome Wide Association Studies has identified fat-mass and obesity-associated (FTO) gene associated with obesity. The relationship between the FTO gene and drug-induced obesity is unclear. Method Two hundred and fifty drug naïve, Chinese Han patients with first-episode schizophrenia were enrolled in the study, and genotyped for four single nucleotide polymorphisms (SNPs rs9939609, rs8050136, rs1421085 and rs9930506) by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and direct sequencing. Body weight and body mass index (BMI) were measured at baseline and six months after risperidone treatment. Results At baseline, body weight and BMI of TT homozygotes were lower than those of A allele carriers in rs9939609; body weight of AA homozygotes was higher than those of G allele carriers in rs9930506 (p’s < 0.05). After 6 months of risperidone treatment, body weight and BMI of TT homozygotes were lower than those of A allele carriers in rs9939609 (p’s <0.01); body weight and BMI of CC homozygotes were lower than those of A allele carriers in rs8050136 (p’s < 0.05); body weight of AA homozygotes was higher than those of G allele carriers in rs9930506 (p’s < 0.05). After controlling for age, gender, age of illness onset, disease duration, weight at baseline and education, weight gain of TT homozygotes at 6 months remained to be lower than those of A allele carriers in rs9939609 (p < 0.01); weight gain of CC homozygotes at 6 months was lower than those of A allele carriers in rs8050136 (p = 0.01). Stepwise multiple regression analysis suggested that, among 4 SNPs, rs9939609 was the strongest predictor of weight gain after 6 months of risperidone treatment (p = 0.001). Conclusions The FTO gene polymorphisms, especially rs9939609, seem to be related to weight gain after risperidone treatment in Chinese Han patients with first episode schizophrenia.
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Abstract
Look AHEAD is the only long-term study in a large cohort of subjects with type 2 diabetes that assessed the effect of intensive lifestyle, predominantly diet and exercise, on a number of outcomes. While Look AHEAD was not able to detect a significant effect of intensive lifestyle modification on cardiovascular outcomes, it clearly demonstrated numerous beneficial and sustained effects on health outcomes that are relevant to this population. Without the exceptional retention of study participants, it would have been difficult to detect these benefits. Our review provides a perspective on aspects related to exercise, diet, and weight loss in relation to cardiovascular outcomes and potential future research.
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Affiliation(s)
- Helmut Steinberg
- Division of Endocrinology, Diabetes, and Metabolism, University of Tennessee Health Science Center, 956 Court Ave, A202, Memphis, TN, 38163, USA
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize recent advances in investigations of dietary factors, genetic factors, and their interactive effects on obesity and weight loss. RECENT FINDINGS Even with a tremendous body of research conducted, controversy still abounds regarding the relative effectiveness of various weight-loss diets. Recent advances in genome-wide association studies have made great strides in unraveling the genetic basis of regulation of body weight. In prospective cohorts, reproducible evidence is emerging to show interactions between genetic factors and dietary factors such as sugar-sweetened beverage on obesity. In randomized clinical trials, individuals' genotypes have also been found to modify diet interventions on weight loss, weight maintenance, and changes in related metabolic traits such as lipids, insulin resistance, and blood pressure. However, replication, functional exploration, and translation of the findings into personalized diet interventions remain the chief challenges. SUMMARY Preliminary but promising data have emerged to lend support to gene-diet interaction in determining weight loss and maintenance; and studies in the area hold great promise to inform future personalized diet interventions on the reduction of obesity and related health problems.
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Affiliation(s)
- Lu Qi
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
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McCaffery JM, Papandonatos GD, Huggins GS, Peter I, Erar B, Kahn SE, Knowler WC, Lipkin EW, Kitabchi AE, Wagenknecht LE, Wing RR. Human cardiovascular disease IBC chip-wide association with weight loss and weight regain in the look AHEAD trial. Hum Hered 2013; 75:160-74. [PMID: 24081232 PMCID: PMC4257841 DOI: 10.1159/000353181] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND/AIMS The present study identified genetic predictors of weight change during behavioral weight loss treatment. METHODS Participants were 3,899 overweight/obese individuals with type 2 diabetes from Look AHEAD, a randomized controlled trial to determine the effects of intensive lifestyle intervention (ILI), including weight loss and physical activity, relative to diabetes support and education, on cardiovascular outcomes. Analyses focused on associations of single nucleotide polymorphisms (SNPs) on the Illumina CARe iSelect (IBC) chip (minor allele frequency >5%; n = 31,959) with weight change at year 1 and year 4, and weight regain at year 4, among individuals who lost ≥ 3% at year 1. RESULTS Two novel regions of significant chip-wide association with year-1 weight loss in ILI were identified (p < 2.96E-06). ABCB11 rs484066 was associated with 1.16 kg higher weight per minor allele at year 1, whereas TNFRSF11A, or RANK, rs17069904 was associated with 1.70 kg lower weight per allele at year 1. CONCLUSIONS This study, the largest to date on genetic predictors of weight loss and regain, indicates that SNPs within ABCB11, related to bile salt transfer, and TNFRSF11A, implicated in adipose tissue physiology, predict the magnitude of weight loss during behavioral intervention. These results provide new insights into potential biological mechanisms and may ultimately inform weight loss treatment.
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Affiliation(s)
- Jeanne M McCaffery
- Weight Control and Diabetes Research Center, Department of Psychiatry and Human Behavior, The Miriam Hospital and Brown Medical School, Providence, R.I., USA
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Huggins GS, Papandonatos GD, Erar B, Belalcazar LM, Brautbar A, Ballantyne C, Kitabchi AE, Wagenknecht LE, Knowler WC, Pownall HJ, Wing RR, Peter I, McCaffery JM. Do genetic modifiers of high-density lipoprotein cholesterol and triglyceride levels also modify their response to a lifestyle intervention in the setting of obesity and type-2 diabetes mellitus?: The Action for Health in Diabetes (Look AHEAD) study. ACTA ACUST UNITED AC 2013; 6:391-9. [PMID: 23861364 DOI: 10.1161/circgenetics.113.000042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND High-density lipoprotein cholesterol (HDL-C) and triglycerides are cardiovascular risk factors susceptible to lifestyle behavior modification and genetics. We hypothesized that genetic variants identified by genome-wide association studies as associated with HDL-C or triglyceride levels modify 1-year treatment response to an intensive lifestyle intervention, relative to a usual care of diabetes mellitus support and education. METHODS AND RESULTS We evaluated 82 single-nucleotide polymorphisms, which represent 31 loci demonstrated by genome-wide association studies to be associated with HDL-C and triglycerides, in 3561 participants who consented for genetic studies and met eligibility criteria. Variants associated with higher baseline HDL-C levels, cholesterol ester transfer protein (CETP) rs3764261 and hepatic lipase (LIPC) rs8034802, were found to be associated with HDL-C increases with intensive lifestyle intervention (P=0.0038 and 0.013, respectively) and had nominally significant treatment interactions (P=0.047 and 0.046, respectively). The fatty acid desaturase-2 rs1535 variant, associated with low baseline HDL-C (P=0.017), was associated with HDL-C increases with intensive lifestyle intervention (0.0037) and had a nominal treatment interaction (P=0.035). Apolipoprotein B (rs693) and LIPC (rs8034802) single-nucleotide polymorphisms showed nominally significant associations with HDL-C and triglyceride changes with intensive lifestyle intervention and a treatment interaction (P<0.05). Phosphatidylglycerophosphate synthase-1 single-nucleotide polymorphisms (rs4082919) showed the most significant triglyceride treatment interaction in the full cohort (P=0.0009). CONCLUSIONS This is the first study to identify genetic variants modifying lipid responses to a randomized lifestyle behavior intervention in overweight or obese individuals with diabetes mellitus. The effects of genetic factors on lipid changes may differ from the effects on baseline lipids and are modifiable by behavioral intervention.
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Affiliation(s)
- Gordon S Huggins
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA 02111, USA.
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