Effects of Trp64Arg mutation in the beta 3-adrenergic receptor gene on weight loss, body fat distribution, glycemic control, and insulin resistance in obese type 2 diabetic patients

Can study of the ADRB3 gene help improve weight loss programs in obese individuals?

INTRODUCTION

Obesity is a chronic disease of multifactorial origin characterized by excess weight and excess fat accumulation, and whose etiology includes intrinsic (genetic, physiological, and metabolic) and extrinsic (social and cultural) factors. Fat accumulation is caused by a prolonged imbalance in the energy balance influenced, among other factors, by adaptive thermogenesis, which is triggered by cold environmental conditions, or by hypercaloric intake. Thermogenesis is regulated by the sympathetic nervous system and occurs in the muscle and brown adipose tissue. There are adrenergic receptors in brown adipose tissue, including the beta-3 adrenergic receptor (ADRB3), the main receptor for the regulation of thermogenesis. The presence in heterozygosis of an SNP-type polymorphism in the ADRB3 gene (Trp64Arg; rs4994) is associated with a lower lipolytic activity, a predisposition to obesity, and resistance to weight loss. The objective of this study was to analyze through a systematic review the weight loss program most appropriate for carriers.

METHODS

A retrospective study of published papers on rs4994 polymorphism in the SNP and PubMed databases was conducted.

RESULTS

Most published studies suggest the presence of obesity and resistance to weight loss in carriers, and report significant improvements in anthropometric parameters when patients receive fat-rich hypocaloric diets.

CONCLUSIONS

Based on these conclusions, specific nutritional and physical exercise guidelines are proposed for individuals carrying the Trp64Arg allele.

Variants in BMI-Associated Genes and Adrenergic Genes are not Associated with Gestational Weight Trajectory

OBJECTIVE

The aim of this study is to define the association between a genetic risk score (GRS) that combined the effect of multiple BMI-associated variants and gestational weight trajectory. Because pregnancy is a state of sympathetic activation, the association between gestational weight trajectory and variants in adrenergic pathways previously associated with weight was examined.

METHODS

In a previously defined cohort of pregnant women with (n = 1,504) and without gestational diabetes (GDM) (n = 435), weight trajectory was calculated using all weights during pregnancy. A GRS for BMI (GRS_BMI ) was calculated using 31 common variants associated with BMI, and 10 variants in the adrenergic pathways were genotyped. Clinical and genetic factors were studied using generalized linear models.

RESULTS

Prepregnancy BMI was associated with the GRS_BMI (P = 9.3 × 10^-11 ) and parity (P = 4.54 × 10^-17 ). The GRS_BMI was associated with gestational weight trajectory in women with and without GDM (P = 0.041 and P < 0.0001, respectively); however, when prepregnancy BMI was included in the models, the associations disappeared (P > 0.05). Variants in adrenergic genes were not associated with gestational weight trajectory.

CONCLUSIONS

A GRS for BMI was associated with prepregnancy BMI but was not independently associated with gestational weight trajectory in women with and without GDM. Selected variants in adrenergic genes were not associated with gestational weight trajectory.

ADRB3 polymorphism rs4994 (Trp64Arg) associates significantly with bodyweight elevation and dyslipidaemias in Saudis but not rs1801253 (Arg389Gly) polymorphism in ARDB1

Background

In some populations, obesity and body weight related disorders show a correlation with polymorphisms in three subtypes of beta-adrenoceptor (β1, β2, and β3) [ADRB1, ADRB2 and ADRB3] genes. We scanned for the polymorphism of Arg389Gly (rs1801253) in ADRB1 and Trp64Arg (rs4994) in ADRB3 genes in Saudi population to determine association, if any, of these polymorphisms with obesity and related disorders.

Methods

We studied 329 non-related adults (33.1% men and 66.9% women), aged 18–36 years. Anthropometric measurements were recorded, and Body mass index (BMI) and waist/hip ratio were calculated; leptin, insulin, lipidogram, and glucose concentrations were determined. ADRB1 and ADRB3 polymorphisms (Arg389Gly and Trp64Arg, respectively) were screened by DNA sequencing. The subjects were divided into three groups according to BMI: normal weight (BMI < 25 kg/m²), overweight (BMI ≥25.1–29.9 kg/m²) subjects, and obese (≥30 kg/m²).

Results

In the age-matched groups of the normal weight, overweight and obese male and female subjects, all anthropometric parameters were found to be significantly higher, and in the obese group, all biochemical parameters were significantly elevated compared to the normal weight controls. The allelic frequency of Gly389 ADRB1 did not differ amongst the three groups, whereas the frequency of Arg64 of ADRB3 gene was significantly higher in the overweight and obese subjects, compared with the normal weight subjects. In addition, subjects carrying Arg64 allele regardless of their BMI had a greater waist and hip circumference, W/H ratio, plasma cholesterol, triglyceride, LDL, leptin, insulin, and glucose level compared to those with the wild-type Trp allele.

Conclusion

The results of this study have shown a significant association between the Trp64Arg polymorphism in ADRB3 gene and the development of overweight and obesity in Saudi populations. It also has an influence on the levels of lipid, insulin, leptin, and glucose, whereas, Arg389Gly polymorphism in ADRB1 is not associated with overweight, obesity or dyslipidaemias in Saudis.

Genetic variants influencing effectiveness of exercise training programmes in obesity - an overview of human studies

Frequent and regular physical activity has significant benefits for health, including improvement of body composition and help in weight control. Consequently, promoting training programmes, particularly in those who are genetically predisposed, is a significant step towards controlling the presently increasing epidemic of obesity. Although the physiological responses of the human body to exercise are quite well described, the genetic background of these reactions still remains mostly unknown. This review not only summarizes the current evidence, through a literature review and the results of our studies on the influence of gene variants on the characteristics and range of the body's adaptive response to training, but also explores research organization problems, future trends, and possibilities. We describe the most reliable candidate genetic markers that are involved in energy balance pathways and body composition changes in response to training programmes, such as FTO, MC4R, ACE, PPARG, LEP, LEPR, ADRB2, and ADRB3. This knowledge can have an enormous impact not only on individualization of exercise programmes to make them more efficient and safer, but also on improved recovery, traumatology, medical care, diet, supplementation and many other areas. Nevertheless, the current studies still represent only the first steps towards a better understanding of the genetic factors that influence obesity-related traits, as well as gene variant x physical activity interactions, so further research is necessary.

Effects of lifestyle intervention on weight and metabolic parameters in patients with impaired glucose tolerance related to beta-3 adrenergic receptor gene polymorphism Trp64Arg(C/T): Results from the Japan Diabetes Prevention Program

The beta‐3 adrenergic receptor (ADRB3), primarily expressed in adipose tissue, is involved in the regulation of energy metabolism. The present study hypothesized that ADRB3 (Trp64Arg, rs4994) polymorphisms modulate the effects of lifestyle intervention on weight and metabolic parameters in patients with impaired glucose tolerance. Data were analyzed from 112 patients with impaired glucose tolerance in the Japan Diabetes Prevention Program, a lifestyle intervention trial, randomized to either an intensive lifestyle intervention group or usual care group. Changes in weight and metabolic parameters were measured after the 6‐month intervention. The ADRB3 polymorphisms were determined using the polymerase chain reaction restriction fragment length polymorphism method. Non‐carriers showed a greater weight reduction compared with the carriers in both the lifestyle intervention group and usual care group, and a greater increase of high‐density lipoprotein cholesterol levels than the carriers only in the lifestyle intervention group. ADRB3 polymorphisms could influence the effects of lifestyle interventions on weight and lipid parameters in impaired glucose tolerance patients.

The role of genes involved in lipolysis on weight loss program in overweight and obese individuals

The ability of obese people to reduce weight in the same treatment varied. Genetic make up as well as the behavioral changes are important for the successfulness of the program. One of the most proposed genetic variations that have been reported in many intervention studies was genes that control lipolysis process. This review summarizes studies that were done showing the influence of genetic polymorphisms in lipolysis pathway and weight loss in a weight loss treatment program. Some studies had shown that certain enzymes involved in this process were related to successfulness of weight loss program. Single Nucleotide Polymorphism (SNP) in PLIN (11482G>A) and ADRB3 (Trp64Arg) are the most studied polymorphisms that have effect on weight loss intervention. However, those studies were not conclusive because of limited number of subjects used and controversies in the results. Thus, replication and confirmation on the role of those genes in weight loss are important due to their potential to be used as predictors of the results of the program.

Incidence of β3-adrenergic receptor polymorphism and prediction of successful weight reduction with mazindol therapy in severely obese Japanese subjects

SUMMARY

Mazindol, a centrally acting monoamine re-uptake inhibitor, enhances satiety and supports body weight loss, but response to this drug among obese patients is very variable. The possible involvement of the Trp64Arg polymorphism of the β3-adrenergic receptor (ADRB3) gene in the development of severe obesity and weight loss response to anorexigenic drugs has not been established. In the present study, the allelic frequency of the Trp64Arg ADRB3 gene polymorphism was determined in massively obese Japanese outpatients (BMI > 35 kg/m(2)), and we investigated whether allelic differences may determine the weight loss effect of mazindol. The allelic frequency of Trp64Arg heterozygotes and homozygotes did not differ in severely obese subjects compared to non-obese subjects. Trp64Arg heterozygotes experienced significantly increased weight loss and reduced blood pressure following mazindol administration for 12 weeks. Thus the ADRB3 gene polymorphism is predictive for difficulty in weight reduction with mazindol treatment, but is not related to the development of severe obesity in the Japanese population.:

[Association of BMI with the beta3 adrenergic receptor gene mutation: a meta-analysis]

The beta3 adrenergic receptor (ADRB3) is a part of the adrenergic system, which is known to play a key role in energy metabolism. The relationship between the Trp64Arg variant of ADRB3 and body mass index (BMI) has been widely examined; however, the results of these studies have been inconsistent. Therefore, we performed a meta-analysis of the relationship between an ADRB3 variant and BMI in 2008. Our results suggested that the Trp64Arg variant of ADRB3 was associated with BMI in East Asians, but not Europeans. Additionally, our report showed the importance of meta-analyses in the field of genetic association studies for common traits. In 1995, Yoshida et al. reported that the Trp64Arg variant of ADRB3 was related to difficulty in weight loss. The decrease in body weight in obese subjects with the mutation was lower than that in obese subjects without the mutation following a 3 month combined low-calorie diet and exercise regimen. However, subsequent studies have yielded inconsistent results. Accordingly, further studies are needed to reliably assess and interpret gene-phenotype associations with this ADRB3 variant.

Effects of exercise training on gut hormone levels after a single bout of exercise in middle-aged Japanese women

The purpose of this study was to investigate the effects of 12 weeks of exercise training on gut hormone levels after a single bout of exercise in middle-aged Japanese women. Twenty healthy middle-aged women were recruited for this study. Several measurements were performed pre and post exercise training, including: body weight and composition, peak oxygen consumption (peak VO2), energy intake after the single bout of exercise, and the release of gut hormones with fasting and after the single bout of exercise. Exercise training resulted in significant increases in acylated ghrelin fasting levels (from 126.6 ± 5.6 to 135.9 ± 5.4 pmol/l, P < 0.01), with no significant changes in GLP-1 (from 0.54 ± 0.04 to 0.55 ± 0.03 pmol/ml) and PYY (from 1.20 ± 0.07 to 1.23 ± 0.06 pmol/ml) fasting levels. GLP-1 levels post exercise training after the single bout of exercise were significantly higher than those pre exercise training (areas under the curve (AUC); from 238.4 ± 65.2 to 286.5 ± 51.2 pmol/ml x 120 min, P < 0.001). There was a tendency for higher AUC for the time courses of PYY post exercise training than for those pre exercise training (AUC; from 519.5 ± 135.5 to 551.4 ± 128.7 pmol/ml x 120 min, P = 0.06). Changes in (delta) GLP-1 AUC were significantly correlated with decreases in body weight (r = -0.743, P < 0.001), body mass index (r = -0.732, P < 0.001), percent body fat (r = -0.731, P < 0.001), and energy intake after a single bout exercise (r = -0.649, P < 0.01) and increases in peak VO2 (r = 0.558, P < 0.05). These results suggest that the ability of exercise training to create a negative energy balance relies not only directly on its impact on energy expenditure, but also indirectly on its potential to modulate energy intake.

Beta-3-adrenergic receptor Trp64Arg polymorphism: does it modulate the relationship between exercise and percentage of body fat in young adult Japanese males?

OBJECTIVES

The Trp64Arg polymorphism of the beta-3-adrenergic receptor gene has been studied as a potential genetic factor contributing to the development of obesity. Several studies have investigated whether or not this polymorphism affects weight reduction due to exercise, but the results of these studies have not been consistent. Moreover, information on a population characterized by a wide ranges of physical activities is scarce. Thus, to further understand the impact of this polymorphism, we examined whether the polymorphism modulates the relationship between physical activity due to exercise (PAE) and percentage of body fat (%BF).

METHODS

The study population was 70 Japanese male young adults with a high prevalence of habitual exercise. PAE was estimated by a questionnaire, and %BF was measured by bioelectrical impedance analysis. Genotyping was done by PCR-restriction fragment length polymorphism analysis.

RESULTS

The median PAE value of the subjects was 6.9 MET-h/day with an interquartile range of 1.5-10.3 MET-h/day. PAE correlated significantly with %BF in the entire population and within the two subpopulations, namely, carriers or non-carriers of the Arg allele. Multiple regression analysis of PAE, Trp64Arg polymorphism, and the interaction term revealed that while the PAE-derived independent variable was statistically significant, the interaction term was insignificant. When the two regression lines of subjects with and without the Arg allele were considered, the difference between the two slopes did not deviate from zero, nor did the vertical distance of the two regression lines. These findings suggest that the impact of this polymorphism is limited.

CONCLUSIONS

In our study population of young adult Japanese males, the impact of the Trp64Arg polymorphism on the association between exercise and body composition was weak, if it existed at all.

Effect of β(3)-adrenergic receptor gene polymorphism on body weight change in middle-aged, overweight women

OBJECTIVES

To examine the effects of β(3)-adrenergic receptor gene polymorphism on body weight change during a weight reduction program for middle-aged, overweight women with careful consideration of their energy intake and expenditure.

METHODS

DESIGN

Intervention study of weight reduction for 12 weeks in a community setting.

SUBJECTS

Eighty overweight middle-aged women who completed the individualized lifestyle modification program.

MEASUREMENTS

β(3)-adrenergic receptor gene polymorphism was identified by polymerase chain reaction and consecutive restriction fragment-length polymorphism analysis. Anthropometrical parameters, lifestyle factors, blood lipid and glucose levels, physical activity level and energy intake were measured before and at the end of the program.

RESULTS

The numbers of subjects with the Trp64Trp, Trp64Arg, and Arg64Arg genotypes were 45, 30 and 5, respectively. Baseline characteristics among subjects with the 64Arg allele had significantly smaller decrease in body weight and energy intake than those without the 64Arg allele. The change of other clinical characteristics did not differ between the two groups. After adjusting for the %change of energy intake, the %change of body weight did not differ between the two groups.

CONCLUSION

The 64Arg allele of the β(3)-AR gene is not likely to be the factor determining the difficulty in losing body weight in Japanese middle-aged, overweight women. Lifestyle factors, such as the decrease in energy intake, might mask the effect of the 64Arg allele on body weight loss. Specific considerations for the management of energy intake would be needed to promote body weight loss for those with the 64Arg allele.

Meta-Analysis of the Association of the Trp64Arg Polymorphism in the β3 Adrenergic Receptor with Insulin Resistance

OBJECTIVE

To clarify the possible association between the Trp64Arg polymorphism and insulin resistance (IR).

RESEARCH METHODS AND PROCEDURES

Articles evaluating the effect of the Trp64Arg polymorphism on IR were identified on the MEDLINE and PubMed databases from 1995 to February, 2004. After extraction of relevant data, main and subgroup meta-analyses were performed to assess the differences in IR indices between Trp/Trp and Trp/Arg genotypes.

RESULTS

Forty eligible papers containing 56 subgroups were included in this meta-analysis. Among a total of 12,805 subjects, 21.9% had Trp64Arg mutation: 20.8%, heterozygotes and 1.1%, homozygotes. Significant associations were found between this mutation and some indices of IR. The weighted mean difference in fasting insulin, 120-minute insulin level after oral glucose tolerance test, and homeostasis model assessment between Arg64 and Trp64 was 0.23 [95% confidence interval (CI), 0.05 to 0.42] pM, 0.89 (95% CI, 0.30 to 1.48) pM, and 0.55 (95% CI, 0.14 to 0.96), respectively. Subgroup analysis further indicated that this significant association existed only in the Asian population (p < 0.01) and in the obese (p = 0.02) and diabetes subgroups (p = 0.03).

DISCUSSION

Numerous studies have been conducted to examine the relationship between the beta3-adrenergic receptor Trp64Arg polymorphism and components of IR syndrome. However, the results have been inconsistent and have led to controversy about whether this polymorphism is associated with these clinical features. The current meta-analysis demonstrated the moderate effects of the Trp64Arg polymorphism on IR in the Asian population and in obese and diabetic subgroups.

Exercise training, genetics and type 2 diabetes-related phenotypes

Type 2 diabetes mellitus (T2DM) is at virtually pandemic levels world-wide. Diabetes has been referred to as 'a geneticist's nightmare'. However, dramatic advances in our understanding of the genetics of T2DM have occurred in the past 5 years. While endurance exercise training and increased habitual physical activity levels have consistently been shown to improve or be associated with improved T2DM-related phenotypes, there is substantial interindividual variation in these responses. There is some evidence that T2DM-related phenotype responses to exercise training are heritable, indicating that they might have a genetic basis. Genome-wide linkage studies have not identified specific chromosomal loci that could account for these differences, and no genome-wide association studies have been performed relative to T2DM-related phenotype responses to exercise training. From candidate gene studies, there are relatively strong and replicated data supporting a role for the PPARγ Pro12Ala variant in the interindividual differences in T2DM-related phenotype responses to training. This is a potentially important candidate locus because it affects T2DM susceptibility, has high biological plausibility and is the target for the primary pharmaceutical method for treating T2DM. Is it time to conduct a hypothesis-driven large-scale exercise training intervention trial based on PPARγ Pro12Ala genotype with T2DM-related phenotypes as the primary outcome measures, while also assessing potential mechanistic changes in skeletal muscle and adipose tissue? Or would it be more appropriate to propose a smaller trial to address the specific skeletal muscle and adipose tissue mechanisms affected by the interaction between the PPARγ Pro12Ala genotype and exercise training?

Association of the ADRA1A gene and the severity of metabolic abnormalities in patients with schizophrenia

Patients with schizophrenia have a higher risk of developing metabolic abnormalities and their associated diseases. Some studies found that the accumulative number of metabolic syndrome components was associated with the severity of metabolic abnormalities. The purpose of this study was to examine the roles of the ADRA1A, ADRA2A, ADRB3, and 5HT2A genes in the risk of having more severe metabolic abnormalities among patients with schizophrenia. We studied a sample of 232 chronic inpatients with schizophrenia (120 males and 112 females) to explore the associations between the four candidate genes and the severity of metabolic syndrome by accumulative number of the components. Four single nucleotide polymorphisms in the candidate genes were genotyped, including the Arg347Cys in ADRA1A, the C1291G in ADRA2A, the Try64Arg in ADRB3, and the T102C in 5HT2A. An association between the accumulative number of metabolic syndrome components and the ADRA1A gene was found after adjusting age, sex, and other related variables (p-value=0.036). Presence of the Arg347 allele in the ADRA1A gene is a risk factor for having more severe metabolic abnormalities. These findings suggest a medical attention of closely monitoring metabolic risks for schizophrenia patients with high-risk genotypes.

Do genetic variations alter the effects of exercise training on cardiovascular disease and can we identify the candidate variants now or in the future?

Cardiovascular disease (CVD) and CVD risk factors are highly heritable, and numerous lines of evidence indicate they have a strong genetic basis. While there is nothing known about the interactive effects of genetics and exercise training on CVD itself, there is at least some literature addressing their interactive effect on CVD risk factors. There is some evidence indicating that CVD risk factor responses to exercise training are also heritable and, thus, may have a genetic basis. While roughly 100 studies have reported significant effects of genetic variants on CVD risk factor responses to exercise training, no definitive conclusions can be generated at the present time, because of the lack of consistent and replicated results and the small sample sizes evident in most studies. There is some evidence supporting “possible” candidate genes that may affect these responses to exercise training: APO E and CETP for plasma lipoprotein-lipid profiles; eNOS, ACE, EDN1, and GNB3 for blood pressure; PPARG for type 2 diabetes phenotypes; and FTO and BAR genes for obesity-related phenotypes. However, while genotyping technologies and statistical methods are advancing rapidly, the primary limitation in this field is the need to generate what in terms of exercise intervention studies would be almost incomprehensible sample sizes. Most recent diabetes, obesity, and blood pressure genetic studies have utilized populations of 10,000–250,000 subjects, which result in the necessary statistical power to detect the magnitude of effects that would probably be expected for the impact of an individual gene on CVD risk factor responses to exercise training. Thus at this time it is difficult to see how this field will advance in the future to the point where robust, consistent, and replicated data are available to address these issues. However, the results of recent large-scale genomewide association studies for baseline CVD risk factors may drive future hypothesis-driven exercise training intervention studies in smaller populations addressing the impact of specific genetic variants on well-defined physiological phenotypes.

Influence of beta 3-adrenergic receptor Trp64Arg polymorphism on the improvement of metabolic syndrome by exercise-based intervention in Japanese middle-aged males

SUMMARY

OBJECTIVES

To date, there have been few intervention studies concerning the association of metabolic syndrome with beta 3-adrenergic receptor (ADRB3) Trp64Arg polymorphism, although ADRB3 Trp64Arg polymorphism has been reported to be associated with weight gain and insulin resistance by several intervention programs. We examined the influence of ADRB3 Trp64Arg polymorphism on the improvement of metabolic syndrome by an exercise-based intervention program.

METHODS

Thirty-six male employees who satisfied the metabolic syndrome criteria participated in a three-month exercise-based intervention program (average age, 49 ± 6 years old). The improvement rate of metabolic syndrome after the intervention was compared between subjects with and without ADRB3 Trp64Arg polymorphism. The Mantel-Haenszel test was employed to adjust the age, diet, and exercise in analysis of the influence of ADRB3 Trp64Arg polymorphism on metabolic syndrome. The Trp64Arg genotype of the β3-adrenoceptor gene was examined in peripheral blood leukocyte DNA by TaqMan PCR assay.

RESULTS

The distribution of polymorphism was 23 (Trp/Trp), 13 (Trp/Arg), and 0 (Arg/Arg). The metabolic syndrome improvement rates after intervention were 21.7% (Trp/Trp) and 53.8% (Trp/Arg) (p = 0.050). After adjustment individually for age, calorie limitation, and 10,000 or more and 12,000 or more steps of walking per day during intervention, the odds ratios of the Trp/Arg genotype for improvement of metabolic syndrome relative to that of the Trp/Trp genotype were 5.1 (p = 0.043), 4.9 (p = 0.051), 3.7 (p = 0.074), and 5.0 (p = 0.045), respectively.

CONCLUSION

The results suggested that ADRB3 Trp64Arg polymorphism influences the metabolic syndrome improvement rate by exercise-based intervention program.

Relationships of adrenoceptor polymorphisms with obesity

Obesity, hypertension, and type 2 diabetes are rapidly growing public health problems. Heightened sympathetic nerve activity is a well-established observation in obesity, hypertension, and type 2 diabetes. Human obesity, hypertension, and diabetes have strong genetic as well as environmental determinants. Reduced energy expenditure and resting metabolic rate are predictive of weight gain, and the sympathetic nervous system participates in regulating energy balance through thermogenesis. The thermogenic effects of catecholamines in obesity are mainly mediated via the β2, and β3-adrenergic receptors in humans. Further, β2-adrenoceptors importantly influence vascular reactivity and may regulate blood pressure. β-adrenoceptor polymorphisms have also been associated with adrenoceptor desensitization, increased adiposity, insulin resistance, and enhanced sympathetic nervous activity. Many epidemiological studies have shown strong relationships between adrenoceptor polymorphisms and obesity, but the observations have been discordant. This paper will discuss the current topics involving the influence of the sympathetic nervous system and β2- and β3-adrenoceptor polymorphisms in obesity.

The future: genes, physical activity and health

The assigned title for the Lindhard presentation was to examine the future of genes, physical activity and health. The current review is a summary of this presentation. Caution is expressed that technology is improving so rapidly that a future view is limited to a few years as opposed to the 100 years passing since Lindhard's achievements. The near futuristic opportunities and challenges for four major topic topics are reviewed here. Concerns are expressed over current usage of the terms 'control' group and 'non-responders' in exercise research. Our view is that 'control' needs to be differentiated between its usage for treatments of exercise to restore natural functions in individuals with less than healthy levels of physical activity and the inherited genome's expectation for physical activity levels to maintain normal function. For the second discussed topic, it is proposed that the term 'non-responders' should be replaced by the term 'low sensitivity' as there may be no such human who is a non-responder to every exercise adaptation. The third futuristic topic is exercise prescription as envisioned for individualized medicine. However, numerous limitations and challenges exist to truly optimal exercise medicine at the level of one individual. Finally, preventative physical activity medicine is discussed. Physical activity as a therapy now exists to prevent most of the chronic diseases. The future needs to understand the molecular basis for how the body becomes dysfunctional when its level of physical activity does not match the norm of physical activity that selected our inherited genome.

Effect of the β3-adrenergic receptor gene polymorphism Trp64Arg on BMI reduction associated with an exercise-based intervention program in Japanese middle-aged males

OBJECTIVES

The β3-Adrenergic receptor gene polymorphism Trp64Arg (ADRB3 Trp64Arg) may be associated with weight gain, especially in the East Asian populations. To date, however, the results of various investigations aimed at determining whether ADRB3 Trp64Arg has any effect on weight reduction after intervention have been inconsistent. The aim of this study was to assess the effect of ADRB3 Trp64Arg on weight reduction in a non-pharmacological intervention program.

METHODS

Fifty-seven Japanese men (average age 48.1 ± 5.9 years) whose body mass index (BMI) was >23.0 kg/m(2) participated in an intervention program in which they were encouraged to exercise by walking with a pedometer for 12 weeks. The BMI was measured at the start of the intervention program and on weeks 4, 8, and 12 (end) of the intervention period. The reduction in the BMI (ΔBMI) was calculated as the BMI value obtained at each point in comparison to the baseline (initial) BMI. The participants were classified into two groups: Arg allele non-carriers (Trp/Trp) and Arg allele carriers (Trp/Arg or Arg/Arg), respectively.

RESULTS

Among the participants, 61.4% were Trp/Trp homozygous, 38.6% were Trp/Arg heterozygous, and 0.0% were Arg/Arg homozygous. There was no significant difference in the ΔBMI between Arg allele non-carriers and Arg allele carriers at week 4 [non-carrier mean ± standard deviation (SD) vs. carrier mean ± SD: 0.25 ± 0.43 vs. 0.24 ± 0.35, respectively; p = 0.954], week 8 (0.56 ± 0.68 vs. 0.58 ± 0.61, respectively; p = 0.913), and week 12 (0.70 ± 0.86 vs. 0.84 ± 0.80, respectively; p = 0.545).

CONCLUSIONS

Our results suggest that ADRB3 Trp64Arg does not influence BMI reduction after an exercise-based intervention program.

The human gene map for performance and health-related fitness phenotypes: the 2006-2007 update

This update of the human gene map for physical performance and health-related fitness phenotypes covers the research advances reported in 2006 and 2007. The genes and markers with evidence of association or linkage with a performance or a fitness phenotype in sedentary or active people, in responses to acute exercise, or for training-induced adaptations are positioned on the map of all autosomes and sex chromosomes. Negative studies are reviewed, but a gene or a locus must be supported by at least one positive study before being inserted on the map. A brief discussion on the nature of the evidence and on what to look for in assessing human genetic studies of relevance to fitness and performance is offered in the introduction, followed by a review of all studies published in 2006 and 2007. The findings from these new studies are added to the appropriate tables that are designed to serve as the cumulative summary of all publications with positive genetic associations available to date for a given phenotype and study design. The fitness and performance map now includes 214 autosomal gene entries and quantitative trait loci plus seven others on the X chromosome. Moreover, there are 18 mitochondrial genes that have been shown to influence fitness and performance phenotypes. Thus,the map is growing in complexity. Although the map is exhaustive for currently published accounts of genes and exercise associations and linkages, there are undoubtedly many more gene-exercise interaction effects that have not even been considered thus far. Finally, it should be appreciated that most studies reported to date are based on small sample sizes and cannot therefore provide definitive evidence that DNA sequence variants in a given gene are reliably associated with human variation in fitness and performance traits.

Adiponectin gene single-nucleotide polymorphisms and treatment response to obesity

BACKGROUND

In the adiponectin gene polymorphisms, single-nucleotide polymorphism (SNP)-45 and SNP276 have reportedly been associated with obesity, Type 2 diabetes, and other features of metabolic syndrome.

AIM

Whether these adiponectin SNP affect obesity-related parameters during caloric restriction in obese subjects.

SUBJECTS AND METHODS

Thirty- two obese Japanese women were treated by meal replacement with a low calorie diet for 8 weeks and asked to maintain their habitual lifestyle. Obesity-related parameters were measured before and after the treatment period. We determined four SNP (T45G, I164T, G276T, and C-11377G) using a fluorescent allele-specific DNA primer assay systemand FRET probe assay system.

RESULTS

After the treatment, the extent of decrease in waist circumference was greater in the subjects with the G/G or G/T genotype of SNP276 than in those with the T/T genotype (p=0.026). As for SNP45, the extent of decrease in triglyceride levels was greater in the subjects with the T/T genotype than in those with the T/G genotype (p=0.003). For SNP-11377, the extent of decrease in systolic blood pressure and fasting plasma glucose was greater in the subjects with the C/G or G/G genotype than in those with the C/C genotype (p=0.044).

CONCLUSION

Our findings indicate that each SNP in the adiponectin gene might modify the change in obesity-related parameters during meal replacement with a low calorie diet.

Gene-environment interaction and obesity

The epidemic of obesity has become a major public health problem. Common-form obesity is underpinned by both environmental and genetic factors. Epidemiological studies have documented that increased intakes of energy and reduced consumption of high-fiber foods, as well as sedentary lifestyle, were among the major driving forces for the epidemic of obesity. Recent genome-wide association studies have identified several genes convincingly related to obesity risk, including the fat mass and obesity associated gene and the melanocortin-4 receptor gene. Testing gene-environment interaction is a relatively new field. This article reviews recent advances in identifying the genetic and environmental risk factors (lifestyle and diet) for obesity. The evidence for gene-environment interaction, especially from observational studies and randomized intervention trials, is examined specifically. Knowledge about the interplay between genetic and environmental components may facilitate the choice of more effective and specific measures for obesity prevention based on the personalized genetic make-up.

Implications of gene-behavior interactions: prevention and intervention for obesity

A vast body of research exists to demonstrate that obesity is a complex disorder with a strong genetic basis and a multifactorial etiology. Yet despite the overwhelming evidence that genes play an important role in the development of obesity, many people argue that the increasing prevalence of obesity is simply due to an abundance of palatable food and a dearth of opportunities for physical exercise. While activity and eating behaviors contribute substantially to the development of obesity, considering these to be the only etiologic factors is directly contradictory to what is now known about how eating and energy balance are regulated. Our understanding of the molecular processes controlling eating behavior, in particular, has accelerated exponentially in the last 10 years, and this is one area in which obesity genetics has made great progress. Our challenge is to understand more fully how genetic variation may interact with behavioral factors to influence the regulation of body weight and adiposity. Although exercise and diet strategies are used routinely for obesity treatment, there is a huge variability in how individuals respond to these interventions. There is also a substantial amount of evidence that such responses may also be regulated by genes. Understanding gene-response relationships is the key to developing more efficacious intervention and prevention programs for obesity.

Implications of gene-behavior interactions: prevention and intervention for obesity

A vast body of research exists to demonstrate that obesity is a complex disorder with a strong genetic basis and a multifactorial etiology. Yet despite the overwhelming evidence that genes play an important role in the development of obesity, many people argue that the increasing prevalence of obesity is simply due to an abundance of palatable food and a dearth of opportunities for physical exercise. While activity and eating behaviors contribute substantially to the development of obesity, considering these to be the only etiologic factors is directly contradictory to what is now known about how eating and energy balance are regulated. Our understanding of the molecular processes controlling eating behavior, in particular, has accelerated exponentially in the last 10 years, and this is one area in which obesity genetics has made great progress. Our challenge is to understand more fully how genetic variation may interact with behavioral factors to influence the regulation of body weight and adiposity. Although exercise and diet strategies are used routinely for obesity treatment, there is a huge variability in how individuals respond to these interventions. There is also a substantial amount of evidence that such responses may also be regulated by genes. Understanding gene-response relationships is the key to developing more efficacious intervention and prevention programs for obesity.

No effect of the Trp64Arg variant of the beta3-adrenergic receptor gene on weight loss by diet and exercise intervention among Japanese adults

Controversy remains as to whether the presence of the tryptophan-to-arginine (Trp64Arg) variant of the beta(3)-adrenergic receptor gene impedes the magnitude of body weight loss by diet and exercise intervention. The objectives of the present study were to compare the changes in body weight between carriers and noncarriers of the Trp64Arg variant before and after 6 months of diet and exercise interventions for weight loss. A total of 37 middle-aged Japanese individuals (12 carriers and 25 noncarriers of the Trp64Arg variant) participated in the study. There were no significant differences in body weight between the 2 groups at the baseline. There were significant reductions in body weight both in carriers and noncarriers, but no significant differences between the 2 groups with respect to changes in these variables. The weight changes were -2.52 kg (95% confidence interval [CI], -3.56 to -1.48) among carriers and -1.89 kg (95% CI, -2.65 to -1.13) among noncarriers, and the change in the variant carrier group minus the change in the variant noncarrier group was -0.47 (95% CI, -1.97 to 1.02). These results suggest that the presence of the Trp64Arg variant of the beta(3)-adrenergic receptor gene may not play a major role as a hindrance to weight reduction.

Lack of association of the Trp64Arg polymorphism of beta3-adrenergic receptor gene with energy expenditure in response to caffeine among young healthy women

A close relationship between coffee intake and certain metabolic disorders is known. Caffeine, one of coffee components, can increase energy expenditure (EE), but there are considerable individual differences in the caffeine effects on EE, and the causes have not been fully established in humans. The Arg allele in the beta(3)-adrenergic receptor gene (beta(3)-AR), a marker for obesity-related traits, may be a contributor to individual variations in EE. This study investigated the effect of the Arg allele of beta(3)-AR on caffeine-induced increases in EE. In 44 healthy young women (21 +/- 1 years), physical characteristics, blood pressure, biochemical profiles and dietary nutritional intake were measured. A caffeine-loading test was conducted at a dosage of 4 mg per body weight (kg). EE was measured using an indirect open-circuit calorimeter for a 10-min period before, and at 30 min and 60 min after the caffeine-loading test. The beta(3)-AR Trp64Arg polymorphism was detected with a PCR-restriction fragment length polymorphism method. The frequency of the Arg allele was 24%. The distribution of the Trp/Trp, Trp/Arg, and Arg/Arg genotypes was 58%, 36%, and 6%, respectively. At the baseline, subjects with the Arg/Arg genotype had a significantly lower EE level than those with the Trp/Trp or Trp/Arg genotype. After the caffeine-loading test, there were caffeine-induced increases in EE in all genotypes, but there were no differences in the levels of increase among the genotypes. These findings suggest that the genotypes of beta(3)-AR Trp64Arg polymorphism might be not associated with caffeine-induced increases in EE levels.

The Trp64Arg polymorphism of the beta3-adrenergic receptor gene is associated with increased small dense low-density lipoprotein in a rural Japanese population: the Mima study

The presence of small dense low-density lipoprotein (sdLDL) is closely associated with an increased risk of developing coronary artery disease. The Trp64Arg polymorphism of the beta(3)-adrenergic receptor (beta(3)-AR) gene is a genetic marker for obesity-related traits. However, any possible association between this polymorphism and sdLDL profiles is unclear. The objective of this study is to investigate the effects of the polymorphism of the beta(3)-AR gene on LDL particle size and sdLDL in a rural Japanese population. Among 277 subjects, body mass index, blood pressure, fasting serum insulin levels, and insulin resistance index (fasting glucose x fasting insulin/405) were determined. The polymorphism of the beta(3)-AR gene was assessed by polymerase chain reaction-restriction fragment length polymorphism using buccal samples. Low-density lipoprotein particle size and sdLDL were measured with the electrophoretic separation of lipoproteins on the LipoPrint System (Quantimetrix, Redondo Beach, CA). The frequency of the beta(3)-AR allele was 0.19. In Arg carriers (Trp/Arg or Arg/Arg), the mean value of LDL particle size was smaller than that of non-Arg carriers (Trp/Trp) (P < .05). The area percentage of sdLDL was higher in Arg carriers (P < .05) than in non-Arg carriers. A multiple regression analysis showed that the area percentage of sdLDL was correlated with the polymorphism of the beta(3)-AR gene (P < .05), independently of age, sex, body mass index, smoking, and insulin resistance index. The present findings suggest that the beta(3)-AR gene polymorphism plays a role in the genetic predisposition to increased sdLDL, independently of insulin resistance.

Influence of the Trp64Arg polymorphism in the beta 3 adrenoreceptor gene on insulin resistance, adipocytokine response, and weight loss secondary to lifestyle modification in obese patients

BACKGROUND

The aim of our study was to investigate the influence of the Trp64Arg polymorphism in the beta 3 adrenoreceptor gene on adipocytokine response, insulin resistance, and weight loss secondary to lifestyle modification (Mediterranean hypocaloric diet and exercise) in obese patients.

METHODS

A population of 65 obese (BMI >30) non-diabetic outpatients was analyzed in a prospective way. Before and after 3 months of a lifestyle modification program, indirect calorimetry, bioimpedance, blood pressure, serial assessment of nutritional intake for 3 days via written food records, and biochemical analysis were performed. The lifestyle modification program consisted of a hypocaloric diet (1520 kcal, 52% carbohydrates, 25% lipids, and 23% proteins). The exercise program consisted of an aerobic exercise at least three times a week (60 min each). The statistical analysis was performed for Trp64/Arg64 and Arg64/Arg64 combined as a mutant group and for type Trp64/Trp64 as a wild group.

RESULTS

The mean age of the study participants was 45.8+/-16.8 years and the mean BMI was 34.4+/-4.6 kg. There were 18 males (27.7%) and 47 females (72.3%). Fifty-five patients (84.6%; 15 males/40 females) had the Trp64/Trp64 genotype (wild group) and ten patients (15.4%; 3 males/7 females) had Trp64/Arg64 (mutant group). In the wild group, BMI, weight, fat mass, systolic blood pressure and waist circumference decreased. In this group, resting metabolic rate (RMR), RMR corrected by fat free mass, and VO(2) increased. In the mutant group, BMI, weight, fat mass, and waist circumference decreased. A significant increase was detected in RMR and VO(2) as well. No differences were detected between baseline values in the two groups. CRP levels were higher in the mutant group than in the wild variants. No differences were detected in other parameters. Only leptin levels decreased significantly in both the wild group (10.1%; p<0.05) and the mutant group (13.6; p<0.05).

CONCLUSION

This study showed that the beneficial effect of mild weight reduction by a low caloric diet and exercise program is the greatest in subjects with a normal homozygote beta 3 adrenoreceptor gene.

Genotype-specific weight loss treatment advice: how close are we?

Obesity, whose prevalence is continually rising, is one of the world’s greatest health care burdens. This multifactorial condition is associated with many obesity-related conditions, such as type 2 diabetes, dyslipidemia, and cardiovascular disease. Weight loss is a significant challenge facing those wishing to reduce their disease risk. Of course, like obesity itself, weight loss is a complex phenomenon dependent on many environmental and genetic influences, and thus individual responses to weight loss interventions are incredibly variable. Currently, there are 3 major interventions used to reduce weight: diet, exercise, and pharmacotherapy. The findings from studies examining gene–diet (nutrigenetic), gene–exercise (actigenetic), and gene–pharmaceutical (pharmacogenetic) interactions, although not clinically applicable at this time, are gaining awareness. This review article summarizes the current evidence to support the contribution of DNA sequence variation in genes related to energy balance (expenditure and intake) in the response to weight loss intervention. There is no doubt that replication using more rigorous study designs that include the study of interactions between multiple genes and interventions is required to move towards the development of genotype-specific weight loss treatment strategies.

The human gene map for performance and health-related fitness phenotypes: the 2005 update

The current review presents the 2005 update of the human gene map for physical performance and health-related fitness phenotypes. It is based on peer-reviewed papers published by the end of 2005. The genes and markers with evidence of association or linkage with a performance or fitness phenotype in sedentary or active people, in adaptation to acute exercise, or for training-induced changes are positioned on the genetic map of all autosomes and the X chromosome. Negative studies are reviewed, but a gene or locus must be supported by at least one positive study before being inserted on the map. By the end of 2000, in the early version of the gene map, 29 loci were depicted. In contrast, the 2005 human gene map for physical performance and health-related phenotypes includes 165 autosomal gene entries and QTL, plus five others on the X chromosome. Moreover, there are 17 mitochondrial genes in which sequence variants have been shown to influence relevant fitness and performance phenotypes. Thus, the map is growing in complexity. Unfortunately, progress is slow in the field of genetics of fitness and performance, primarily because the number of laboratories and scientists focused on the role of genes and sequence variations in exercise-related traits continues to be quite limited.

Congenic strains confirm aerobic running capacity quantitative trait loci on rat chromosome 16 and identify possible intermediate phenotypes

We previously identified two inbred rat strains divergent for treadmill aerobic running capacity (ARC), the low-performing Copenhagen (COP) and the high-performing DA rats, and used an F(2)(COPxDA) population to identify ARC quantitative trait loci (QTLs) on rat chromosome 16 (RNO16) and the proximal portion of rat chromosome 3 (RNO3). Two congenic rat strains were bred to further investigate these ARC QTLs by introgressing RNO16 and the proximal portion of RNO3 from DA rats into the genetic background of COP rats and were named COP.DA(chr 16) and COP.DA(chr 3), respectively. COP.DA(chr 16) rats had significantly greater ARC compared with COP rats (696.7 +/- 38.2 m vs. 571.9 +/- 27.5 m, P = 0.03). COP.DA(chr 3) rats had increased, although not significant, ARC compared with COP rats (643.6 +/- 40.9 m vs. 571.9 +/- 27.5 m). COP.DA(chr 16) rats had significantly greater subcutaneous abdominal fat, as well as decreased fasting triglyceride levels, compared with COP rats (P < 0.05), indicating that genes responsible for strain differences in fat metabolism are also located on RNO16. While this colocalization of QTLs may be coincidental, it is also possible that these differences in energy balance may be associated with the superior running performance of COP.DA(chr 16) consomic rats.

Effect of genotype on success of lifestyle intervention in subjects at risk for type 2 diabetes

Lifestyle intervention programs including increased physical activity and healthy nutrition have been proven to delay the onset of type 2 diabetes. This is achieved mainly by reducing body weight and improving insulin sensitivity. However, response to lifestyle or dietary interventions does differ between individuals, and the genetic or environmental factors that may account for these differences are not yet precisely characterized. Identification of these factors would be desirable in order to provide an individually tailored preventive strategy for patients at risk of developing diabetes. This review summarizes the so far known genetic variations, which determine responders and nonresponders to a lifestyle intervention. In addition, general methodological approaches to study gene-lifestyle interactions are described.

Impact of Aging and .BETA.3-Adrenergic-Receptor Polymorphism on Thermic and Sympathetic Responses to a High-Fat Meal

The present study was designed to investigate the effect of aging and beta3-adrenergic-receptor (beta3-AR) polymorphism on the thermic effect of meal (TEM) and sympathetic nervous system (SNS) response to a high-fat meal in 13 boys, 12 young men, and 11 middle-aged men. SNS activity was assessed via power spectral analysis of heart rate variability. Significantly higher very-low-frequency (VLF) components associated with thermogenic SNS activity and energy expenditure per lean body mass (EE(LBM)) were observed in boys during the pre- and postprandial periods. There were no significant differences in VLF and EE(LBM) in the preprandial period between the young and middle-aged men. After feeding, however, the middle-aged men showed a significantly lower TEM (% test-meal energy) and VLF compared to the young men. A multiple regression analysis revealed that age was the only significant variable contributing to both TEM and VLF, but beta3-AR polymorphism and percentage of body fat were not statistically significant. In conclusion, age likely has a greater influence on TEM and SNS thermoregulation than genetic factors such as beta3-AR polymorphism, suggesting that this age-related decrease in thermogenic response may be involved in the development of obesity among middle-aged men.

Gene-diet interactions on body weight changes

Obesity is one of the most pressing problems in the industrialized world. The susceptibility to obesity is partly determined by genetic factors, but an "obesity-promoting environment" is typically necessary for its phenotypic expression. Such a genetically mediated susceptibility to environmental exposure is referred to as gene-environment interaction. This article reviews the effect of genotype-diet interactions on body weight and body composition changes. A few well-controlled studies with monozygotic twins have specifically addressed the genetic background of interindividual variation in response to overfeeding or energy restriction. Some individuals will gain or lose weight more easily than others, but subjects sharing the same genotype (monozygotic twins) will respond in a similar way, suggesting that the responsiveness to diet is mediated by their genotype. Further evidence for gene-environment interactions comes from candidate gene studies. Genes involved in pathways regulating energy expenditure and food intake may play a role in the predisposition to obesity. For example, DNA sequence variation in genes encoding the adrenergic receptors and uncoupling proteins are of particular relevance. This growing body of research may help in the development of antiobesity treatments and perhaps genetic tests to predict the risk for obesity.

Electrophysiology and kinesiology for health and disease

This paper summarizes my Basmajian keynote presentation at the 2004 International Society of Electrophysiology and Kinesiology Conference. I dedicate this paper to Dr. Herbert A. deVries, the mentor of my research career. The following topics will be covered from the standpoint of Electrophysiology and Kinesiology for health and disease: (1) electromechanical manifestations of neuromuscular fatigue and muscle soreness, (2) cardiac depolarization-repolarization characteristics of normal and patients, (3) etiology of obesity and diabetes and autonomic nervous system, and (4) functional electrical stimulation for health and disease, respectively.

Does weight loss prognosis depend on genetic make-up?

The prevalence of obesity is rising throughout the world. Indeed, obesity has reached epidemic proportions in many developed and transition countries. Obesity is a complex disease with multifactorial origin, which in many cases appears as a polygenic condition affected by environmental factors. Treatment or prevention of obesity is necessary to reverse or avoid the onset of type 2 diabetes and other obesity-related diseases. Weight loss is a complex trait that depends on many environmental, behavioural and genetic influences. An effective programme for the management of overweight and obesity must take into account all of these factors. Individual responses to weight loss interventions vary widely and reliable predictors of successful slimming are poorly understood. The individual genetic make-up participating in energy expenditure regulation, appetite control, lipid metabolism and adipogenesis, have been reported to affect the risk of treatment failure in some subjects. In addition, the genotype could also help to predict the changes in lipid profile, cardiovascular risk factors and insulin sensitivity in response to weight loss. Herein, the current evidence from human studies that support the existence of a genetic component and the participation of different polymorphisms in the prognosis of weight loss induced by interventions leading to a negative energy balance are reviewed.

The human gene map for performance and health-related fitness phenotypes: the 2003 update

This review presents the 2003 update of the human gene map for physical performance and health-related fitness phenotypes. It is based on peer-reviewed papers published by the end of 2003 and includes association studies with candidate genes, genome-wide scans with polymorphic markers, and single-gene defects causing exercise intolerance to variable degrees. The genes and markers with evidence of association or linkage with a performance or fitness phenotype in sedentary or active people, in adaptation to acute exercise, or for training-induced changes are positioned on the genetic map of all autosomes and the X chromosome. Negative studies are reviewed but a gene or locus must be supported by at least one positive study before being inserted on the map. By the end of 2000, 29 loci were depicted on the first edition of the map. In contrast, the 2003 human gene map for physical performance and health-related phenotypes includes 109 autosomal gene entries and QTL, plus two on the X chromosome. Moreover, there are 15 mitochondrial genes in which sequence variants have been shown to influence relevant fitness and performance phenotypes.

The genetics of obesity

Obesity prevalence has increased markedly over the past few decades. The obesity pandemic has huge implications for public health and our society. Although multiple studies show that the genetic contribution to obesity is significant, our genes have not changed appreciably over this time period. It was hypothesized that natural selection favors genotypes that result in a thrifty metabolism because individuals who carry these genotypes would be more likely to survive times of nutrient scarcity and to pass these genotypes to successive generations. Now that most of the world has adopted an increasingly "obesigenic" lifestyle of excess caloric intake and decreased physical activity, these same genes contribute to obesity and poor health. With the exception of the rare mutations that cause severe morbid obesity, it seems that numerous genes, each with modest effect, contribute to an individual's predisposition toward the more common forms of obesity. Variants in several candidate genes have been identified: association analyses and functional studies show that they contribute to modest obesity and related phenotypes. More recently, insights regarding gene-gene interactions have begun to emerge. Genome-wide scans for obesity phenotypes have led to the identification of several chromosome regions that are likely to harbor obesity susceptibility genes. Because of the increasing number of genome scans, several regions of replication have emerged. Positional cloning of these genes will undoubtedly unveil new insights into the molecular and pathophysiologic mechanisms of energy homeostasis and obesity.

The Trp(64)Arg polymorphism of the beta(3)-adrenergic receptor gene is not associated with body weight or body mass index in Japanese: a longitudinal analysis

The beta(3)-adrenergic receptor (ADRB3) is expressed mainly in visceral adipose tissue and is thought to contribute to lipolysis and the delivery of free fatty acids to the portal vein. Although many studies have examined the relationship between the Trp(64)Arg mutation of ADRB3 and obesity, the results have been inconsistent. We examined the cross-sectional relationship of ADRB3 variants with indexes of obesity, and their longitudinal changes over 10 yr, in men and women, aged 40-69 yr, who were randomly selected from the Japanese rural population. The study considered both dietary energy intake and physical activity levels. Among the 746 participants, the genotype frequencies of the Trp(64)Trp, Trp(64)Arg, and Arg(64)Arg variants were 483, 224, and 39, respectively. The cross-sectional analysis showed no significant differences in height, weight, body mass index, blood pressure, serum total and high density lipoprotein cholesterols, and hemoglobin A(1c) among the genotype groups even after adjustments for gender, age, smoking, alcohol drinking, physical activity, and energy intake. No significant differences in the weight changes between the genotype groups were evident in the longitudinal analysis. We conclude that the Trp(64)Arg mutation of ADRB3 has little or no influence on either body weight or body mass index in the general Japanese population.

Association studies of genetic polymorphisms in central obesity: a critical review

During the past decade, mutations affecting liability to central obesity have been discovered at a phenomenal rate, and despite few consistently replicated findings, a number of intriguing results have emerged in the literature. Association studies have been proposed to identify the genetic determinants of complex traits such as central obesity. The advantages of the association method include its relative robustness to genetic heterogeneity and the ability to detect much smaller effect sizes than is detectable using feasible sample sizes in linkage studies. However, the current literature linking central obesity to genetic variants is teeming with reports of associations that either cannot be replicated or for which corroboration by linkage has been impossible to find. Explanations for this lack of reproducibility are well rehearsed, and typically include poor study design, incorrect assumptions about the underlying genetic architecture, and simple overinterpretation of data. These limitations create concern about the validity of association studies and cause problems in establishing robust criteria for undertaking association studies. In this article, the current status of the literature of association studies for genetic dissection of central obesity is critically reviewed.