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Precision Medicine and Obesity. Handb Exp Pharmacol 2022; 274:467-485. [PMID: 34910252 PMCID: PMC9200903 DOI: 10.1007/164_2021_566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Obesity is a chronic, relapsing, and multifactorial disease, with a rising prevalence and an associated high economic burden. Achieving successful and sustained weight loss outcomes with current interventions is challenging. This is due, at least in part, to the disease's heterogenous pathophysiology that is yet to be completely understood. Technological advances and greater capabilities for the extraction and storage of information have facilitated the application of precision medicine. Several precision medicine initiatives have been proposed to improve obesity outcomes. Most of these initiatives are based on -omics technologies. Although the data generated from these technologies have led to developing hypotheses that may explain the underpinnings of obesity, their applicability to the clinical practice is yet to be determined. There are other initiatives that have identified quantitative or qualitative physiologic traits that can be targeted and that could have a more immediate clinical impact. This review aims to provide a perspective of current initiatives for precision medicine for obesity.
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Zajc Petranović M, Rizzieri AE, Sivaraj D, Smolej Narančić N, Škarić-Jurić T, Celinšćak Ž, Stojanović Marković A, Peričić Salihović M, Kalászi J, Kalászi M, Lin JQ, Mehta S, Burleson J, Rizzieri DA. CVD Risk Factors in the Ukrainian Roma and Meta-Analysis of Their Prevalence in Roma Populations Worldwide. J Pers Med 2021; 11:jpm11111138. [PMID: 34834490 PMCID: PMC8622536 DOI: 10.3390/jpm11111138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
The Roma population suffers from severe poverty, social exclusion, and some of the worst health conditions in the industrialized world. Herein, we report on cardiovascular disease (CVD) risk factors in the Ukrainian Roma and present a meta-analysis of the prevalence of CVD risk factors in 16 Roma populations worldwide. The meta-analyses of CVD risk factors in Roma (n = 16,552) vs. non-Roma majority population of the same country (n = 127,874) included publicly available data. Ukrainian field survey included 339 adults of both sexes and outcomes of interest were hypertension, body mass index (BMI), smoking, education, and employment status. Furthermore, 35.7% of the Ukrainian Roma were hypertensive, 69.3% unemployed, and 48.4% never went to school. Ukrainian Roma women were more likely to be underweight and more prone to be hypertensive, with odds of hypertension increasing with age, BMI, and positive smoking status. Meta-analyses showed that, in comparison with non-Roma worldwide, the Roma bear significantly higher risk factor loads related to smoking (OR = 2.850), diabetes (OR = 1.433), abdominal obesity (OR = 1.276), and metabolic syndrome (OR = 1.975), with lower loads for hypertension (OR = 0.607) and BMI ≥ 25 kg/m2 (OR = 0.872). To conclude, the CVD risk factors which are more common in Roma than in the majority population may reflect their poor health-related behaviors and inadequate access to health education.
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Affiliation(s)
- Matea Zajc Petranović
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
- Correspondence: (M.Z.P.); (D.A.R.)
| | - Ashley Elizabeth Rizzieri
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - Dharshan Sivaraj
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA;
| | - Nina Smolej Narančić
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Tatjana Škarić-Jurić
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Željka Celinšćak
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Anita Stojanović Marković
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Marijana Peričić Salihović
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Julia Kalászi
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - Marianna Kalászi
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - John Q. Lin
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA;
| | - Sanica Mehta
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - Jill Burleson
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - David A. Rizzieri
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
- Correspondence: (M.Z.P.); (D.A.R.)
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Szentkereszty-Kovács Z, Fiatal S, Janka EA, Kovács D, Szegedi A, Remenyik É, Törőcsik D. Leptin Receptor (rs1137101) and Brain-Derived Neurotrophic Factor (rs925946) Gene Variants Are Associated with Obesity in the Early- but Not in the Late-Onset Population of Hungarian Psoriatic Patients. Life (Basel) 2021; 11:life11101086. [PMID: 34685457 PMCID: PMC8538564 DOI: 10.3390/life11101086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Psoriatic patients have considerably higher odds of being obese compared with the general population; however, the exact pathophysiological link between psoriasis and obesity needs to be elucidated. Methods: To investigate the association of psoriasis with established obesity-related gene variants, we conducted a population-based case-control study including 3541 subjects (574 psoriasis cases and 2967 controls from the general Hungarian population). Genotyping of 20 SNPs at ADIPOQ, BDNF, FTO, GNPDA2, LEPR, MC4R, NEGR1, NPY, PPARG, TMEM18, and UCP2 were determined, and differences in genotype and allele distributions were investigated. Multiple logistic regression analyses were implemented. Results: Analysis revealed an association between the G allele of the rs1137101 polymorphism (LEPR gene) and obesity risk (OR: 3.30 (1.45; 7.50), p = 0.004) in the early-onset group of psoriatic patients. Furthermore, the T allele of rs925946 polymorphism (BDNF gene) was also associated with increased risk of obesity in early-onset psoriasis (OR: 2.26 (1.24; 4.14), p = 0.008). Conclusions: Our results suggest that in psoriatic patients, there are prominent differences in the causes of obesity that should be accounted for, including not only environmental factors but also patient characteristics, such as the time of disease onset as well as genetic factors.
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Affiliation(s)
- Zita Szentkereszty-Kovács
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Szilvia Fiatal
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai út 26, 4012 Debrecen, Hungary;
| | - Eszter Anna Janka
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Dóra Kovács
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Andrea Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Éva Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Dániel Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
- Correspondence: ; Tel.: +36-52-255-602
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Antioxidants-Related Superoxide Dismutase ( SOD), Catalase ( CAT), Glutathione Peroxidase ( GPX), Glutathione-S-Transferase ( GST), and Nitric Oxide Synthase ( NOS) Gene Variants Analysis in an Obese Population: A Preliminary Case-Control Study. Antioxidants (Basel) 2021; 10:antiox10040595. [PMID: 33924357 PMCID: PMC8070436 DOI: 10.3390/antiox10040595] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/22/2022] Open
Abstract
Oxidative stress and antioxidants play an important role in obesity etiopathology. Genetic variants, including single nucleotide polymorphisms (SNPs) of the antioxidant-related genes, may impact disease risk in several populations. This preliminary study aimed to explore the association of 12 SNPs related to superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), glutathione-S-transferase (GST), and nitric oxide synthase (NOS) genes with obesity susceptibility in a Saudi population. A total of 384 unrelated participants, including 154 (40.1%) obese individuals, were enrolled. TaqMan OpenArray Genotyping assays were used. Six SNPs were significantly more prevalent in obese cohorts: (1) GSTM1 rs1056806*C/T; (2) SOD1 rs2234694*A; (3) SOD2 rs4880*G; (4) SOD3 rs2536512*A; (5) GPX1 rs1800668*A; (6) NOS3 rs1799983*G. Four SNPs were associated with higher obesity risk under heterozygote and dominant models for GSTM1 rs1056806 (C/T), homozygote model for SOD2 rs4880 (A/G), and homozygote and recessive models for GPX1 rs1800668 (A/G). In contrast, SOD3 rs2536512 (A/G) were less likely to be obese under heterozygote and dominant models. The CGAG, CAAA, TGGG, and CGAG combined genotypes showed a higher risk of obesity. In conclusion, the present results suggest that oxidative-stress-related genetic determinants could significantly associate with obesity risk in the study population.
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Piko P, Dioszegi J, Sandor J, Adany R. Changes in the Prevalence of Metabolic Syndrome and Its Components as Well as in Relevant Preventive Medication between 2006 and 2018 in the Northeast Hungarian Population. J Pers Med 2021; 11:jpm11010052. [PMID: 33467044 PMCID: PMC7829989 DOI: 10.3390/jpm11010052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 12/21/2022] Open
Abstract
Metabolic syndrome (MetS) is a worldwide problem with severe health consequences. In this study, we examine the changes in the prevalence of MetS and its components in two disadvantaged counties of Northeastern Hungary. Two health examination surveys were performed in the Hungarian population aged 20–64 years in 2006 (n = 450) and 2018 (n = 397) and the data were compared to each other. It was found that the prevalence of MetS increased significantly in the period examined (from 34.9% to 42.2%, p = 0.035) due to the increased prevalence of raised blood pressure (from 45.6% to 57.0%, p = 0.002) and raised fasting glucose concentration (13.2% vs. 24.8%, p < 0.001). The increase mainly affects the younger (20–34 years old) age group (12.1% in 2006 vs. 31.6% in 2018, p = 0.001). It is quite alarming that the prevalence of MetS and its components has increased significantly in the last decade, while the prevalence of preventive medication is unchanged (antihypertensive and antidiabetic treatments) or even significantly decreased (lipid-lowering medication). Consequently, the number of individuals untreated for hypertension and metabolic disturbances is severely increased. A targeted public health strategy is desperately needed to prevent further worsening the situation.
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Affiliation(s)
- Peter Piko
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Judit Dioszegi
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Roza Adany
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77174)
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Piko P, Werissa NA, Fiatal S, Sandor J, Adany R. Impact of Genetic Factors on the Age of Onset for Type 2 Diabetes Mellitus in Addition to the Conventional Risk Factors. J Pers Med 2020; 11:jpm11010006. [PMID: 33375163 PMCID: PMC7822179 DOI: 10.3390/jpm11010006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 12/14/2022] Open
Abstract
It is generally accepted that the early detection of type 2 diabetes mellitus (T2DM) is important to prevent the development of complications and comorbidities, as well as premature death. The onset of type 2 diabetes mellitus results from a complex interplay between genetic, environmental, and lifestyle risk factors. Our study aims to evaluate the joint effect of T2DM associated single nucleotide polymorphisms (SNPs) on the age of onset for T2DM in combination with conventional risk factors (such as sex, body mass index (BMI), and TG/HDL-C ratio) in the Hungarian population. This study includes 881 T2DM patients (Case population) and 1415 samples from the Hungarian general population (HG). Twenty-three SNPs were tested on how they are associated with the age of onset for T2DM in the Case population and 12 of them with a certified effect on the age of T2DM onset were chosen for an optimized genetic risk score (GRS) analysis. Testing the validity of the GRS model developed was carried out on the HG population. The GRS showed a significant association with the age of onset for T2DM (β = -0.454, p = 0.001) in the Case population, as well as among T2DM patients in the HG one (β = -0.999, p = 0.003) in the replication study. The higher the GRS, the earlier was the T2DM onset. Individuals with more than eight risk alleles will presumably be diabetic six and a half years earlier than those with less than four risk alleles. Our results suggest that there is a considerable genetic predisposition for the early onset of T2DM; therefore, in addition to conventional risk factors, GRS can be used as a tool for estimating the risk of the earlier onset of T2DM and stratifying populations at risk in order to define preventive interventions.
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Affiliation(s)
- Peter Piko
- MTA-DE Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary; (P.P.); (N.A.W.)
| | - Nardos Abebe Werissa
- MTA-DE Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary; (P.P.); (N.A.W.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Szilvia Fiatal
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (S.F.); (J.S.)
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (S.F.); (J.S.)
| | - Roza Adany
- MTA-DE Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary; (P.P.); (N.A.W.)
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (S.F.); (J.S.)
- Correspondence: ; Tel.: +36-5251-2764
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