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Published in: Current Diabetes Reports 10/2018

Open Access 01-10-2018 | Genetics (AP Morris, Section Editor)

Genetics of Severe Obesity

Authors: Una Fairbrother, Elliot Kidd, Tanya Malagamuwa, Andrew Walley

Published in: Current Diabetes Reports | Issue 10/2018

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Abstract

Purpose of Review

This review aims to present current information on genes underlying severe obesity, with the main emphasis on the three genes LEP, LEPR and MC4R.

Recent Findings

There is a substantial amount of evidence that variants in at least ten different genes are the cause of severe monogenic obesity. The majority of these are involved in the leptin-melanocortin signalling pathway. Due to the frequency of some of the identified variants, it is clear that monogenic variants also make a significant contribution to common obesity.

Summary

The artificial distinction between rare monogenic obesity and common polygenic obesity is now obsolete with the identification of MC4R variants of strong effect in the general population.
Literature
1.
go back to reference GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–27.CrossRef GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–27.CrossRef
2.
go back to reference • Ghosh S, Bouchard C. Convergence between biological, behavioural and genetic determinants of obesity. Nat Rev Genet. 2017;18:731–48. Excellent review of all the contributing factors to obesity. CrossRefPubMed • Ghosh S, Bouchard C. Convergence between biological, behavioural and genetic determinants of obesity. Nat Rev Genet. 2017;18:731–48. Excellent review of all the contributing factors to obesity. CrossRefPubMed
4.
go back to reference Corbin LJ, Timpson NJ. Body mass index: has epidemiology started to break down causal contributions to health and disease? Obesity. 2016;24:1630–8.CrossRefPubMed Corbin LJ, Timpson NJ. Body mass index: has epidemiology started to break down causal contributions to health and disease? Obesity. 2016;24:1630–8.CrossRefPubMed
5.
go back to reference Specchia ML, Veneziano MA, Cadeddu C, Ferriero AM, Mancuso A, Ianuale C, et al. Economic impact of adult obesity on health systems: a systematic review. Eur J Pub Health. 2015;25:255–62.CrossRef Specchia ML, Veneziano MA, Cadeddu C, Ferriero AM, Mancuso A, Ianuale C, et al. Economic impact of adult obesity on health systems: a systematic review. Eur J Pub Health. 2015;25:255–62.CrossRef
6.
go back to reference Grieve E, Fenwick E, Yang H-C, Lean M. The disproportionate economic burden associated with severe and complicated obesity: a systematic review. Obes Rev. 2013;14:883–94.CrossRefPubMed Grieve E, Fenwick E, Yang H-C, Lean M. The disproportionate economic burden associated with severe and complicated obesity: a systematic review. Obes Rev. 2013;14:883–94.CrossRefPubMed
7.
go back to reference He Y, Pan A, Wang Y, et al. Prevalence of overweight and obesity in 15.8 million men aged 15–49 years in rural China from 2010 to 2014. Sci Report. 2017;7:5012.CrossRef He Y, Pan A, Wang Y, et al. Prevalence of overweight and obesity in 15.8 million men aged 15–49 years in rural China from 2010 to 2014. Sci Report. 2017;7:5012.CrossRef
8.
go back to reference • Silventoinen K, Jelenkovic A, Sund R, et al. Differences in genetic and environmental variation in adult BMI by sex, age, time period, and region: an individual-based pooled analysis of 40 twin cohorts. Am J Clin Nutr. 2017;106:457–66. Largest current study estimating the heritability of obesity in twins. CrossRefPubMedPubMedCentral • Silventoinen K, Jelenkovic A, Sund R, et al. Differences in genetic and environmental variation in adult BMI by sex, age, time period, and region: an individual-based pooled analysis of 40 twin cohorts. Am J Clin Nutr. 2017;106:457–66. Largest current study estimating the heritability of obesity in twins. CrossRefPubMedPubMedCentral
9.
go back to reference Adams TD, Hunt SC, Mason LA, Ramirez ME, Fisher AG, Williams RR. Familial aggregation of morbid obesity. Obes Res. 1993;1:261–70.CrossRefPubMed Adams TD, Hunt SC, Mason LA, Ramirez ME, Fisher AG, Williams RR. Familial aggregation of morbid obesity. Obes Res. 1993;1:261–70.CrossRefPubMed
11.
go back to reference Han JC (2016) Rare syndromes and common variants of the brain-derived neurotrophic factor gene in human obesity. In: Prog. Mol. Biol. Transl. Sci. pp 75–95. Han JC (2016) Rare syndromes and common variants of the brain-derived neurotrophic factor gene in human obesity. In: Prog. Mol. Biol. Transl. Sci. pp 75–95.
12.
go back to reference Frodyma D, Neilsen B, Costanzo-Garvey D, Fisher K, Lewis R. Coordinating ERK signaling via the molecular scaffold kinase suppressor of Ras. F1000Research. 2017;6:1621.CrossRefPubMedPubMedCentral Frodyma D, Neilsen B, Costanzo-Garvey D, Fisher K, Lewis R. Coordinating ERK signaling via the molecular scaffold kinase suppressor of Ras. F1000Research. 2017;6:1621.CrossRefPubMedPubMedCentral
13.
go back to reference Wasim M, Awan FR, Najam SS, Khan AR, Khan HN. Role of leptin deficiency, inefficiency, and leptin receptors in obesity. Biochem Genet. 2016;54:565–72.CrossRefPubMed Wasim M, Awan FR, Najam SS, Khan AR, Khan HN. Role of leptin deficiency, inefficiency, and leptin receptors in obesity. Biochem Genet. 2016;54:565–72.CrossRefPubMed
14.
16.
go back to reference Novoselova TV, Chan LF, Clark AJL. Pathophysiology of melanocortin receptors and their accessory proteins. Best Pract Res Clin Endocrinol Metab. 2018;32:93–106.CrossRefPubMed Novoselova TV, Chan LF, Clark AJL. Pathophysiology of melanocortin receptors and their accessory proteins. Best Pract Res Clin Endocrinol Metab. 2018;32:93–106.CrossRefPubMed
17.
go back to reference Ramos-Molina B, Martin MG, Lindberg I (2016) PCSK1 variants and human obesity. In: Prog. Mol. Biol. Transl. Sci. pp 47–74. Ramos-Molina B, Martin MG, Lindberg I (2016) PCSK1 variants and human obesity. In: Prog. Mol. Biol. Transl. Sci. pp 47–74.
18.
go back to reference Stijnen P, Ramos-Molina B, O’Rahilly S, Creemers JWM. PCSK1 mutations and human Endocrinopathies: from obesity to gastrointestinal disorders. Endocr Rev. 2016;37:347–71.CrossRefPubMed Stijnen P, Ramos-Molina B, O’Rahilly S, Creemers JWM. PCSK1 mutations and human Endocrinopathies: from obesity to gastrointestinal disorders. Endocr Rev. 2016;37:347–71.CrossRefPubMed
19.
go back to reference Anderson EJP, Çakir I, Carrington SJ, Cone RD, Ghamari-Langroudi M, Gillyard T, et al. 60 YEARS OF POMC: regulation of feeding and energy homeostasis by α-MSH. J Mol Endocrinol. 2016;56:T157–74.CrossRefPubMedPubMedCentral Anderson EJP, Çakir I, Carrington SJ, Cone RD, Ghamari-Langroudi M, Gillyard T, et al. 60 YEARS OF POMC: regulation of feeding and energy homeostasis by α-MSH. J Mol Endocrinol. 2016;56:T157–74.CrossRefPubMedPubMedCentral
20.
go back to reference Rubinstein M, Low MJ. Molecular and functional genetics of the proopiomelanocortin gene, food intake regulation and obesity. FEBS Lett. 2017;591:2593–606.CrossRefPubMed Rubinstein M, Low MJ. Molecular and functional genetics of the proopiomelanocortin gene, food intake regulation and obesity. FEBS Lett. 2017;591:2593–606.CrossRefPubMed
21.
go back to reference Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994;372:425–32.CrossRefPubMed Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994;372:425–32.CrossRefPubMed
22.
go back to reference Tartaglia LA, Dembski M, Weng X, Deng N, Culpepper J, Devos R, et al. Identification and expression cloning of a leptin receptor, OB-R. Cell. 1995;83:1263–71.CrossRefPubMed Tartaglia LA, Dembski M, Weng X, Deng N, Culpepper J, Devos R, et al. Identification and expression cloning of a leptin receptor, OB-R. Cell. 1995;83:1263–71.CrossRefPubMed
23.
go back to reference Farooqi IS, Jebb SA, Langmack G, Lawrence E, Cheetham CH, Prentice AM, et al. Effects of recombinant leptin therapy in a child with congenital leptin deficiency. N Engl J Med. 1999;341:879–84.CrossRefPubMed Farooqi IS, Jebb SA, Langmack G, Lawrence E, Cheetham CH, Prentice AM, et al. Effects of recombinant leptin therapy in a child with congenital leptin deficiency. N Engl J Med. 1999;341:879–84.CrossRefPubMed
24.
go back to reference Huvenne H, Le Beyec J, Pépin D, et al. Seven novel deleterious LEPR mutations found in early-onset obesity: a ΔExon6-8 shared by subjects from Reunion Island, France, suggests a founder effect. J Clin Endocrinol Metab. 2015;100:E757–66.CrossRefPubMed Huvenne H, Le Beyec J, Pépin D, et al. Seven novel deleterious LEPR mutations found in early-onset obesity: a ΔExon6-8 shared by subjects from Reunion Island, France, suggests a founder effect. J Clin Endocrinol Metab. 2015;100:E757–66.CrossRefPubMed
25.
go back to reference Saeed S, Bonnefond A, Manzoor J, Shabir F, Ayesha H, Philippe J, et al. Genetic variants in LEP , LEPR , and MC4R explain 30% of severe obesity in children from a consanguineous population. Obesity. 2015;23:1687–95.CrossRefPubMed Saeed S, Bonnefond A, Manzoor J, Shabir F, Ayesha H, Philippe J, et al. Genetic variants in LEP , LEPR , and MC4R explain 30% of severe obesity in children from a consanguineous population. Obesity. 2015;23:1687–95.CrossRefPubMed
26.
go back to reference Masuzaki H, Ogawa Y, Isse N, Satoh N, Okazaki T, Shigemoto M, et al. Human obese gene expression. Adipocyte-specific expression and regional differences in the adipose tissue. Diabetes. 1995;44:855–8.CrossRefPubMed Masuzaki H, Ogawa Y, Isse N, Satoh N, Okazaki T, Shigemoto M, et al. Human obese gene expression. Adipocyte-specific expression and regional differences in the adipose tissue. Diabetes. 1995;44:855–8.CrossRefPubMed
27.
go back to reference Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996;334:292–5.CrossRefPubMed Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996;334:292–5.CrossRefPubMed
28.
go back to reference Miyawaki T, Masuzaki H, Ogawa Y, Hosoda K, Nishimura H, Azuma N, et al. Clinical implications of leptin and its potential humoral regulators in long-term low-calorie diet therapy for obese humans. Eur J Clin Nutr. 2002;56:593–600.CrossRefPubMed Miyawaki T, Masuzaki H, Ogawa Y, Hosoda K, Nishimura H, Azuma N, et al. Clinical implications of leptin and its potential humoral regulators in long-term low-calorie diet therapy for obese humans. Eur J Clin Nutr. 2002;56:593–600.CrossRefPubMed
29.
go back to reference Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature. 1998;395:763–70.CrossRefPubMed Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature. 1998;395:763–70.CrossRefPubMed
30.
go back to reference Chen W, Balland E, Cowley MA. Hypothalamic insulin resistance in obesity: effects on glucose homeostasis. Neuroendocrinology. 2017;104:364–81.CrossRefPubMed Chen W, Balland E, Cowley MA. Hypothalamic insulin resistance in obesity: effects on glucose homeostasis. Neuroendocrinology. 2017;104:364–81.CrossRefPubMed
31.
go back to reference Dulloo AG, Stock MJ, Solinas G, Boss O, Montani JP, Seydoux J. Leptin directly stimulates thermogenesis in skeletal muscle. FEBS Lett. 2002;515:109–13.CrossRefPubMed Dulloo AG, Stock MJ, Solinas G, Boss O, Montani JP, Seydoux J. Leptin directly stimulates thermogenesis in skeletal muscle. FEBS Lett. 2002;515:109–13.CrossRefPubMed
32.
go back to reference Ghilardi N, Ziegler S, Wiestner A, Stoffel R, Heim MH, Skoda RC. Defective STAT signaling by the leptin receptor in diabetic mice. Proc Natl Acad Sci U S A. 1996;93:6231–5.CrossRefPubMedPubMedCentral Ghilardi N, Ziegler S, Wiestner A, Stoffel R, Heim MH, Skoda RC. Defective STAT signaling by the leptin receptor in diabetic mice. Proc Natl Acad Sci U S A. 1996;93:6231–5.CrossRefPubMedPubMedCentral
33.
go back to reference Kloek C, Haq AK, Dunn SL, Lavery HJ, Banks AS, Myers MG. Regulation of Jak kinases by intracellular leptin receptor sequences. J Biol Chem. 2002;277:41547–55.CrossRefPubMed Kloek C, Haq AK, Dunn SL, Lavery HJ, Banks AS, Myers MG. Regulation of Jak kinases by intracellular leptin receptor sequences. J Biol Chem. 2002;277:41547–55.CrossRefPubMed
35.
go back to reference Lammert A, Kiess W, Bottner A, Glasow A, Kratzsch J. Soluble leptin receptor represents the main leptin binding activity in human blood. Biochem Biophys Res Commun. 2001;283:982–8.CrossRefPubMed Lammert A, Kiess W, Bottner A, Glasow A, Kratzsch J. Soluble leptin receptor represents the main leptin binding activity in human blood. Biochem Biophys Res Commun. 2001;283:982–8.CrossRefPubMed
37.
go back to reference Chen H, Charlat O, Tartaglia LA, Woolf EA, Weng X, Ellis SJ, et al. Evidence that the diabetes gene encodes the leptin receptor: identification of a mutation in the leptin receptor gene in db/db mice. Cell. 1996;84:491–5.CrossRefPubMed Chen H, Charlat O, Tartaglia LA, Woolf EA, Weng X, Ellis SJ, et al. Evidence that the diabetes gene encodes the leptin receptor: identification of a mutation in the leptin receptor gene in db/db mice. Cell. 1996;84:491–5.CrossRefPubMed
38.
39.
go back to reference Pan WW, Myers MG. Leptin and the maintenance of elevated body weight. Nat Rev Neurosci. 2018;19:95–105.CrossRefPubMed Pan WW, Myers MG. Leptin and the maintenance of elevated body weight. Nat Rev Neurosci. 2018;19:95–105.CrossRefPubMed
40.
go back to reference Frederich RC, Hamann A, Anderson S, Löllmann B, Lowell BB, Flier JS. Leptin levels reflect body lipid content in mice: evidence for diet-induced resistance to leptin action. Nat Med. 1995;1:1311–4.CrossRefPubMed Frederich RC, Hamann A, Anderson S, Löllmann B, Lowell BB, Flier JS. Leptin levels reflect body lipid content in mice: evidence for diet-induced resistance to leptin action. Nat Med. 1995;1:1311–4.CrossRefPubMed
41.
go back to reference Münzberg H, Flier JS, Bjørbæk C. Region-specific leptin resistance within the hypothalamus of diet-induced obese mice. Endocrinology. 2004;145:4880–9.CrossRefPubMed Münzberg H, Flier JS, Bjørbæk C. Region-specific leptin resistance within the hypothalamus of diet-induced obese mice. Endocrinology. 2004;145:4880–9.CrossRefPubMed
42.
43.
go back to reference Fourati M, Mnif M, Kharrat N, Charfi N, Kammoun M, Fendri N, et al. Association between leptin gene polymorphisms and plasma leptin level in three consanguineous families with obesity. Gene. 2013;527:75–81.CrossRefPubMed Fourati M, Mnif M, Kharrat N, Charfi N, Kammoun M, Fendri N, et al. Association between leptin gene polymorphisms and plasma leptin level in three consanguineous families with obesity. Gene. 2013;527:75–81.CrossRefPubMed
44.
go back to reference Ghalandari H, Hosseini-Esfahani F, Mirmiran P. The Association of Polymorphisms in leptin/leptin receptor genes and ghrelin/ghrelin receptor genes with overweight/obesity and the related metabolic disturbances: a review. Int J Endocrinol Metab. 2015;13:e19073.CrossRefPubMedPubMedCentral Ghalandari H, Hosseini-Esfahani F, Mirmiran P. The Association of Polymorphisms in leptin/leptin receptor genes and ghrelin/ghrelin receptor genes with overweight/obesity and the related metabolic disturbances: a review. Int J Endocrinol Metab. 2015;13:e19073.CrossRefPubMedPubMedCentral
45.
go back to reference Wu L, Sun D. Leptin receptor gene polymorphism and the risk of cardiovascular disease: a systemic review and meta-analysis. Int J Environ Res Public Health. 2017;14:375.CrossRefPubMedCentral Wu L, Sun D. Leptin receptor gene polymorphism and the risk of cardiovascular disease: a systemic review and meta-analysis. Int J Environ Res Public Health. 2017;14:375.CrossRefPubMedCentral
47.
go back to reference Lin T-C, Huang K-W, Liu C-W, Chang Y-C, Lin W-M, Yang T-Y, et al. Leptin signaling axis specifically associates with clinical prognosis and is multifunctional in regulating cancer progression. Oncotarget. 2018;9:17210–9.PubMedPubMedCentral Lin T-C, Huang K-W, Liu C-W, Chang Y-C, Lin W-M, Yang T-Y, et al. Leptin signaling axis specifically associates with clinical prognosis and is multifunctional in regulating cancer progression. Oncotarget. 2018;9:17210–9.PubMedPubMedCentral
48.
go back to reference Dubern B, Clement K. Leptin and leptin receptor-related monogenic obesity. Biochimie. 2012;94:2111–5.CrossRefPubMed Dubern B, Clement K. Leptin and leptin receptor-related monogenic obesity. Biochimie. 2012;94:2111–5.CrossRefPubMed
49.
go back to reference Zhang L, Yuan L-H, Xiao Y, Lu M, Zhang L, Wang Y. Association of Leptin Gene −2548 G/a polymorphism with obesity: a meta-analysis. Ann Nutr Metab. 2014;64:127–36.CrossRefPubMed Zhang L, Yuan L-H, Xiao Y, Lu M, Zhang L, Wang Y. Association of Leptin Gene −2548 G/a polymorphism with obesity: a meta-analysis. Ann Nutr Metab. 2014;64:127–36.CrossRefPubMed
50.
go back to reference Şahın S, Rüstemoğlu A, Tekcan A, Taşliyurt T, Güven H, Yığıt S. Investigation of associations between obesity and LEP G2548A and LEPR 668A/G polymorphisms in a Turkish population. Dis Markers. 2013;35:673–7.CrossRefPubMedPubMedCentral Şahın S, Rüstemoğlu A, Tekcan A, Taşliyurt T, Güven H, Yığıt S. Investigation of associations between obesity and LEP G2548A and LEPR 668A/G polymorphisms in a Turkish population. Dis Markers. 2013;35:673–7.CrossRefPubMedPubMedCentral
51.
go back to reference Lu J, Zou D, Zheng L, Chen G, Lu J, Feng Z. Synergistic effect of LEP and LEPR gene polymorphism on body mass index in a Chinese population. Obes Res Clin Pract. 2013;7:e445–9.CrossRefPubMed Lu J, Zou D, Zheng L, Chen G, Lu J, Feng Z. Synergistic effect of LEP and LEPR gene polymorphism on body mass index in a Chinese population. Obes Res Clin Pract. 2013;7:e445–9.CrossRefPubMed
52.
go back to reference Shahid A, Rana S, Mahmood S, Saeed S. Role of leptin G-2548A polymorphism in age- and gender-specific development of obesity. J Biosci. 2015;40:521–30.CrossRefPubMed Shahid A, Rana S, Mahmood S, Saeed S. Role of leptin G-2548A polymorphism in age- and gender-specific development of obesity. J Biosci. 2015;40:521–30.CrossRefPubMed
53.
go back to reference Li WD, Reed DR, Lee JH, Xu W, Kilker RL, Sodam BR, et al. Sequence variants in the 5′ flanking region of the leptin gene are associated with obesity in women. Ann Hum Genet. 1999;63:227–34.CrossRefPubMed Li WD, Reed DR, Lee JH, Xu W, Kilker RL, Sodam BR, et al. Sequence variants in the 5′ flanking region of the leptin gene are associated with obesity in women. Ann Hum Genet. 1999;63:227–34.CrossRefPubMed
54.
go back to reference Nieters A, Becker N, Linseisen J. Polymorphisms in candidate obesity genes and their interaction with dietary intake of n-6 polyunsaturated fatty acids affect obesity risk in a sub-sample of the EPIC-Heidelberg cohort. Eur J Nutr. 2002;41:210–21.CrossRefPubMed Nieters A, Becker N, Linseisen J. Polymorphisms in candidate obesity genes and their interaction with dietary intake of n-6 polyunsaturated fatty acids affect obesity risk in a sub-sample of the EPIC-Heidelberg cohort. Eur J Nutr. 2002;41:210–21.CrossRefPubMed
55.
go back to reference Wang T-N, Huang M-C, Chang W-T, Ko AM-S, Tsai E-M, Liu C-S, et al. G-2548A polymorphism of the leptin gene is correlated with extreme obesity in Taiwanese aborigines*. Obesity. 2006;14:183–7.CrossRefPubMed Wang T-N, Huang M-C, Chang W-T, Ko AM-S, Tsai E-M, Liu C-S, et al. G-2548A polymorphism of the leptin gene is correlated with extreme obesity in Taiwanese aborigines*. Obesity. 2006;14:183–7.CrossRefPubMed
56.
go back to reference Mercer JG, Hoggard N, Williams LM, Lawrence CB, Hannah LT, Trayhurn P. Localization of leptin receptor mRNA and the long form splice variant (Ob-Rb) in mouse hypothalamus and adjacent brain regions by in situ hybridization. FEBS Lett. 1996;387:113–6.CrossRefPubMed Mercer JG, Hoggard N, Williams LM, Lawrence CB, Hannah LT, Trayhurn P. Localization of leptin receptor mRNA and the long form splice variant (Ob-Rb) in mouse hypothalamus and adjacent brain regions by in situ hybridization. FEBS Lett. 1996;387:113–6.CrossRefPubMed
57.
go back to reference Fei H, Okano HJ, Li C, Lee GH, Zhao C, Darnell R, et al. Anatomic localization of alternatively spliced leptin receptors (Ob-R) in mouse brain and other tissues. Proc Natl Acad Sci U S A. 1997;94:7001–5.CrossRefPubMedPubMedCentral Fei H, Okano HJ, Li C, Lee GH, Zhao C, Darnell R, et al. Anatomic localization of alternatively spliced leptin receptors (Ob-R) in mouse brain and other tissues. Proc Natl Acad Sci U S A. 1997;94:7001–5.CrossRefPubMedPubMedCentral
58.
go back to reference Wauman J, Zabeau L, Tavernier J. The leptin receptor complex: heavier than expected? Front Endocrinol (Lausanne). 2017;8:30. Wauman J, Zabeau L, Tavernier J. The leptin receptor complex: heavier than expected? Front Endocrinol (Lausanne). 2017;8:30.
59.
go back to reference de Luca C, Kowalski TJ, Zhang Y, Elmquist JK, Lee C, Kilimann MW, et al. Complete rescue of obesity, diabetes, and infertility in db/db mice by neuron-specific LEPR-B transgenes. J Clin Invest. 2005;115:3484–93.CrossRefPubMedPubMedCentral de Luca C, Kowalski TJ, Zhang Y, Elmquist JK, Lee C, Kilimann MW, et al. Complete rescue of obesity, diabetes, and infertility in db/db mice by neuron-specific LEPR-B transgenes. J Clin Invest. 2005;115:3484–93.CrossRefPubMedPubMedCentral
60.
go back to reference Nuzzaci D, Laderrière A, Lemoine A, Nédélec E, Pénicaud L, Rigault C, et al. Plasticity of the Melanocortin system: determinants and possible consequences on food intake. Front Endocrinol (Lausanne). 2015;6:143. Nuzzaci D, Laderrière A, Lemoine A, Nédélec E, Pénicaud L, Rigault C, et al. Plasticity of the Melanocortin system: determinants and possible consequences on food intake. Front Endocrinol (Lausanne). 2015;6:143.
61.
go back to reference Waterson MJ, Horvath TL. Neuronal regulation of energy homeostasis: beyond the hypothalamus and feeding. Cell Metab. 2015;22:962–70.CrossRefPubMed Waterson MJ, Horvath TL. Neuronal regulation of energy homeostasis: beyond the hypothalamus and feeding. Cell Metab. 2015;22:962–70.CrossRefPubMed
62.
go back to reference Clément K, Vaisse C, Lahlou N, Cabrol S, Pelloux V, Cassuto D, et al. A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature. 1998;392:398–401.CrossRefPubMed Clément K, Vaisse C, Lahlou N, Cabrol S, Pelloux V, Cassuto D, et al. A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature. 1998;392:398–401.CrossRefPubMed
63.
go back to reference Farooqi IS, Volders K, Stanhope R, Heuschkel R, White A, Lank E, et al. Hyperphagia and early-onset obesity due to a novel homozygous missense mutation in prohormone convertase 1/3. J Clin Endocrinol Metab. 2007;92:3369–73.CrossRefPubMed Farooqi IS, Volders K, Stanhope R, Heuschkel R, White A, Lank E, et al. Hyperphagia and early-onset obesity due to a novel homozygous missense mutation in prohormone convertase 1/3. J Clin Endocrinol Metab. 2007;92:3369–73.CrossRefPubMed
64.
go back to reference Chua SC, Chung WK, Wu-Peng XS, Zhang Y, Liu SM, Tartaglia L, et al. Phenotypes of mouse diabetes and rat fatty due to mutations in the OB (leptin) receptor. Science. 1996;271:994–6.CrossRefPubMed Chua SC, Chung WK, Wu-Peng XS, Zhang Y, Liu SM, Tartaglia L, et al. Phenotypes of mouse diabetes and rat fatty due to mutations in the OB (leptin) receptor. Science. 1996;271:994–6.CrossRefPubMed
65.
go back to reference Quinton ND, Smith RF, Clayton PE, Gill MS, Shalet S, Justice SK, et al. Leptin binding activity changes with age: the link between leptin and puberty. J Clin Endocrinol Metab. 1999;84:2336–41.PubMed Quinton ND, Smith RF, Clayton PE, Gill MS, Shalet S, Justice SK, et al. Leptin binding activity changes with age: the link between leptin and puberty. J Clin Endocrinol Metab. 1999;84:2336–41.PubMed
66.
go back to reference Considine RV, Considine EL, Williams CJ, Hyde TM, Caro JF. The hypothalamic leptin receptor in humans: identification of incidental sequence polymorphisms and absence of the db/db mouse and fa/fa rat mutations. Diabetes. 1996;45:992–4.CrossRefPubMed Considine RV, Considine EL, Williams CJ, Hyde TM, Caro JF. The hypothalamic leptin receptor in humans: identification of incidental sequence polymorphisms and absence of the db/db mouse and fa/fa rat mutations. Diabetes. 1996;45:992–4.CrossRefPubMed
67.
go back to reference Matsuda J, Masuzaki H, Miyawaki T, Azuma N, Nishimura H, Nishi S, et al. Human leptin receptor gene in obese Japanese subjects: evidence against either obesity-causing mutations or association of sequence variants with obesity. Diabetologia. 1997;40:1204–10.CrossRefPubMed Matsuda J, Masuzaki H, Miyawaki T, Azuma N, Nishimura H, Nishi S, et al. Human leptin receptor gene in obese Japanese subjects: evidence against either obesity-causing mutations or association of sequence variants with obesity. Diabetologia. 1997;40:1204–10.CrossRefPubMed
68.
go back to reference Hinney A, Becker I, Heibült O, Nottebom K, Schmidt A, Ziegler A, et al. Systematic mutation screening of the pro-Opiomelanocortin gene: identification of several genetic variants including three different insertions, one nonsense and two missense point mutations in Probands of different weight extremes. J Clin Endocrinol Metab. 1998;83:3737–41.CrossRefPubMed Hinney A, Becker I, Heibült O, Nottebom K, Schmidt A, Ziegler A, et al. Systematic mutation screening of the pro-Opiomelanocortin gene: identification of several genetic variants including three different insertions, one nonsense and two missense point mutations in Probands of different weight extremes. J Clin Endocrinol Metab. 1998;83:3737–41.CrossRefPubMed
69.
go back to reference Pearce LR, Atanassova N, Banton MC, Bottomley B, van der Klaauw A, Revelli JP, et al. KSR2 mutations are associated with obesity, insulin resistance, and impaired cellular fuel oxidation. Cell. 2013;155:765–77.CrossRefPubMedPubMedCentral Pearce LR, Atanassova N, Banton MC, Bottomley B, van der Klaauw A, Revelli JP, et al. KSR2 mutations are associated with obesity, insulin resistance, and impaired cellular fuel oxidation. Cell. 2013;155:765–77.CrossRefPubMedPubMedCentral
70.
go back to reference Hinney A, Volckmar A-L, Knoll N (2013) Melanocortin-4 receptor in energy homeostasis and obesity pathogenesis. In: Prog. Mol. Biol. Transl. Sci. pp 147–191 Hinney A, Volckmar A-L, Knoll N (2013) Melanocortin-4 receptor in energy homeostasis and obesity pathogenesis. In: Prog. Mol. Biol. Transl. Sci. pp 147–191
71.
go back to reference Ju SH, Cho G-B, Sohn J-W. Understanding melanocortin-4 receptor control of neuronal circuits: toward novel therapeutics for obesity syndrome. Pharmacol Res. 2018;129:10–9.CrossRefPubMed Ju SH, Cho G-B, Sohn J-W. Understanding melanocortin-4 receptor control of neuronal circuits: toward novel therapeutics for obesity syndrome. Pharmacol Res. 2018;129:10–9.CrossRefPubMed
72.
go back to reference Xu J, Bartolome CL, Low CS, Yi X, Chien C-H, Wang P, et al. Genetic identification of leptin neural circuits in energy and glucose homeostases. Nature. 2018;556:505–9.CrossRefPubMedPubMedCentral Xu J, Bartolome CL, Low CS, Yi X, Chien C-H, Wang P, et al. Genetic identification of leptin neural circuits in energy and glucose homeostases. Nature. 2018;556:505–9.CrossRefPubMedPubMedCentral
73.
go back to reference Bell BB, Harlan SM, Morgan DA, Guo D-F, Rahmouni K. Differential contribution of POMC and AgRP neurons to the regulation of regional autonomic nerve activity by leptin. Mol Metab. 2018;8:1–12.CrossRefPubMed Bell BB, Harlan SM, Morgan DA, Guo D-F, Rahmouni K. Differential contribution of POMC and AgRP neurons to the regulation of regional autonomic nerve activity by leptin. Mol Metab. 2018;8:1–12.CrossRefPubMed
74.
go back to reference da Fonseca ACP, Mastronardi C, Johar A, Arcos-Burgos M, Paz-Filho G. Genetics of non-syndromic childhood obesity and the use of high-throughput DNA sequencing technologies. J Diabetes Complicat. 2017;31:1549–61.CrossRef da Fonseca ACP, Mastronardi C, Johar A, Arcos-Burgos M, Paz-Filho G. Genetics of non-syndromic childhood obesity and the use of high-throughput DNA sequencing technologies. J Diabetes Complicat. 2017;31:1549–61.CrossRef
75.
go back to reference Yeo GSH, Farooqi IS, Aminian S, Halsall DJ, Stanhope RG, O’Rahilly S. A frameshift mutation in MC4R associated with dominantly inherited human obesity. Nat Genet. 1998;20:111–2.CrossRefPubMed Yeo GSH, Farooqi IS, Aminian S, Halsall DJ, Stanhope RG, O’Rahilly S. A frameshift mutation in MC4R associated with dominantly inherited human obesity. Nat Genet. 1998;20:111–2.CrossRefPubMed
76.
go back to reference Vaisse C, Clement K, Guy-Grand B, Froguel P. A frameshift mutation in human MC4R is associated with a dominant form of obesity. Nat Genet. 1998;20:113–4.CrossRefPubMed Vaisse C, Clement K, Guy-Grand B, Froguel P. A frameshift mutation in human MC4R is associated with a dominant form of obesity. Nat Genet. 1998;20:113–4.CrossRefPubMed
77.
go back to reference Farooqi IS, Keogh JM, Yeo GSH, Lank EJ, Cheetham T, O’Rahilly S. Clinical Spectrum of obesity and mutations in the Melanocortin 4 receptor gene. N Engl J Med. 2003;348:1085–95.CrossRefPubMed Farooqi IS, Keogh JM, Yeo GSH, Lank EJ, Cheetham T, O’Rahilly S. Clinical Spectrum of obesity and mutations in the Melanocortin 4 receptor gene. N Engl J Med. 2003;348:1085–95.CrossRefPubMed
78.
go back to reference Lubrano-Berthelier C, Dubern B, Lacorte J-M, Picard F, Shapiro A, Zhang S, et al. Melanocortin 4 receptor mutations in a large cohort of severely obese adults: prevalence, functional classification, genotype-phenotype relationship, and lack of association with binge eating. J Clin Endocrinol Metab. 2006;91:1811–8.CrossRefPubMed Lubrano-Berthelier C, Dubern B, Lacorte J-M, Picard F, Shapiro A, Zhang S, et al. Melanocortin 4 receptor mutations in a large cohort of severely obese adults: prevalence, functional classification, genotype-phenotype relationship, and lack of association with binge eating. J Clin Endocrinol Metab. 2006;91:1811–8.CrossRefPubMed
80.
go back to reference Vaisse C, Clement K, Durand E, Hercberg S, Guy-Grand B, Froguel P. Melanocortin-4 receptor mutations are a frequent and heterogeneous cause of morbid obesity. J Clin Invest. 2000;106:253–62.CrossRefPubMedPubMedCentral Vaisse C, Clement K, Durand E, Hercberg S, Guy-Grand B, Froguel P. Melanocortin-4 receptor mutations are a frequent and heterogeneous cause of morbid obesity. J Clin Invest. 2000;106:253–62.CrossRefPubMedPubMedCentral
81.
go back to reference Gibbs RA, Boerwinkle E, Doddapaneni H, et al. A global reference for human genetic variation. Nature. 2015;526:68–74.CrossRef Gibbs RA, Boerwinkle E, Doddapaneni H, et al. A global reference for human genetic variation. Nature. 2015;526:68–74.CrossRef
83.
go back to reference Branson R, Potoczna N, Kral JG, Lentes K-U, Hoehe MR, Horber FF. Binge eating as a major phenotype of Melanocortin 4 receptor gene mutations. N Engl J Med. 2003;348:1096–103.CrossRefPubMed Branson R, Potoczna N, Kral JG, Lentes K-U, Hoehe MR, Horber FF. Binge eating as a major phenotype of Melanocortin 4 receptor gene mutations. N Engl J Med. 2003;348:1096–103.CrossRefPubMed
84.
go back to reference Valette M, Bellisle F, Carette C, Poitou C, Dubern B, Paradis G, et al. Eating behaviour in obese patients with melanocortin-4 receptor mutations: a literature review. Int J Obes. 2013;37:1027–35.CrossRef Valette M, Bellisle F, Carette C, Poitou C, Dubern B, Paradis G, et al. Eating behaviour in obese patients with melanocortin-4 receptor mutations: a literature review. Int J Obes. 2013;37:1027–35.CrossRef
85.
go back to reference Valette M, Poitou C, Kesse-Guyot E, Bellisle F, Carette C, Le Beyec J, et al. Association between melanocortin-4 receptor mutations and eating behaviors in obese patients: a case–control study. Int J Obes. 2014;38:883–5.CrossRef Valette M, Poitou C, Kesse-Guyot E, Bellisle F, Carette C, Le Beyec J, et al. Association between melanocortin-4 receptor mutations and eating behaviors in obese patients: a case–control study. Int J Obes. 2014;38:883–5.CrossRef
86.
go back to reference Valette M, Poitou C, Le Beyec J, Bouillot J-L, Clement K, Czernichow S. Melanocortin-4 receptor mutations and polymorphisms do not affect weight loss after bariatric surgery. PLoS One. 2012;7:e48221.CrossRefPubMedPubMedCentral Valette M, Poitou C, Le Beyec J, Bouillot J-L, Clement K, Czernichow S. Melanocortin-4 receptor mutations and polymorphisms do not affect weight loss after bariatric surgery. PLoS One. 2012;7:e48221.CrossRefPubMedPubMedCentral
87.
go back to reference Censani M, Conroy R, Deng L, Oberfield SE, McMahon DJ, Zitsman JL, et al. Weight loss after bariatric surgery in morbidly obese adolescents with MC4R mutations. Obesity. 2014;22:225–31.CrossRefPubMed Censani M, Conroy R, Deng L, Oberfield SE, McMahon DJ, Zitsman JL, et al. Weight loss after bariatric surgery in morbidly obese adolescents with MC4R mutations. Obesity. 2014;22:225–31.CrossRefPubMed
88.
go back to reference Frayling TM, Timpson NJ, Weedon MN, et al (2007) A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science (80- ) 316:889–894. Frayling TM, Timpson NJ, Weedon MN, et al (2007) A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science (80- ) 316:889–894.
89.
90.
go back to reference Justice AE, Winkler TW, Feitosa MF, Graff M, Fisher VA, Young K, et al. Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits. Nat Commun. 2017;8:14977.CrossRefPubMedPubMedCentral Justice AE, Winkler TW, Feitosa MF, Graff M, Fisher VA, Young K, et al. Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits. Nat Commun. 2017;8:14977.CrossRefPubMedPubMedCentral
91.
go back to reference Meyre D, Delplanque J, Chevre JC, et al. Genome-wide association study for early-onset and morbid adult obesity identifies three new risk loci in European populations. Nat Genet. 2009;41:157–9.CrossRefPubMed Meyre D, Delplanque J, Chevre JC, et al. Genome-wide association study for early-onset and morbid adult obesity identifies three new risk loci in European populations. Nat Genet. 2009;41:157–9.CrossRefPubMed
92.
go back to reference Liu R, Zou Y, Hong J, Cao M, Cui B, Zhang H, et al. Rare loss-of-function variants in NPC1 predispose to human obesity. Diabetes. 2017;66:935–47.CrossRefPubMed Liu R, Zou Y, Hong J, Cao M, Cui B, Zhang H, et al. Rare loss-of-function variants in NPC1 predispose to human obesity. Diabetes. 2017;66:935–47.CrossRefPubMed
93.
go back to reference Jiao H, Arner P, Hoffstedt J, Brodin D, Dubern B, Czernichow S, et al. Genome wide association study identifies KCNMA1contributing to human obesity. BMC Med Genet. 2011;4:51. Jiao H, Arner P, Hoffstedt J, Brodin D, Dubern B, Czernichow S, et al. Genome wide association study identifies KCNMA1contributing to human obesity. BMC Med Genet. 2011;4:51.
94.
go back to reference Wheeler E, Huang N, Bochukova EG, Keogh JM, Lindsay S, Garg S, et al. Genome-wide SNP and CNV analysis identifies common and low-frequency variants associated with severe early-onset obesity. Nat Genet. 2013;45:513–7.CrossRefPubMedPubMedCentral Wheeler E, Huang N, Bochukova EG, Keogh JM, Lindsay S, Garg S, et al. Genome-wide SNP and CNV analysis identifies common and low-frequency variants associated with severe early-onset obesity. Nat Genet. 2013;45:513–7.CrossRefPubMedPubMedCentral
95.
go back to reference •• Berndt SI, Gustafsson S, Mägi R, et al. Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture. Nat Genet. 2013;45:501–12. Largest current study of the genetics of severe obesity. CrossRefPubMedPubMedCentral •• Berndt SI, Gustafsson S, Mägi R, et al. Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture. Nat Genet. 2013;45:501–12. Largest current study of the genetics of severe obesity. CrossRefPubMedPubMedCentral
96.
go back to reference • Turcot V, Lu Y, Highland HM, et al. Protein-altering variants associated with body mass index implicate pathways that control energy intake and expenditure in obesity. Nat Genet. 2018;50:26–41. Large study of rare variant contribution to obesity. CrossRefPubMed • Turcot V, Lu Y, Highland HM, et al. Protein-altering variants associated with body mass index implicate pathways that control energy intake and expenditure in obesity. Nat Genet. 2018;50:26–41. Large study of rare variant contribution to obesity. CrossRefPubMed
97.
go back to reference Sina M, Hinney A, Ziegler A, Neupert T, Mayer H, Siegfried W, et al. Phenotypes in three pedigrees with autosomal dominant obesity caused by Haploinsufficiency mutations in the Melanocortin-4 receptor gene. Am J Hum Genet. 1999;65:1501–7.CrossRefPubMedPubMedCentral Sina M, Hinney A, Ziegler A, Neupert T, Mayer H, Siegfried W, et al. Phenotypes in three pedigrees with autosomal dominant obesity caused by Haploinsufficiency mutations in the Melanocortin-4 receptor gene. Am J Hum Genet. 1999;65:1501–7.CrossRefPubMedPubMedCentral
98.
go back to reference Hinney A, Schmidt A, Nottebom K, Heibült O, Becker I, Ziegler A, et al. Several mutations in the Melanocortin-4 receptor gene including a nonsense and a frameshift mutation associated with dominantly inherited obesity in humans. J Clin Endocrinol Metab. 1999;84:1483–6.CrossRefPubMed Hinney A, Schmidt A, Nottebom K, Heibült O, Becker I, Ziegler A, et al. Several mutations in the Melanocortin-4 receptor gene including a nonsense and a frameshift mutation associated with dominantly inherited obesity in humans. J Clin Endocrinol Metab. 1999;84:1483–6.CrossRefPubMed
99.
go back to reference Stutzmann F, Vatin V, Cauchi S, Morandi A, Jouret B, Landt O, et al. Non-synonymous polymorphisms in melanocortin-4 receptor protect against obesity: the two facets of a Janus obesity gene. Hum Mol Genet. 2007;16:1837–44.CrossRefPubMed Stutzmann F, Vatin V, Cauchi S, Morandi A, Jouret B, Landt O, et al. Non-synonymous polymorphisms in melanocortin-4 receptor protect against obesity: the two facets of a Janus obesity gene. Hum Mol Genet. 2007;16:1837–44.CrossRefPubMed
100.
go back to reference Brommage R, Desai U, Revelli J-P, Donoviel DB, Fontenot GK, DaCosta CM, et al. High-throughput screening of mouse knockout lines identifies true lean and obese phenotypes. Obesity (Silver Spring). 2008;16:2362–7.CrossRef Brommage R, Desai U, Revelli J-P, Donoviel DB, Fontenot GK, DaCosta CM, et al. High-throughput screening of mouse knockout lines identifies true lean and obese phenotypes. Obesity (Silver Spring). 2008;16:2362–7.CrossRef
101.
go back to reference Costanzo-Garvey DL, Pfluger PT, Dougherty MK, Stock JL, Boehm M, Chaika O, et al. KSR2 is an essential regulator of AMP kinase, energy expenditure, and insulin sensitivity. Cell Metab. 2009;10:366–78.CrossRefPubMedPubMedCentral Costanzo-Garvey DL, Pfluger PT, Dougherty MK, Stock JL, Boehm M, Chaika O, et al. KSR2 is an essential regulator of AMP kinase, energy expenditure, and insulin sensitivity. Cell Metab. 2009;10:366–78.CrossRefPubMedPubMedCentral
102.
go back to reference Revelli J-P, Smith D, Allen J, Jeter-Jones S, Shadoan MK, Desai U, et al. Profound obesity secondary to Hyperphagia in mice lacking kinase suppressor of Ras 2. Obesity. 2011;19:1010–8.CrossRefPubMed Revelli J-P, Smith D, Allen J, Jeter-Jones S, Shadoan MK, Desai U, et al. Profound obesity secondary to Hyperphagia in mice lacking kinase suppressor of Ras 2. Obesity. 2011;19:1010–8.CrossRefPubMed
103.
go back to reference Kai AKL, Lam AKM, Chen Y, Tai ACP, Zhang X, Lai AKW, et al. Exchange protein activated by cAMP 1 ( Epac1 )-deficient mice develop β-cell dysfunction and metabolic syndrome. FASEB J. 2013;27:4122–35.CrossRefPubMed Kai AKL, Lam AKM, Chen Y, Tai ACP, Zhang X, Lai AKW, et al. Exchange protein activated by cAMP 1 ( Epac1 )-deficient mice develop β-cell dysfunction and metabolic syndrome. FASEB J. 2013;27:4122–35.CrossRefPubMed
104.
go back to reference Hu Y, Robichaux WG, Mei FC, Kim ER, Wang H, Tong Q, et al. Role of exchange protein directly activated by cyclic AMP isoform 1 in energy homeostasis: regulation of leptin expression and secretion in white adipose tissue. Mol Cell Biol. 2016;36:2440–50.CrossRefPubMedPubMedCentral Hu Y, Robichaux WG, Mei FC, Kim ER, Wang H, Tong Q, et al. Role of exchange protein directly activated by cyclic AMP isoform 1 in energy homeostasis: regulation of leptin expression and secretion in white adipose tissue. Mol Cell Biol. 2016;36:2440–50.CrossRefPubMedPubMedCentral
105.
go back to reference Komai AM, Musovic S, Peris E, Alrifaiy A, El Hachmane MF, Johansson M, et al. White adipocyte adiponectin exocytosis is stimulated via β 3 -adrenergic signaling and activation of Epac1: catecholamine resistance in obesity and type 2 diabetes. Diabetes. 2016;65:3301–13.CrossRefPubMed Komai AM, Musovic S, Peris E, Alrifaiy A, El Hachmane MF, Johansson M, et al. White adipocyte adiponectin exocytosis is stimulated via β 3 -adrenergic signaling and activation of Epac1: catecholamine resistance in obesity and type 2 diabetes. Diabetes. 2016;65:3301–13.CrossRefPubMed
Metadata
Title
Genetics of Severe Obesity
Authors
Una Fairbrother
Elliot Kidd
Tanya Malagamuwa
Andrew Walley
Publication date
01-10-2018
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 10/2018
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-018-1053-x

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