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01-02-2020 | Obesity | Original Contributions

Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity

Authors: M.I. Cooiman, L. Kleinendorst, E.O. Aarts, I.M.C. Janssen, H.K. Ploos van Amstel, A.I. Blakemore, E.J. Hazebroek, H.J. Meijers-Heijboer, B. van der Zwaag, F.J. Berends, M.M. van Haelst

Published in: Obesity Surgery | Issue 2/2020

Abstract

Background

Mutations in the leptin-melanocortin pathway genes are known to cause monogenic obesity. The prevalence of these gene mutations and their effect on weight loss response after bariatric surgery are still largely unknown.

Objective

To determine the prevalence of genetic obesity in a large bariatric cohort and evaluate their response to bariatric surgery.

Methods

Mutation analysis of 52 obesity-associated genes. Patient inclusion criteria were a BMI > 50 kg/m², an indication for revisional surgery or an early onset of obesity (< 10 years of age).

Results

A total of 1014 patients were included, of whom 30 (3%) were diagnosed with genetic obesity, caused by pathogenic heterozygous mutations in either MC4R, POMC, PCSK1, SIM1, or PTEN. The percentage total body weight loss (%TBWL) after Roux-en-Y gastric bypass (RYGB) surgery was not significantly different for patients with a mutation in MC4R, POMC, and PCSK1 compared with patients lacking a molecular diagnosis. Of the confirmed genetic obesity cases, only patients with MC4R mutations receiving a sleeve gastrectomy (SG) showed significantly lower %TBWL compared with patients lacking a molecular diagnosis, during 2 years of follow-up.

Conclusions

In this cohort of morbid obese bariatric patients, an estimated prevalence of monogenic obesity of 3% is reported. Among these patients, the clinical effects of heterozygous mutations in POMC and PCSK1 do not interfere with the effectiveness of most commonly performed bariatric procedures within the first 2 years of follow-up. Patients with MC4R mutations achieved superior weight loss after primary RYGB compared with SG.

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Title: Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity
Authors: M.I. Cooiman
L. Kleinendorst
E.O. Aarts
I.M.C. Janssen
H.K. Ploos van Amstel
A.I. Blakemore
E.J. Hazebroek
H.J. Meijers-Heijboer
B. van der Zwaag
F.J. Berends
M.M. van Haelst
Publication date: 01-02-2020
Publisher: Springer US
Keywords: Obesity
Obesity
Sleeve Gastrectomy
Bariatric Surgery
Bariatric Surgery
Published in: Obesity Surgery / Issue 2/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-019-04184-w

ACC 2024 Congress

Springer Medicine

Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity

Abstract

Background

Objective

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

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