Chen Hsin-Hung, Lee Wei-Jei, Wang Weu, Huang Ming-Te, Lee Yi-Chih, Pan Wen-Harn
Institute of Microbiology and Biochemistry, College of Life Science, National Taiwan University, ROC.
Obes Surg. 2007 Jul;17(7):926-33. doi: 10.1007/s11695-007-9171-6.
Variability in weight loss has been observed from morbidly obese patients receiving bariatric operations. Genetic effects may play a crucial role in this variability.
304 morbidly obese patients (BMI > or =39) were recruited, 77 receiving laparoscopic adjustable gastric banding (LAGB) and 227 laparoscopic mini-gastric bypass (LMGB), and 304 matched non-obese controls (BMI < or =24). Initially, all subjects were genotyped for 4 SNPs (single nucleotide polymorphisms) on UCP2 gene in a case-control study. The SNPs significantly associated with morbid obesity (P < 0.05) were considered as candidate markers affecting weight change. Subsequently, effects on predicting weight loss of those candidate markers were explored in LAGB and LMGB, respectively. The peri-operative parameters were also compared between LAGB and LMGB.
The rs660339 (Ala55Val), on exon 4, was associated with morbid obesity (P = 0.049). Morbidly obese patients with either TT or CT genotypes on rs660339 experienced greater weight loss compared to patients with CC after LAGB at 12 months (BMI loss 12.2 units vs 8.1 units) and 24 months (BMI loss 13.1 units vs 9.3 units). However, this phenomenon was not observed in patients after LMGB. Although greater weight loss was observed in patients receiving LMGB, this procedure had a higher operative complication rate than LAGB (7.5% vs. 2.8%; P < 0.05).
Ala55Val may play a crucial role in obesity development and weight loss after LAGB. It may be considered as clinicians incorporate genetic susceptibility testing into weight loss prediction prior to bariatric operations.
在接受减肥手术的病态肥胖患者中，已观察到体重减轻存在差异。基因效应可能在这种差异中起关键作用。
招募了304例病态肥胖患者（BMI≥39），其中77例接受腹腔镜可调节胃束带术（LAGB），227例接受腹腔镜迷你胃旁路术（LMGB），并选取304例匹配的非肥胖对照者（BMI≤24）。最初，在一项病例对照研究中，对所有受试者的UCP2基因上的4个单核苷酸多态性（SNP）进行基因分型。与病态肥胖显著相关（P<0.05）的SNP被视为影响体重变化的候选标志物。随后，分别在LAGB和LMGB中探讨这些候选标志物对预测体重减轻的影响。还比较了LAGB和LMGB的围手术期参数。
外显子4上的rs660339（Ala55Val）与病态肥胖相关（P = 0.049）。rs660339基因型为TT或CT的病态肥胖患者在LAGB术后12个月（BMI降低12.2单位对8.1单位）和24个月（BMI降低13.1单位对9.3单位）时，与CC基因型患者相比体重减轻更多。然而，在LMGB术后患者中未观察到这种现象。尽管接受LMGB的患者体重减轻更多，但该手术的手术并发症发生率高于LAGB（7.5%对2.8%；P<0.05）。
Ala55Val可能在肥胖发生及LAGB术后体重减轻中起关键作用。在减肥手术前，临床医生将基因易感性检测纳入体重减轻预测时，它可能会被考虑在内。
