MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK.
Br J Clin Pharmacol. 2009 Dec;68(6):811-29. doi: 10.1111/j.1365-2125.2009.03523.x.
The genetic contribution to interindividual variation in common obesity has been estimated at 40-70%. Yet, despite a relatively high heritability, the search for obesity susceptibility genes has been an arduous task. This paper reviews recent progress made in the obesity genetics field with an emphasis on established obesity susceptibility loci identified through candidate gene as well as genome-wide studies. For the last 15 years, candidate gene and genome-wide linkage studies have been the two main genetic epidemiological approaches to identify genetic loci for common traits, yet progress has been slow and success limited. Only recently have candidate gene studies started to succeed; by means of large-scale studies and meta-analyses at least five variants in four candidate genes have been found to be robustly associated with obesity-related traits. Genome-wide linkage studies, however, have so far not been able to pinpoint genetic loci for common obesity. The genome-wide association approach, which has become available in recent years, has dramatically changed the pace of gene discoveries for common disease, including obesity. Three waves of large-scale high-density genome-wide association studies have already discovered at least 15 previously unanticipated genetic loci incontrovertibly associated with body mass index and extreme obesity risk. Although the combined contribution of these loci to the variation in obesity risk at the population level is small and their predictive value is typically low, these recently discovered loci are set to improve fundamentally our insights into the pathophysiology of obesity.
个体间常见肥胖的遗传差异可归因于 40-70%。尽管遗传率相对较高,但寻找肥胖易感基因一直是一项艰巨的任务。本文重点介绍了通过候选基因和全基因组研究确定的已建立的肥胖易感基因座,回顾了肥胖遗传学领域的最新进展。在过去的 15 年中,候选基因和全基因组连锁研究一直是识别常见性状遗传基因座的两种主要遗传流行病学方法,但进展缓慢,成功有限。直到最近,候选基因研究才开始取得成功;通过大规模研究和荟萃分析,至少在四个候选基因中的五个变体与肥胖相关特征具有稳健的相关性。然而,全基因组连锁研究迄今为止还无法确定常见肥胖的遗传基因座。近年来出现的全基因组关联研究方法极大地改变了包括肥胖症在内的常见疾病的基因发现速度。三波大规模高密度全基因组关联研究已经发现了至少 15 个以前未预料到的与体重指数和极端肥胖风险明显相关的遗传基因座。尽管这些基因座在人群水平上对肥胖风险变异的综合贡献很小,并且其预测价值通常较低,但这些新发现的基因座将从根本上改善我们对肥胖症病理生理学的认识。