Bandstein Marcus, Mwinyi Jessica, Ernst Barbara, Thurnheer Martin, Schultes Bernd, Schiöth Helgi B
a Department of Neuroscience, Functional Pharmacology , Uppsala University , Uppsala , Sweden ;
b Interdisciplinary Obesity Center , eSwiss Medical & Surgical Center , St. Gallen , Switzerland.
Scand J Gastroenterol. 2016 Sep;51(9):1050-5. doi: 10.3109/00365521.2016.1166519. Epub 2016 May 16.
Bariatric surgery is the most efficient treatment of severe obesity. We investigated to what extent BMI- or waist-hip ratio (WHR)-related genetic variants are associated with excess BMI loss (EBMIL) two years after Roux-en-Y gastric bypass (RYGB) surgery, and elucidated the affected biological pathways.
Two-hundred fifty-one obese patients (age: 43 ± 10.7, preoperative BMI: 45.1 ± 6.1 kg/m(2), 186 women) underwent RYGB surgery and were followed up after two years with regard to BMI. Patients were genotyped for 32 single-nucleotide polymorphisms (SNPs) that were investigated with regard to their impact on response to RYGB and preoperatively measured Three Factor Eating Questionnaire (TFEQ) scores.
Homozygous T carriers of the SNP rs4846567 in proximity to the Lysophospholipase-like 1 (LYPLAL1) gene showed a 7% higher EBMIL compared to wild-type and heterozygous carriers (p = 0.031). TT-allele carriers showed furthermore lower scores for Hunger (74%, p < 0.001), lower Disinhibition (53%, p < 0.001), and higher Cognitive restraint (21%, p = 0.017) than GG/GT carriers in the TFEQ. Patients within the lowest quartile of Hunger scores had a 32% greater EBMIL compared to patients in the highest quartile (p < 0.001).
The LYPLAL1 genotype is associated with differences in eating behavior and loss of extensive body weight following RYGB surgery. Genotyping and the use of eating behavior-related questionnaires may help to estimate the RYGB-associated therapy success.
减重手术是治疗重度肥胖最有效的方法。我们研究了体重指数(BMI)或腰臀比(WHR)相关基因变异在胃旁路术(RYGB)后两年与超重体重减轻(EBMIL)的关联程度,并阐明了受影响的生物学途径。
251例肥胖患者(年龄:43±10.7岁,术前BMI:45.1±6.1kg/m²,186例女性)接受了RYGB手术,并在术后两年对BMI进行随访。对患者进行32个单核苷酸多态性(SNP)基因分型,研究这些基因对RYGB反应的影响以及术前测量的三因素饮食问卷(TFEQ)得分。
靠近溶血磷脂酶样1(LYPLAL1)基因的SNP rs4846567的纯合T携带者与野生型和杂合携带者相比,EBMIL高7%(p = 0.031)。在TFEQ中,TT等位基因携带者的饥饿得分更低(74%,p < 0.001),去抑制得分更低(53%,p < 0.001),认知抑制得分更高(21%,p = 0.017)。饥饿得分处于最低四分位数的患者与最高四分位数的患者相比,EBMIL高32%(p < 0.001)。
LYPLAL1基因型与RYGB手术后饮食行为差异和大量体重减轻有关。基因分型和使用与饮食行为相关的问卷可能有助于评估RYGB相关治疗的成功率。