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[基因多态性对儿童期体重指数变化及肥胖状态的影响]

[Effect of genetic polymorphisms on change in body mass index and obesity status during childhood].

作者信息

Zhang M X, Cheng H, Zhao X Y, Wu L J, Yan Y K, Mi J

机构信息

Department of Epidemiology, Capital Institute of Pediatric, Beijing 100020, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jul 6;51(7):635-641. doi: 10.3760/cma.j.issn.0253-9624.2017.07.011.

Abstract

The present study aimed to prospectively validate whether the single nucleotide polymorphisms (SNPs) in obesity-related genes were associated with change in body mass index (BMI) and obesity status during childhood. Based on the Beijing Child and Adolescent Metabolic Syndrome study (BCAMS), which was initiated between April and October in 2004, we conducted a follow-up study among 1 624 children aged 6 to 11 years old with genetic data in December 2010. A total of 777 children (246 obese and 531 non-obese) were reassessed for BMI. -score of BMI was used to standardize for age and sex. The changes in BMI -score during follow up were calcnlated SNPs were genotyped by quantitative Real-time PCR (rs9939609, rs6499640, rs7138803, rs1805081, rs17782313, rs6265, rs10938397, rs6235, rs29941, rs2844479, rs10913469 and rs4788102). Overweight and obesity were diagnosed by the age-and sex-specific BMI cutoffs recommended by the International Obesity Task Force. A multilocus genetic risk score for BMI was calculated as the simple sum of alleles of all the SNPs associated with BMI. Linear regression models and logistic regression models were performed to assess the associations of change in BMI Z-score and obese status with genotypes (assuming an additive model), respectively. During 6 years of follow-up, 158 previously obese children remained obese as they aged into adolescence, and 88 transiently obese children were not obese during the second survey, 58 children were newly identified obese, and the other 473 children remained their non-obese state. BMI Z-score increased from 1.41±0.05 at baseline to 1.57±0.06 at follow up.The genotypes of the SNPs except rs6499640(=0.033) and rs6265(=0.041) were in Hardy-Weinberg equilibrium in each group (0.05). Each additional copy of the rs9939609 A allele was significantly associated with an increase in BMI Z-score (β=0.205, 0.014) during follow up. Per C allele of rs17782313 was associated with an increase in BMI Z-score at baseline (β=0.268, 0.003). As the non-obese reference, a significantly relative risk of obesity at follow up was observed for children carrying rs9939609 A-allele versus the T-allele carriers (2.37, 95% 1.45-3.88, 0.001). Rs17782313 C-allele was significantly increase the risk of obesity only at baseline (1.79, 95% 1.24-2.60, 0.002). Rs1805081 A-allele was significantly associated with durative of obesity (1.45, 95% 1.04-2.03, 0.028). Each unit higher genetic risk score was associated with increases risk of 0.18 times (1.18, 95% 1.05-1.33) in childhood transient obesity, and 0.22 times (1.22, 95% 1.06-1.42) in incident obesity at follow-up. But it was not significantly associated with persisted obesity during 6 years of follow-up (1.09, 95% 0.99-1.20). We confirmed that the change of BMI and obesity status in children was affected by different genetic factors. Individual who carries more risk alleles in obesity-related genes may increase the susceptibility to obesity.

摘要

本研究旨在前瞻性验证肥胖相关基因中的单核苷酸多态性(SNP)是否与儿童期体重指数(BMI)变化及肥胖状态相关。基于2004年4月至10月启动的北京儿童和青少年代谢综合征研究(BCAMS),我们于2010年12月对1624名6至11岁有基因数据的儿童进行了随访研究。共对777名儿童(246名肥胖儿童和531名非肥胖儿童)的BMI进行了重新评估。BMI的Z评分用于按年龄和性别进行标准化。计算随访期间BMI Z评分的变化,通过定量实时PCR对SNP进行基因分型(rs9939609、rs6499640、rs7138803、rs1805081、rs17782313、rs6265、rs10938397、rs6235、rs29941、rs2844479、rs10913469和rs4788102)。超重和肥胖根据国际肥胖特别工作组推荐的年龄和性别特异性BMI切点进行诊断。计算BMI的多基因风险评分,作为所有与BMI相关SNP等位基因的简单总和。分别进行线性回归模型和逻辑回归模型,以评估BMI Z评分变化和肥胖状态与基因型的关联(假设为加性模型)。在6年的随访期间,158名先前肥胖的儿童进入青春期后仍肥胖,88名短暂肥胖的儿童在第二次调查时不肥胖,58名儿童新被确定为肥胖,其他473名儿童仍处于非肥胖状态。BMI Z评分从基线时的1.41±0.05增加到随访时的1.57±0.06。除rs6499640(P = 0.033)和rs6265(P = 0.041)外,各SNP的基因型在每组中均处于Hardy-Weinberg平衡(P>0.05)。rs9939609 A等位基因每增加一个拷贝,在随访期间与BMI Z评分显著增加相关(β = 0.205,P = 0.014)。rs17782313的每个C等位基因与基线时BMI Z评分增加相关(β = 0.268,P = 0.003)。以非肥胖者为对照,携带rs9939609 A等位基因的儿童在随访时肥胖的相对风险显著高于携带T等位基因者(RR = 2.37,95%CI 1.45 - 3.88,P = 0.001)。rs17782313 C等位基因仅在基线时显著增加肥胖风险(RR = 1.79,95%CI 1.24 - 2.60,P = 0.002)。rs1805081 A等位基因与肥胖持续时间显著相关(RR = 1.45,95%CI 1.04 - 2.03,P = 0.028)。多基因风险评分每增加一个单位,儿童期短暂肥胖的风险增加0.18倍(RR = 1.18,95%CI 1.05 - 1.33),随访时新发肥胖的风险增加0.22倍(RR = 1.22,95%CI 1.06 - 1.42)。但在6年随访期间与持续性肥胖无显著关联(RR = 1.09,95%CI 0.99 - 1.20)。我们证实儿童BMI和肥胖状态的变化受不同遗传因素影响。在肥胖相关基因中携带更多风险等位基因的个体可能增加肥胖易感性。

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