Clinic of Pediatric Endocrinology, University of Health Sciences Turkey, Dr. BehçetUz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey.
Clinic of Medical Genetics, University of Health Sciences Turkey, Dr. BehçetUz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey.
J Pediatr Endocrinol Metab. 2022 Jul 8;35(8):1041-1050. doi: 10.1515/jpem-2022-0027. Print 2022 Aug 26.
Non-syndromic monogenic obesity is a rare cause of early-onset severe obesity in the childhood period. The aim of this study was to screen four obesity related genes ( and ) in children and adolescents who had severe, non-syndromic early onset obesity.
Next-generation sequencing of all exons in and was performed in 154 children and adolescents with early onset severe obesity obesity.
Fifteen different variants in nineteen patients were identified with a variant detection rate of 12.3%. While six different heterozygous variants were observed in gene (10/154 patients; 6.5%), five different variants in gene (four of them were heterozygous and one of them was homozygous) (6/154 patients; 3.9%) and four different homozygous variants in gene (3/154 patients; 1.9%) were described. However, no variants were detected in the LEP gene. The most common pathogenic variant was c.496G>A in gene, which was detected in four unrelated patients. Six novel variants (6/15 variants; 40%) were described in seven patients. Four of them including c.233C>A and c.752T>C in gene and c.761dup and c.1221dup in gene were evaluated as pathogenic or likely pathogenic.
In conclusion, MC4R variants are the most common genetic cause of monogenic early-onset obesity, consistent with the literature. The c.496G>A variant in gene is highly prevalent in early-onset obese patients.
非综合征性单基因肥胖症是儿童期早发性重度肥胖的罕见病因。本研究旨在筛选患有重度、非综合征性早发性肥胖的儿童和青少年中与肥胖相关的四个基因( 和 )。
对 154 名早发性重度肥胖症患儿和青少年的 和 所有外显子进行下一代测序。
在 19 名患者的 15 个不同变异体中,变异体检测率为 12.3%。在 基因中观察到 6 个不同的杂合变异体(10/154 患者;6.5%),在 基因中观察到 5 个不同的变异体(其中 4 个为杂合子,1 个为纯合子)(6/154 患者;3.9%)和 4 个不同的纯合变异体在 基因(3/154 患者;1.9%)。然而,在 LEP 基因中未检测到变异体。最常见的致病性变异是 基因中的 c.496G>A,在 4 名无亲缘关系的患者中均有发现。在 7 名患者中描述了 6 个新的变异体(6/15 变异体;40%)。其中 4 个包括 基因中的 c.233C>A 和 c.752T>C 以及 基因中的 c.761dup 和 c.1221dup 被评估为致病性或可能致病性。
总之,MC4R 变异是单基因早发性肥胖的最常见遗传原因,与文献一致。 基因中的 c.496G>A 变异在早发性肥胖患者中非常普遍。