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Physical activity attenuates the influence of FTO variants on obesity risk: a meta-analysis of 218,166 adults and 19,268 children
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2011 (English)In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 8, no 11, e1001116- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n = 218,166) and nine studies of children and adolescents (n = 19,268).

METHODS AND FINDINGS: All studies identified to have data on the FTO rs9939609 variant (or any proxy [r(2)>0.8]) and PA were invited to participate, regardless of ethnicity or age of the participants. PA was standardized by categorizing it into a dichotomous variable (physically inactive versus active) in each study. Overall, 25% of adults and 13% of children were categorized as inactive. Interaction analyses were performed within each study by including the FTO×PA interaction term in an additive model, adjusting for age and sex. Subsequently, random effects meta-analysis was used to pool the interaction terms. In adults, the minor (A-) allele of rs9939609 increased the odds of obesity by 1.23-fold/allele (95% CI 1.20-1.26), but PA attenuated this effect (p(interaction)  = 0.001). More specifically, the minor allele of rs9939609 increased the odds of obesity less in the physically active group (odds ratio  = 1.22/allele, 95% CI 1.19-1.25) than in the inactive group (odds ratio  = 1.30/allele, 95% CI 1.24-1.36). No such interaction was found in children and adolescents.

CONCLUSIONS: The association of the FTO risk allele with the odds of obesity is attenuated by 27% in physically active adults, highlighting the importance of PA in particular in those genetically predisposed to obesity.

Place, publisher, year, edition, pages
2011. Vol. 8, no 11, e1001116- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-51101DOI: 10.1371/journal.pmed.1001116PubMedID: 22069379OAI: diva2:475265
Available from: 2012-01-10 Created: 2012-01-10 Last updated: 2015-01-09Bibliographically approved
In thesis
1. Interplay between genetics and environment in obesity
Open this publication in new window or tab >>Interplay between genetics and environment in obesity
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background. Being one of the largest current global health problems, obesity is a result of interplay between genetic and environmental factors. In this thesis we studied the genetic underpinning of adipose tissue distribution; investigated causality between obesity and periodontitis using instrumental variable analyses in genetic epidemiology settings; studied interactions between obesity-associated loci and physical activity on obesity; and checked if loci identified in genome-wide association studies are good candidates for gene-environment interactions using heterogeneity of variance analyses.

Methods. In Paper 1 we performed a meta-analysis of large-scale genetic association studies for waist traits in 224,459 participants followed by a variety of statistical and bioinformatics methods to obtain insights into the biology of the underlying adipose distributions. In Paper 2 we used genetic variants associated with body mass index (BMI) as instruments within a Mendelian randomization framework to study causality between obesity and periodontitis in 49,066 participants. In Paper 3 we studied the interaction between an FTO single nucleotide polymorphism (SNP) rs9939609 and physical activity in obesity outcomes through meta-analysis of 237,434 participants. In Paper 4 we evaluated if SNPs established through main-effects meta-analysis of genome-wide association studies represent strong or weak candidates for gene-environment interactions, inferred by the degree of phenotypic heterogeneity across genotypes at a given SNP locus.

Results. In Paper 1 we identified 49 loci (33 novel) associated with waist-to-hip ratio adjusted for BMI (P<5×10-8), 20 of which displayed significant sexual dimorphism, of which 19 displayed a stronger effect in women than in men. We also detected 19 additional loci newly associated with related waist and hip circumference measures. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation, and insulin resistance as processes affecting fat distribution, providing insights into potential pathophysiological mechanisms. In Paper 2 we confirmed observational associations between BMI and periodontitis with a pooled odds ratio (OR) of 1.13 per standard deviation increase in BMI (95%CI:1.03, 1.24) in all participants and 1.25 (95%CI:1.10, 1.42) in participants with clinical data. The instrumental variable meta-analysis yielded an OR of 1.05 (95%CI:0.80, 1.38) per BMI standard deviation, and 0.90 (95%CI:0.56, 1.46) in participants with clinical data. In Paper 3 we showed that physical activity attenuates the influence of FTO variation in rs9939609 on obesity (Pinteraction=0.001) with the A allele of rs9939609 increasing the odds of obesity less in the physically active group, with a per-allele OR of 1.22 (95%CI:1.19, 1.25), than in the inactive group, with a per-allele OR of 1.30 (95%CI:1.24, 1.36). In Paper 4 we show that rank-ordered distributions of P-values between marginal effects genome-wide association studies (GWAS) and heterogeneity of variance analyses for all SNPs for BMI and lipid traits have very weak correlations for most traits (Spearman rho of 0.0034 for total cholesterol and 0.0044 for BMI for the squared phenotype residuals regression method) indicating that variants with strong marginal effects are in general poor candidates for gene-environment interactions based on heterogeneity of variance analyses, although a small number of variants convey strong marginal and variance effects, such as those at the FTO locus, meaning that they are likely to convey both marginal and interaction effects.

Conclusion. The work outlined in this thesis sheds light on the complexity of genetic and environmental factors in obesity. We have identified novel loci associated with waist traits and described pathways implicated in adipose distribution. We have shown that based on Mendelian randomization analyses the association between periodontitis and obesity is unlikely to be causal. We have confirmed interactions between a bona-fide obesity locus (FTO) and physical activity on obesity and have shown that, in contrast to FTO, the majority of genetic variants identified through GWAS are unlikely to be good candidates for gene-environment interactions based on heterogeneity of variance analyses.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2015. 82 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1694
obesity, GWAS, gene-environment interactions, waist-hip ratio, body mass index, periodontitis, Mendelian randomization, heterogeneity of variance
National Category
Medical and Health Sciences
urn:nbn:se:umu:diva-97929 (URN)978-91-7601-201-7 (ISBN)
Public defence
2015-01-30, Hörsal D, Unod T9, Norrlands universitetssjukhus, Umeå, 11:07 (English)
Available from: 2015-01-09 Created: 2015-01-09 Last updated: 2015-03-27Bibliographically approved

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