Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity

M. I. Cooiman; L. Kleinendorst; E. O. Aarts; I. M.C. Janssen; H. K.Ploos van Amstel; A. I. Blakemore; E. J. Hazebroek; H. J. Meijers-Heijboer; B. van der Zwaag; F. J. Berends; M. M. van Haelst

doi:10.1007/s11695-019-04184-w

Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity

M. I. Cooiman^*, L. Kleinendorst, E. O. Aarts, I. M.C. Janssen, H. K.Ploos van Amstel, A. I. Blakemore, E. J. Hazebroek, H. J. Meijers-Heijboer, B. van der Zwaag, F. J. Berends, M. M. van Haelst

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Mutations in the leptin-melanocortin pathway genes are known to cause monogenic obesity. The prevalence of these gene mutations and their effect on weight loss response after bariatric surgery are still largely unknown.

OBJECTIVE: To determine the prevalence of genetic obesity in a large bariatric cohort and evaluate their response to bariatric surgery.

METHODS: Mutation analysis of 52 obesity-associated genes. Patient inclusion criteria were a BMI > 50 kg/m 2, an indication for revisional surgery or an early onset of obesity (< 10 years of age).

RESULTS: A total of 1014 patients were included, of whom 30 (3%) were diagnosed with genetic obesity, caused by pathogenic heterozygous mutations in either MC4R, POMC, PCSK1, SIM1, or PTEN. The percentage total body weight loss (%TBWL) after Roux-en-Y gastric bypass (RYGB) surgery was not significantly different for patients with a mutation in MC4R, POMC, and PCSK1 compared with patients lacking a molecular diagnosis. Of the confirmed genetic obesity cases, only patients with MC4R mutations receiving a sleeve gastrectomy (SG) showed significantly lower %TBWL compared with patients lacking a molecular diagnosis, during 2 years of follow-up.

CONCLUSIONS: In this cohort of morbid obese bariatric patients, an estimated prevalence of monogenic obesity of 3% is reported. Among these patients, the clinical effects of heterozygous mutations in POMC and PCSK1 do not interfere with the effectiveness of most commonly performed bariatric procedures within the first 2 years of follow-up. Patients with MC4R mutations achieved superior weight loss after primary RYGB compared with SG.

Original language	English
Pages (from-to)	470-477
Number of pages	8
Journal	Obesity Surgery
Volume	30
Issue number	2
DOIs	https://doi.org/10.1007/s11695-019-04184-w
Publication status	Published - Feb 2020

Keywords

Bariatric surgery
Early onset obesity
Gastric bypass
Obesity
Obesity genetics
Revisional surgery
Sleeve gastrectomy

Access to Document

10.1007/s11695-019-04184-w

Cite this

Cooiman, M. I., Kleinendorst, L., Aarts, E. O., Janssen, I. M. C., van Amstel, H. K. P., Blakemore, A. I., Hazebroek, E. J., Meijers-Heijboer, H. J., van der Zwaag, B., Berends, F. J., & van Haelst, M. M. (2020). Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity. Obesity Surgery, 30(2), 470-477. https://doi.org/10.1007/s11695-019-04184-w

@article{6ce6766ce09441d4b1d635e0dfab4912,

title = "Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity",

abstract = "BACKGROUND: Mutations in the leptin-melanocortin pathway genes are known to cause monogenic obesity. The prevalence of these gene mutations and their effect on weight loss response after bariatric surgery are still largely unknown.OBJECTIVE: To determine the prevalence of genetic obesity in a large bariatric cohort and evaluate their response to bariatric surgery.METHODS: Mutation analysis of 52 obesity-associated genes. Patient inclusion criteria were a BMI > 50 kg/m 2, an indication for revisional surgery or an early onset of obesity (< 10 years of age). RESULTS: A total of 1014 patients were included, of whom 30 (3%) were diagnosed with genetic obesity, caused by pathogenic heterozygous mutations in either MC4R, POMC, PCSK1, SIM1, or PTEN. The percentage total body weight loss (%TBWL) after Roux-en-Y gastric bypass (RYGB) surgery was not significantly different for patients with a mutation in MC4R, POMC, and PCSK1 compared with patients lacking a molecular diagnosis. Of the confirmed genetic obesity cases, only patients with MC4R mutations receiving a sleeve gastrectomy (SG) showed significantly lower %TBWL compared with patients lacking a molecular diagnosis, during 2 years of follow-up.CONCLUSIONS: In this cohort of morbid obese bariatric patients, an estimated prevalence of monogenic obesity of 3% is reported. Among these patients, the clinical effects of heterozygous mutations in POMC and PCSK1 do not interfere with the effectiveness of most commonly performed bariatric procedures within the first 2 years of follow-up. Patients with MC4R mutations achieved superior weight loss after primary RYGB compared with SG.",

keywords = "Bariatric surgery, Early onset obesity, Gastric bypass, Obesity, Obesity genetics, Revisional surgery, Sleeve gastrectomy",

author = "Cooiman, {M. I.} and L. Kleinendorst and Aarts, {E. O.} and Janssen, {I. M.C.} and {van Amstel}, {H. K.Ploos} and Blakemore, {A. I.} and Hazebroek, {E. J.} and Meijers-Heijboer, {H. J.} and {van der Zwaag}, B. and Berends, {F. J.} and {van Haelst}, {M. M.}",

note = "Funding Information: We would like to thank all participating patients for their contribution. Publisher Copyright: {\textcopyright} 2019, Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

month = feb,

doi = "10.1007/s11695-019-04184-w",

language = "English",

volume = "30",

pages = "470--477",

journal = "Obesity Surgery",

issn = "0960-8923",

publisher = "Springer New York",

number = "2",

}

TY - JOUR

T1 - Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity

AU - Cooiman, M. I.

AU - Kleinendorst, L.

AU - Aarts, E. O.

AU - Janssen, I. M.C.

AU - van Amstel, H. K.Ploos

AU - Blakemore, A. I.

AU - Hazebroek, E. J.

AU - Meijers-Heijboer, H. J.

AU - van der Zwaag, B.

AU - Berends, F. J.

AU - van Haelst, M. M.

N1 - Funding Information: We would like to thank all participating patients for their contribution. Publisher Copyright: © 2019, Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/2

Y1 - 2020/2

N2 - BACKGROUND: Mutations in the leptin-melanocortin pathway genes are known to cause monogenic obesity. The prevalence of these gene mutations and their effect on weight loss response after bariatric surgery are still largely unknown.OBJECTIVE: To determine the prevalence of genetic obesity in a large bariatric cohort and evaluate their response to bariatric surgery.METHODS: Mutation analysis of 52 obesity-associated genes. Patient inclusion criteria were a BMI > 50 kg/m 2, an indication for revisional surgery or an early onset of obesity (< 10 years of age). RESULTS: A total of 1014 patients were included, of whom 30 (3%) were diagnosed with genetic obesity, caused by pathogenic heterozygous mutations in either MC4R, POMC, PCSK1, SIM1, or PTEN. The percentage total body weight loss (%TBWL) after Roux-en-Y gastric bypass (RYGB) surgery was not significantly different for patients with a mutation in MC4R, POMC, and PCSK1 compared with patients lacking a molecular diagnosis. Of the confirmed genetic obesity cases, only patients with MC4R mutations receiving a sleeve gastrectomy (SG) showed significantly lower %TBWL compared with patients lacking a molecular diagnosis, during 2 years of follow-up.CONCLUSIONS: In this cohort of morbid obese bariatric patients, an estimated prevalence of monogenic obesity of 3% is reported. Among these patients, the clinical effects of heterozygous mutations in POMC and PCSK1 do not interfere with the effectiveness of most commonly performed bariatric procedures within the first 2 years of follow-up. Patients with MC4R mutations achieved superior weight loss after primary RYGB compared with SG.

AB - BACKGROUND: Mutations in the leptin-melanocortin pathway genes are known to cause monogenic obesity. The prevalence of these gene mutations and their effect on weight loss response after bariatric surgery are still largely unknown.OBJECTIVE: To determine the prevalence of genetic obesity in a large bariatric cohort and evaluate their response to bariatric surgery.METHODS: Mutation analysis of 52 obesity-associated genes. Patient inclusion criteria were a BMI > 50 kg/m 2, an indication for revisional surgery or an early onset of obesity (< 10 years of age). RESULTS: A total of 1014 patients were included, of whom 30 (3%) were diagnosed with genetic obesity, caused by pathogenic heterozygous mutations in either MC4R, POMC, PCSK1, SIM1, or PTEN. The percentage total body weight loss (%TBWL) after Roux-en-Y gastric bypass (RYGB) surgery was not significantly different for patients with a mutation in MC4R, POMC, and PCSK1 compared with patients lacking a molecular diagnosis. Of the confirmed genetic obesity cases, only patients with MC4R mutations receiving a sleeve gastrectomy (SG) showed significantly lower %TBWL compared with patients lacking a molecular diagnosis, during 2 years of follow-up.CONCLUSIONS: In this cohort of morbid obese bariatric patients, an estimated prevalence of monogenic obesity of 3% is reported. Among these patients, the clinical effects of heterozygous mutations in POMC and PCSK1 do not interfere with the effectiveness of most commonly performed bariatric procedures within the first 2 years of follow-up. Patients with MC4R mutations achieved superior weight loss after primary RYGB compared with SG.

KW - Bariatric surgery

KW - Early onset obesity

KW - Gastric bypass

KW - Obesity

KW - Obesity genetics

KW - Revisional surgery

KW - Sleeve gastrectomy

UR - http://www.scopus.com/inward/record.url?scp=85074605158&partnerID=8YFLogxK

U2 - 10.1007/s11695-019-04184-w

DO - 10.1007/s11695-019-04184-w

M3 - Article

C2 - 31650404

AN - SCOPUS:85074605158

SN - 0960-8923

VL - 30

SP - 470

EP - 477

JO - Obesity Surgery

JF - Obesity Surgery

IS - 2

ER -

Genetic Obesity and Bariatric Surgery Outcome in 1014 Patients with Morbid Obesity

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this