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Submitted on March 4, 2005
Accepted on June 16, 2005
Dipartimento di Medicina Sperimentale e Clinica, Università Magna Græcia di Catanzaro, Catanzaro, Italy (G.S.,F.A.,C.R.,M.L.H.); Divisione di Medicina Interna (L.P.,P.V.,V.G.,M.M.,F.F.), Divisione di Chirurgia Generale (M.P., G.F.); Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milano, Italy; Department of Internal Medicine, University of Rome-Tor Vergata Rome, Italy (M.C., M.L.H.); Universita‘ di Milano, Cattedra di Medicina Interna and Seconda Divisione di Medicina Interna, Ospedale San Paolo, Milano (A.E.P.)
* To whom correspondence should be addressed. E-mail: sesti{at}unicz.it or folli.franco{at}hsr.it.
Context. It is unknown whether genetic factors that play an important role in body weight homeostasis influence the response to laparoscopic adjustable gastric banding (LAGB).
Objective. We investigated the impact of common polymorphisms in four candidate genes on weight loss after LAGB.
Design. 6 months follow-up study.
Setting. Hospitalized care.
Patients. 167 unrelated morbidly obese subjects were recruited according to the following criteria: age, 18-66 yr inclusive, BMI, greater than 40 kg/m2, or greater than 35.0 kg/m2 in the presence of comorbidities.
Intervention. LAGB
Main outcome measures. Weight loss.
Results. The following single nucleotide polymorphisms were detected by digestion of PCR products with appropriate restriction enzymes: Gly972Arg of the IRS1 gene, Pro12Ala of the PPARG gene, C-174G in the promoter of IL6 gene, and G-866A in the promoter of UCP2 gene. Baseline characteristics including body mass index (BMI) did not differ between the genotypes. At 6 months follow-up after LAGB, carriers of G-174G IL6 genotype had lost more weight than G-174C or C-174C genotype (P = 0.037), and carriers of A-866A UCP2 genotype had lost more weight as compared with G-866G (P = 0.018) and G-866A (P = 0.035) genotype, respectively. Weight loss was lower in carriers of Gly972Arg IRS1 genotype than Gly972Gly carriers, but not statistically significant (P = 0.06). No difference between carriers of Pro12Ala and Pro12Pro PPARG genotype was observed.
Conclusions. These data demonstrate that genetic factors, which play an important role in the regulation of body weight, may account for differences in the therapeutic response to LAGB.
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