Zusammenfassung
Die Speicherung überschüssiger Energie im Fettgewebe wird durch fettreiche Ernährung
und Bewegungsmangel begünstigt. Zudem besteht eine spezifische genetische Prädisposition
für die Entstehung von Adipositas, was am interindividuell unterschiedlichen Ausmaß
einer Gewichtszunahme bei kalorischem Überangebot deutlich wird. Zwar konnten in den
vergangenen Jahren zahlreiche Genvarianten identifiziert werden, die eine Assoziation
mit dem Körpergewicht bzw. mit adipositasassoziierten Stoffwechselstörungen zeigten.
Allerdings fand sich einerseits oftmals eine unzureichende Reproduzierbarkeit der
erhobenen Befunde an unterschiedlichen Kollektiven, andererseits blieben Gen-Gen-Interaktionen
weitgehend unberücksichtigt. Angesichts der Tatsache, dass die Prädisposition für
Adipositas zumeist nicht auf ein einzelnes Gen, sondern auf additive oder synergistische
Effekte einer Vielzahl von Genvarianten zurückzuführen ist, müssen hier in Zukunft
verstärkt Anstrengungen für ein besseres Verständnis relevanter Interaktionen erfolgen.
Die Suche nach den entscheidenden molekularen Grundlagen der Adipositas wird nicht
nur einen besseren Einblick in die Pathophysiologie des Energiestoffwechsels ermöglichen,
sondern auch zur Entwicklung neuer Therapiestrategien für adipöse Patienten beitragen.
Abstract
The deposition of excess energy in adipose tissue is enhanced by high fat diets and
lack of physical activity. Furthermore, the existence of a specific genetic predisposition
towards the development of obesity becomes evident by marked interindividual differences
in the response to caloric oversupply. In recent years, numerous genetic variants
were identified with possible importance for human obesity and its associated metabolic
disorders. However, in many cases genetic findings were divergent when tested in different
cohorts. Furthermore, potential gene-gene interactions were rarely taken into account.
Given the fact that an individual's predisposition for obesity is not due to the effect
of a single gene, but the result of complex additive or synergistic effects of multiple
genetic variants, more effort needs to be directed towards a better understanding
of gene-gene interactions. The search for the key molecular basics of obesity will
not only improve our understanding of the pathophysiology of energy metabolism, but
will ultimately contribute to the development of new therapeutic strategies for obese
patients.
Schlüsselwörter
Adipositas - Genetik - Gen-Gen-Interaktion - Fettgewebe - β-adrenerger Rezeptor
Key words
Obesity - genetics - gene-gene interaction - adipose tissue - β-adrenergic receptor
Literatur
- 1
Neel J V.
Diabetes mellitus. A „thrifty” genotype rendered detrimental by „progress”?.
Amer J Hum Gen.
1962;
14
353-362
- 2 Hamann A, Hinney A, Hebebrand J.
Genetische Aspekte der Adipositas. In: Wechsler JG (Hrsg) Adipositas. Berlin; Blackwell im Druck
- 3
Stunkard A J, Sorensen T I, Hanis C, Teasdale T W, Chakraborty R, Schull W J, Schulsinger F.
An adoption study of human obesity.
N Engl J Med.
1986;
314
193-198
- 4
Bouchard C, Perusse L.
Genetics of obesity.
Annu Rev Nutr.
1993;
13
337-354
- 5
Barsh G S, Farooqi I S, O'Rahilly S.
Genetics of body-weight regulation.
Nature.
2000;
404
644-651
- 6
Vaisse C, Clement K, Guy-Grand B, Froguel P.
A frameshift mutation in human MC4R is associated with a dominant form of obesity.
Nat Genet.
1998;
20
113-114
- 7
Hinney A, Schmidt A, Nottebom K, Heibult O, Becker I, Ziegler A, Gerber G, Sina M,
Gorg T, Mayer H, Siegfried W, Fichter M, Remschmidt H, Hebebrand J.
Several mutations in the melanocortin-4 receptor gene including a nonsense and a frameshift
mutation associated with dominantly inherited obesity in humans.
J Clin Endocrinol Metab.
1999;
84
1483-1486
- 8
Susulic V S, Frederich R C, Lawitts J, Tozzo E, Kahn B B, Harper M E, Himms-Hagen J,
Flier J S, Lowell B B.
Targeted disruption of the β 3-adrenergic receptor gene.
J Biol Chem.
1995;
270
29483-29492
- 9
Valet P, Grujic D, Wade J, Ito M, Zingaretti M C, Soloveva V, Ross S R, Graves R A,
Cinti S, Lafontan M, Lowell B B.
Expression of human α 2-adrenergic receptors in adipose tissue of β 3-adrenergic receptor-deficient
mice promotes diet-induced obesity.
J Biol Chem.
2000;
275
34797-34802
- 10
Bachman E S, Dhillon H, Zhang C Y, Cinti S, Bianco A C, Kobilka B K, Lowell B B.
βAR signaling required for diet-induced thermogenesis and obesity resistance.
Science.
2002;
297
843-845
- 11
Erickson J C, Clegg K E, Palmiter R D.
Sensitivity to leptin and susceptibility to seizures of mice lacking neuropeptide
Y.
Nature.
1996;
381
415-421
- 12
Hollopeter G, Erickson J C, Palmiter R D.
Role of neuropeptide Y in diet-, chemical- and genetic-induced obesity of mice.
Int J Obes Relat Metab Disord.
1998;
22
506-512
- 13
Erickson J C, Hollopeter G, Palmiter R D.
Attenuation of the obesity syndrome of ob/ob mice by the loss of neuropeptide Y.
Science.
1996;
274
1704-1707
- 14
Savage D B, Agostini M, Barroso I, Gurnell M, Luan J, Meirhaeghe A, Harding A H, Ihrke G,
Rajanayagam O, Soos M A, George S, Berger D, Thomas E L, Bell J D, Meeran K, Ross R J,
Vidal-Puig A, Wareham N J, O'Rahilly S, Chatterjee V K, Schafer A J.
Digenic inheritance of severe insulin resistance in a human pedigree.
Nat Genet.
2002;
31
379-384
- 15
Clement K, Vaisse C, Manning B S, Basdevant A, Guy-Grand B, Ruiz J, Silver K D, Shuldiner A R,
Froguel P, Strosberg A D.
Genetic variation in the β 3-adrenergic receptor and an increased capacity to gain
weight in patients with morbid obesity.
N Engl J Med.
1995;
333
352-354
- 16
Walston J, Silver K, Bogardus C, Knowler W C, Celi F S, Austin S, Manning B, Strosberg A D,
Stern M P, Raben N. et al .
Time of onset of non-insulin-dependent diabetes mellitus and genetic variation in
the β 3-adrenergic-receptor gene.
N Engl J Med.
1995;
333
343-347
- 17
Widén E, Lehto M, Kanninen T, Walston J, Shuldiner A, Groop L.
Association of a polymorphism in the β3-adrenergic receptor gene with features of
the insulin resistance syndrome in finns.
N Engl J Med.
1995;
333
348-351
- 18
Allison D B, Heo M, Faith M S, Pietrobelli A.
Meta-analysis of the association of the Trp64Arg polymorphism in the β3 adrenergic
receptor with body mass index.
Int J Obes Relat Metab Disord.
1998;
22
559-566
- 19
Fujisawa T, Ikegami H, Kawaguchi Y, Ogihara T.
Meta-analysis of the association of Trp64Arg polymorphism of β 3-adrenergic receptor
gene with body mass index.
J Clin Endocrinol Metab.
1998;
83
2441-2444
- 20
Hamann A, Münzberg H, Tafel J, Ziegler R.
Bedeutung der Thermogenese für den Energiestoffwechsel und die Therapie der Adipositas.
Dtsch Med Wochenschr.
2001;
126
241-246
- 21
Hamann A, Tafel J, Busing B, Munzberg H, Hinney A, Mayer H, Siegfried W, Ricquier D,
Greten H, Hebebrand J, Matthaei S.
Analysis of the uncoupling protein-1 (UCP1) gene in obese and lean subjects: identification
of four amino acid variants.
Int J Obes Relat Metab Disord.
1998;
22
939-941
- 22
Cassard-Doulcier A M, Bouillaud F, Chagnon M, Gelly C, Dionne F T, Oppert J M, Bouchard C,
Chagnon Y, Ricquier D.
The Bcl I polymorphism of the human uncoupling protein (ucp) gene is due to a point
mutation in the 5'-flanking region.
Int J Obes Relat Metab Disord.
1996;
20
278-279
- 23
Fumeron F, Durack-Bown I, Betoulle D, Cassard-Doulcier A M, Tuzet S, Bouillaud F,
Melchior J C, Ricquier D, Apfelbaum M.
Polymorphisms of uncoupling protein (UCP) and β 3 adrenoreceptor genes in obese people
submitted to a low calorie diet.
Int J Obes Relat Metab Disord.
1996;
20
1051-1054
- 24
Clement K, Ruiz J, Cassard-Doulcier A M, Bouillaud F, Ricquier D, Basdevant A, Guy-Grand B,
Froguel P.
Additive effect of A→G (-3826) variant of the uncoupling protein gene and the Trp64Arg
mutation of the β 3-adrenergic receptor gene on weight gain in morbid obesity.
Int J Obes Relat Metab Disord.
1996;
20
1062-1066
- 25
Valve R, Heikkinen S, Rissanen A, Laakso M, Uusitupa M.
Synergistic effect of polymorphisms in uncoupling protein 1 and β3- adrenergic receptor
genes on basal metabolic rate in obese Finns.
Diabetologia.
1998;
41
357-361
- 26
Kogure A, Yoshida T, Sakane N, Umekawa T, Takakura Y, Kondo M.
Synergic effect of polymorphisms in uncoupling protein 1 and β3-adrenergic receptor
genes on weight loss in obese Japanese.
Diabetologia.
1998;
41
1399
- 27
Fogelholm M, Valve R, Kukkonen-Harjula K, Nenonen A, Hakkarainen V, Laakso M, Uusitupa M.
Additive effects of the mutations in the β3-adrenergic receptor and uncoupling protein-1
genes on weight loss and weight maintenance in Finnish women.
J Clin Endocrinol Metab.
1998;
83
4246-4250
- 28
Schaffler A, Palitzsch K D, Watzlawek E, Drobnik W, Schwer H, Scholmerich J, Schmitz G.
Frequency and significance of the A→G (-3826) polymorphism in the promoter of the
gene for uncoupling protein-1 with regard to metabolic parameters and adipocyte transcription
factor binding in a large population-based Caucasian cohort.
Eur J Clin Invest.
1999;
29
770-779
- 29
Ukkola O, Rankinen T, Weisnagel S J, Sun G, Perusse L, Chagnon Y C, Despres J P, Bouchard C.
Interactions among the α2-, β2-, and β3-adrenergic receptor genes and obesity-related
phenotypes in the Quebec Family Study.
Metabolism.
2000;
49
1063-1070
- 30
Hamann A, Brieske C, Tafel J, Buttron P, Schwarzloh B, Munzberg H, Hinney A, Mayer H,
Siegfried W, Hebebrand J, Greten H, Algenstaedt P, Ziegler R.
Identification of a deletion variant in the gene encoding the human α2A-adrenergic
receptor.
Eur J Endocrinol.
2001;
144
291-295
- 31
Oppert J M, Tourville J, Chagnon M, Mauriege P, Dionne F T, Perusse L, Bouchard C.
DNA polymorphisms in the α 2- and β 2-adrenoceptor genes and regional fat distribution
in humans: association and linkage studies.
Obes Res.
1995;
3
249-255
- 32
Mentuccia D, Proietti-Pannunzi L, Tanner K, Bacci V, Pollin T I, Poehlman E T, Shuldiner A R,
Celi F S.
Association between a novel variant of the human type 2 deiodinase gene Thr92Ala and
insulin resistance: evidence of interaction with the Trp64Arg variant of the β-3-adrenergic
receptor.
Diabetes.
2002;
51
880-883
PD Dr. med. Andreas Hamann
Abteilung Innere Medizin I · Medizinische Klinik und Poliklinik · Universitätsklinikum
Heidelberg
Bergheimer Straße 58
69115 Heidelberg
Phone: 06221/568603
Fax: 06221/564036
Email: andreas_hamann@med.uni-heidelberg.de