Association of leptin receptor gene polymorphisms and meta-inflammation markers with metabolically unhealthy obesity in children
DOI:
https://doi.org/10.14739/2310-1210.2021.5.227291Keywords:
leptin receptor gene, polymorphism, interleukin-6, meta-inflammation, obesity, childrenAbstract
The aim: to study the contribution of single-nucleotide polymorphisms (SNP) of the leptin receptor (LEPR) gene and meta-inflammation markers to the formation of metabolically unhealthy obesity (MUO) in children.
Materials and methods. A total of 109 obese children aged 6–18 years were examined. Based on the recommendations of the National Heart, Lung, and Blood Institute (NHLBI), 2 observation groups were formed. The main group (n = 56) was represented by patients with MUO. The control group (n = 53) comprised children with metabolically healthy obesity (MHO). Serum levels of interleukin-1β (IL-1β) were measured using a chemiluminescent immunoassay (CLIA) method, interleukin-6, leptin, adiponectin – by enzyme-linked immunosorbent assay (ELISA) and the serum level of C-reactive protein were quantified by latex turbidimetric method (Synevo, Ukraine). The method of next-generation sequencing (NGS) (CeXGat, Germany) was used to identify LEPR SNP. Statistical methods were used: analysis of variance, Spearman’s correlation analysis and multiple discriminant analysis.
Results. In obese children aged 6 to 18 years, there was an increase in pro-inflammatory adipokines IL-6 and leptin and a decrease in anti-inflammatory adiponectin. Statistically significant changes in these indicators were more expressed in the main group: IL-6 – 7.4 ± 0.5 pg/ml (ρ = 0.65; P ≤ 0.001); adiponectin – 3.9 ± 0.8 μg/ml (ρ = -0.27; P = 0.007) among all the children examined, leptin in girls – 47.8 ± 4.4 ng/ml (ρ = -0.28; P = 0.003) compared with the results of patients in the control group: IL-6 – 4.3 ± 0.3 pg/ml, adiponectin – 7.7 ± 2.4 μg/ml, leptin in girls – 32.5 ± 4.3 ng/ml, P ≤ 0.05. The most important in the development of MUO were the following SNP of the LEPR gene: rs3790435 (CiMUO = 0.939), rs2186248 (CiMUO = 0.862), P < 0.05. A strong correlation was found between MUO and serum IL-6 level (ρ = 0.7), LEPR SNP rs3790435 (ρ = 0.7), basal hyperinsulinemia (ρ = 0.72); Р ≤ 0.001. The risk of IL-6-dependent meta-inflammation in the presence of SNP rs3790435 of the LEPR gene: OR = 17.11; 95 % CI 2.8–20.4.
Conclusions. Meta-inflammation in MUO is IL-6-dependent. Among the 10 SNPs of the LEPR gene that we identified, SNP rs3790435 of the LEPR gene has a strong association with the formation of MUO. SNP rs2186248 LEPR was described by us for the first time when it was found in 94.1 % of obese children, but it was characterized by the presence of a weak association with MUO.
References
- Lobstein, T., & Brinsden, H. (2019). Atlas of Childhood Obesity. World Obesity Federation. https://data.worldobesity.org/publications/11996-Childhood-Obesity-Atlas-Report-ART-V2.pdf
- Genovesi, S., Antolini, L., Orlando, A., Gilardini, L., Bertoli, S., Giussani, M., Invitti, C., Nava, E., Battaglino, M. G., Leone, A., Valsecchi, M. G., & Parati, G. (2020). Cardiovascular Risk Factors Associated With the Metabolically Healthy Obese (MHO) Phenotype Compared to the Metabolically Unhealthy Obese (MUO) Phenotype in Children. Frontiers in Endocrinology, 11, Article 27. https://doi.org/10.3389/fendo.2020.00027
- Magge, S. N., Goodman, E., Armstrong, S. C., COMMITTEE ON NUTRITION, SECTION ON ENDOCRINOLOGY, & SECTION ON OBESITY. (2017). The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering. Pediatrics, 140(2), Article e20171603. https://doi.org/10.1542/peds.2017-1603
- Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, & National Heart, Lung, and Blood Institute. (2011). Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report. Pediatrics, 128(Suppl 5), S213-S256. https://doi.org/10.1542/peds.2009-2107C
- Abaturov, A., & Nikulina, A. (2019). Genotype C/C 13910 of the Lactase Gene as a Risk Factor for the Formation of Insulin-Resistant Obesity in Children. Acta Medica, 62(4), 150-155. https://doi.org/10.14712/18059694.2020.4
- Elkins, C., Fruh, S., Jones, L., & Bydalek, K. (2019). Clinical Practice Recommendations for Pediatric Dyslipidemia. Journal of Pediatric Health Care, 33(4), 494-504. https://doi.org/10.1016/j.pedhc.2019.02.009
- Vukovic, R., Dos Santos, T. J., Ybarra, M., & Atar, M. (2019). Children With Metabolically Healthy Obesity: A Review. Frontiers in Endocrinology, 10, Article 865. https://doi.org/10.3389/fendo.2019.00865
- Tsatsoulis, A., & Paschou, S. A. (2020). Metabolically Healthy Obesity: Criteria, Epidemiology, Controversies, and Consequences. Current Obesity Reports, 9(2), 109-120. https://doi.org/10.1007/s13679-020-00375-0
- Nunziata, A., Funcke, J. B., Borck, G., von Schnurbein, J., Brandt, S., Lennerz, B., Moepps, B., Gierschik, P., Fischer-Posovszky, P., & Wabitsch, M. (2018). Functional and Phenotypic Characteristics of Human Leptin Receptor Mutations. Journal of the Endocrine Society, 3(1), 27-41. https://doi.org/10.1210/js.2018-00123
- Voigtmann, F., Wolf, P., Landgraf, K., Stein, R., Kratzsch, J., Schmitz, S., Abou Jamra, R., Blüher, M., Meiler, J., Beck-Sickinger, A. G., Kiess, W., & Körner, A. (2021). Identification of a novel leptin receptor (LEPR) variant and proof of functional relevance directing treatment decisions in patients with morbid obesity. Metabolism, 116, Article 154438. https://doi.org/10.1016/j.metabol.2020.154438
- Li, J., Yang, S., Jiao, X., Yang, Y., Sun, H., Zhang, M., Yang, Y., Qin, Y., & Wei, Y. (2019). Targeted Sequencing Analysis of the Leptin Receptor Gene Identifies Variants Associated with Obstructive Sleep Apnoea in Chinese Han Population. Lung, 197(5), 577-584. https://doi.org/10.1007/s00408-019-00254-z
- Rojano-Rodriguez, M. E., Beristain-Hernandez, J. L., Zavaleta-Villa, B., Maravilla, P., Romero-Valdovinos, M., & Olivo-Diaz, A. (2016). Leptin receptor gene polymorphisms and morbid obesity in Mexican patients. Hereditas, 153, Article 2. https://doi.org/10.1186/s41065-016-0006-0
- Manriquez, V., Aviles, J., Salazar, L., Saavedra, N., Seron, P., Lanas, F., Fajardo, C. M., Hirata, M. H., Hirata, R., & Cerda, A. (2018). Polymorphisms in Genes Involved in the Leptin-Melanocortin Pathway are Associated with Obesity-Related Cardiometabolic Alterations in a Southern Chilean Population. Molecular Diagnosis & Therapy, 22(1), 101-113. https://doi.org/10.1007/s40291-017-0306-8
- Wu, J., Zhuo, Q., Tian, Y., Piao, J., & Yang, X. (2017). [Relationship of diabetes mellitus in older Han adults in China with leptin receptor gene rs1137100 and rs1137101 polymorphrism]. Wei sheng yan jiu, 46(3), 384-388.
- Almeida, S. M., Furtado, J. M., Mascarenhas, P., Ferraz, M. E., Ferreira, J. C., Monteiro, M. P., Vilanova, M., & Ferraz, F. P. (2018). Association between LEPR, FTO, MC4R, and PPARG-2 polymorphisms with obesity traits and metabolic phenotypes in school-aged children. Endocrine, 60(3), 466-478. https://doi.org/10.1007/s12020-018-1587-3
- Almandil, N. B., Lodhi, R. J., Ren, H., Besag, F., Rossolatos, D., Ohlsen, R., Slomp, C., Lapetina, D. L., Plazzotta, G., Murray, M. L., Al-Sulaiman, A. A., Gringras, P., Wong, I., & Aitchison, K. J. (2018). Associations between the LEP -2548G/A Promoter and Baseline Weight and between LEPR Gln223Arg and Lys656Asn Variants and Change in BMI z Scores in Arab Children and Adolescents Treated with Risperidone. Molecular Neuropsychiatry, 4(2), 111-117. https://doi.org/10.1159/000490463
- Ren, D., Xu, J. H., Bi, Y., Zhang, Z., Zhang, R., Li, Y., Hu, J., Guo, Z., Niu, W., Yang, F., Li, W., Xu, Y., He, L., Yu, T., Wu, J., Li, X., Du, J., & He, G. (2019). Association study between LEPR, MC4R polymorphisms and overweight/obesity in Chinese Han adolescents. Gene, 692, 54-59. https://doi.org/10.1016/j.gene.2018.12.073
- Fairbrother, U., Kidd, E., Malagamuwa, T., & Walley, A. (2018). Genetics of Severe Obesity. Current Diabetes Reports, 18(10), Article 85. https://doi.org/10.1007/s11892-018-1053-x
- Dos Santos Rocha, A., de Cássia Ribeiro-Silva, R., Nunes de Oliveira Costa, G., Alexandrina Figueiredo, C., Cunha Rodrigues, L., Maria Alvim Matos, S., Leovigildo Fiaccone, R., Oliveira, P. R., Alves-Santos, N. H., Blanton, R. E., & Lima Barreto, M. (2018). Food Consumption as a Modifier of the Association between LEPR Gene Variants and Excess Body Weight in Children and Adolescents: A Study of the SCAALA Cohort. Nutrients, 10(8), Article 1117. https://doi.org/10.3390/nu10081117
- Furusawa, T., Naka, I., Yamauchi, T., Natsuhara, K., Kimura, R., Nakazawa, M., Ishida, T., Inaoka, T., Matsumura, Y., Ataka, Y., Nishida, N., Tsuchiya, N., Ohtsuka, R., & Ohashi, J. (2010). The Q223R polymorphism in LEPR is associated with obesity in Pacific Islanders. Human Genetics, 127(3), 287-294. https://doi.org/10.1007/s00439-009-0768-9
- Abaturov, A., & Nikulina, A. (2021). The Role of Leptin Receptor Gene Polymorphism in the Formation of Insulin Resistance in Children. Metabolism, 116, Article 154672. https://doi.org/10.1016/j.metabol.2020.154672
- WHO Multicentre Growth Reference Study Group. (2006). WHO Child Growth Standards based on length/height, weight and age. Acta Paediatrica, 95(S450), 76-85. https://doi.org/10.1111/j.1651-2227.2006.tb02378.x
- American Diabetes Association. (2019). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care, 42(Suppl. 1), S13-S28. https://doi.org/10.2337/dc19-S002
- Alberti, K. G., Zimmet, P., & Shaw, J. (2007). International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabetic Medicine, 24(5), 451-463. https://doi.org/10.1111/j.1464-5491.2007.02157.x
- Weihe, P., & Weihrauch-Blüher, S. (2019). Metabolic Syndrome in Children and Adolescents: Diagnostic Criteria, Therapeutic Options and Perspectives. Current Obesity Reports, 8(4), 472-479. https://doi.org/10.1007/s13679-019-00357-x
- Ranasinghe, P., Jayawardena, R., Gamage, N., Pujitha Wickramasinghe, V., & Hills, A. P. (2021). The range of non-traditional anthropometric parameters to define obesity and obesity-related disease in children: a systematic review. European Journal of Clinical Nutrition, 75(2), 373-384. https://doi.org/10.1038/s41430-020-00715-2
- Peplies, J., Jiménez-Pavón, D., Savva, S. C., Buck, C., Günther, K., Fraterman, A., Russo, P., Iacoviello, L., Veidebaum, T., Tornaritis, M., De Henauw, S., Mårild, S., Molnár, D., Moreno, L. A., Ahrens, W., & IDEFICS consortium. (2014). Percentiles of fasting serum insulin, glucose, HbA1c and HOMA-IR in pre-pubertal normal weight European children from the IDEFICS cohort. International Journal of Obesity, 38(Suppl. 2), S39-S47. https://doi.org/10.1038/ijo.2014.134
- Haugaard, L. K., Baker, J. L., Perng, W., Belfort, M. B., Rifas-Shiman, S. L., Switkowski, K., Oken, E., & Gillman, M. W. (2016). Growth in Total Height and Its Components and Cardiometabolic Health in Childhood. PLOS ONE, 11(9), Article e0163564. https://doi.org/10.1371/journal.pone.0163564
- ACMG Board of Directors. (2015). Clinical utility of genetic and genomic services: a position statement of the American College of Medical Genetics and Genomics. Genetics in Medicine, 17(6), 505-507. https://doi.org/10.1038/gim.2015.41
- Jiang, H., Lei, R., Ding, S. W., & Zhu, S. (2014). Skewer: a fast and accurate adapter trimmer for next-generation sequencing paired-end reads. BMC Bioinformatics, 15, Article 182. https://doi.org/10.1186/1471-2105-15-182
- Li, H., & Durbin, R. (2009). Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics, 25(14), 1754-1760. https://doi.org/10.1093/bioinformatics/btp324
- Mose, L. E., Wilkerson, M. D., Hayes, D. N., Perou, C. M., & Parker, J. S. (2014). ABRA: improved coding indel detection via assembly-based realignment. Bioinformatics, 30(19), 2813-2815. https://doi.org/10.1093/bioinformatics/btu376
- Wingett, S. W., & Andrews, S. (2018). FastQ Screen: A tool for multi-genome mapping and quality control [version 2; peer review: 4 approved]. F1000Research, 7, Article 1338. https://doi.org/10.12688/f1000research.15931.2
- Wickham, H. (2009). Manipulating data. In ggplot2 (pp. 157-175). Springer. https://doi.org/10.1007/978-0- 387-98141-3_9
- R-Project. (n.d.). The R Project for Statistical Computing. https://www.r-project.org/
- Rentzsch, P., Witten, D., Cooper, G. M., Shendure, J., & Kircher, M. (2019). CADD: predicting the deleteriousness of variants throughout the human genome. Nucleic Acids Research, 47(D1), D886-D894. https://doi.org/10.1093/nar/gky1016
- Vigeland, M. D., Gjotterud, K. S., & Selmer, K. K. (2016). FILTUS: a desktop GUI for fast and efficient detection of disease-causing variants, including a novel autozygosity detector. Bioinformatics, 32(10), 1592-1594. https://doi.org/10.1093/bioinformatics/btw046
- Hu, Z., Fu, Y., Halees, A. S., Kielbasa, S. M., & Weng, Z. (2004). SeqVISTA: a new module of integrated computational tools for studying transcriptional regulation. Nucleic Acids Research, 32(Suppl. 2), W235-W241. https://doi.org/10.1093/nar/gkh483
- Liu, X., Wu, C., Li, C., & Boerwinkle, E. (2016). dbNSFP v3.0: A One-Stop Database of Functional Predictions and Annotations for Human Nonsynonymous and Splice-Site SNVs. Human Mutation, 37(3), 235-241. https://doi.org/10.1002/humu.22932
- Ambroszkiewicz, J., Klemarczyk, W., Gajewska, J., Chełchowska, M., Rowicka, G., Ołtarzewski, M., & Laskowska-Klita, T. (2011). Serum concentration of adipocytokines in prepubertal vegetarian and omnivorous children. Medycyna wieku rozwojowego, 15(3), 326-334.
- Han, M. S., White, A., Perry, R. J., Camporez, J. P., Hidalgo, J., Shulman, G. I., & Davis, R. J. (2020). Regulation of adipose tissue inflammation by interleukin 6. Proceedings of the National Academy of Sciences of the United States of America, 117(6), 2751-2760. https://doi.org/10.1073/pnas.1920004117
- Wueest, S., & Konrad, D. (2018). The role of adipocyte-specific IL-6-type cytokine signaling in FFA and leptin release. Adipocyte, 7(3), 226-228. https://doi.org/10.1080/21623945.2018.1493901
- Lehrskov, L. L., & Christensen, R. H. (2019). The role of interleukin-6 in glucose homeostasis and lipid metabolism. Seminars in Immunopathology, 41(4), 491-499. https://doi.org/10.1007/s00281-019-00747-2
- Pîrsean, C., Neguț, C., Stefan-van Staden, R. I., Dinu-Pirvu, C. E., Armean, P., & Udeanu, D. I. (2019). The salivary levels of leptin and interleukin-6 as potential inflammatory markers in children obesity. PLOS ONE, 14(1), Article e0210288. https://doi.org/10.1371/journal.pone.0210288
- Zhang, Y., Li, C., Zhang, W., Zheng, X., & Chen, X. (2020). Decreased Insulin Resistance by Myo-Inositol Is Associated with Suppressed Interleukin 6/Phospho-STAT3 Signaling in a Rat Polycystic Ovary Syndrome Model. Journal of Medicinal Food, 23(4), 375-387. https://doi.org/10.1089/jmf.2019.4580
- Kimura, A., & Kishimoto, T. (2010). IL-6: regulator of Treg/Th17 balance. European Journal of Immunology, 40(7), 1830-1835. https://doi.org/10.1002/eji.201040391
- El-Alameey, I. R., Fadl, N. N., Hameed, E. R., Sherif, L. S., & Ahmed, H. H. (2015). Clinical Relevance of Transforming Growth Factor-β1, Interleukin-6 and Haptoglobin for Prediction of Obesity Complications in Prepubertal Egyptian Children. Open Access Macedonian Journal of Medical Sciences, 3(1), 105-110. https://doi.org/10.3889/oamjms.2015.017
- Li, J., Yang, S., Jiao, X., Yang, Y., Sun, H., Zhang, M., Yang, Y., Qin, Y., & Wei, Y. (2019). Targeted Sequencing Analysis of the Leptin Receptor Gene Identifies Variants Associated with Obstructive Sleep Apnoea in Chinese Han Population. Lung, 197(5), 577-584. https://doi.org/10.1007/s00408-019-00254-z
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 



