Study of obesity associated proopiomelanocortin gene polymorphism: relation to metabolic profile and eating habits in a sample of obese Egyptian children and adolescents

Background: Melanocortinergic system represents a known system involved in the central regulation of body weight with the central proopiomelanocortin [POMC] neurons forming a potent anorexigenic network. Polymorphisms in the POMC gene locus are associated with obesity phenotypes

Aim: To assess the contribution of the POMC gene 9-bp insertional polymorphism in the susceptibility to obesity and its relation to body mass index [BMI] and adiposity-related co-morbidities in obese children and adolescents; as well as binge eating behavior

Patients and methods: Fifty obese children and adolescents with simple obesity were screened for Binge Eating Disorder [BED] by The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5], they were compared to 50 age, sex and pubertal stage-matched non obese controls. Anthropometric measurements, blood pressure, abdominal ultrasound for fatty liver, measurement of fasting lipid profile, fasting insulin, fasting blood glucose and assessment of POMC gene 9-bp insertional polymorphism were done

Results: Obese patients had significantly higher anthropometric measurements, blood pressure percentiles, fasting glucose, fasting insulin, homeostasis model assessment for insulin resistance [HOMA-IR] and fasting lipid profiles, and higher frequency of occurrence of non alcoholic fatty liver disease and BED. Allelic frequencies of POMC gene 9 bp insertional polymorphism were comparable in patients and controls [p= 0.956]. Fasting insulin levels were significantly higher in the heterozygous cases having the polymorphism than in wild homozygous cases; whereas no difference was observed among the controls

Conclusion: This polymorphism was associated with higher fasting insulin levels in the obese patients only. These findings support the hypothesis that the melanocortin pathway may modulate glucose metabolism in obese subjects indicating a possible gene-environment interaction. POMC variant may be involved in the natural history of polygenic obesity, contributing to the link between type 2 diabetes and obesity

Craniofacial proportions and anthropometric measurements among growth hormone deficient Egyptian children

Untreated children with growth hormone deficiency [GHD] have typical somatic features, including short stature, acromicria and distinctive craniofacial features including small head circumference. By using a cross sectional study design, we investigated the effect of GHD on craniofacial growth with photographic facial morphometrics and various anthropometric measurements, in 20 children with GHD compared with 20 healthy children and normal first degree relatives of the same age and sex group. Untreated children with GHD had retarded facial height and width [p<0.01] compared with the control group. Moreover all anthropometric measurements [weight, height, head circumference, sitting height, arm span and sub-ischial leg length] were reduced in GHD children in comparison to controls [p<0.01] except ear length which was above 3[rd] percentile. Also small head circumference for chronologic age and for height age was observed in GHD children [p<0.01]. In addition small hands and feet for age [below 3[rd] percentile] were found in untreated GHD children when compared with normal controls. This report validates and quantifies the clinical impression of foreshortened facies in GHD children