[Individual social characteristics, municipal environment and the prevalence of weight problems in early childhood: a multilevel analysis]. / Caractéristiques sociales individuelles, contexte résidentiel et prévalence des problèmes de poids dans la petite enfance: une analyse multiniveau.

BACKGROUND: Few studies have examined the prevalence of weight problems before the age of 5 years although this period is critical in the development of obesity. An inverse association between socio-economic status and weight problems is well documented in adult women but not for young children. Similarly several studies of adults and adolescents or older children show that the prevalence of weight problems is associated with the level of deprivation of the neighbourhood environment and the degree of urbanization, independent of social individual factors, even though this has not been examined for young children. METHODS: We evaluated prevalence rates of weight problems in children aged 3.5-4.5 years in southeastern France and their association with both individual social factors and municipal environment characteristics. Random stratified cluster sampling allowed us to select 112 nursery schools. Physicians from the early childhood protective services conducted a mandatory medical examination and collected data with a new questionnaire (EVALMATER), developed to standardise these examinations. Overweight and obesity were defined by international references after calculation of each child's BMI (kg/m(2)). We constructed a social disadvantage index to assess characteristics of the municipalities where the nursery schools were located and used multilevel analysis to study the associations of municipal characteristics (the disadvantage index and a urban/rural classification of the municipalities) with weight problems independently of individual socio-economic variables. RESULTS: The study included 2495/2959 (84.3%) children, with a mean age of 3.9+/-0.3 years. The prevalence of overweight was 8.2% (CI95%=7.1-9.3) and that of obesity 2.1% (CI95%=1.5-2.7). Prevalence of obesity was significantly higher in girls, only children, those who had not attended day-care before nursery school, whose mother was not employed, or whose father was not a white-collar-worker. Independently of these variables, it was also significantly higher among children who lived in urban areas or deprived municipalities. None of these factors were found associated with overweight alone. CONCLUSION: Actions of prevention in France should target parents of young children.

Cytokines in genetic susceptibility to multiple sclerosis: a candidate gene approach. French Multiple Sclerosis Genetics Group.

The immune system is involved in the pathophysiology of multiple sclerosis (MS) but the initiating antigen(s) is not yet identified. Since cytokines control both the intensity and the quality of the immune response they may be relevant candidates for the genetic susceptibility to MS. To analyze the contribution of type 1 and type 2 cytokine and cytokine receptor genes in the genetic susceptibility to MS, we have examined, in 116 French MS sibpairs, whether there is significant linkage between MS and 15 cytokine or cytokine receptor genes using 31 highly polymorphic genetic markers. The data were analyzed using the maximum likelihood score and the transmission disequilibrium approaches. None of the candidate genes tested was significantly linked to MS on the whole population. However, after stratification of the analysis on the basis of sharing (or not) of the HLA-DRB1*1501 allele, indication of linkage was found for the IL2-RB gene. These findings suggest that the IL2-RB locus contributes to the genetic susceptibility in a subgroup of MS patients.

Genetic analysis of a complex disease in the presence of an environmental risk factor.

The role of a gene in a disease may be hidden by the presence of another risk factor such as an environmental factor. In that case, stratifying the data according to this factor strengthens power to detect linkage or association. We followed this strategy on the simulated data provided by GAW11. The transmission/disequilibrium test (TDT) and the maximum likelihood score (MLS) were performed on the first replicate of 100 sib pairs from the population in which the disease risk was significantly influenced by an environmental factor (E1). However, only the TDT was powerful enough to detect one of the four loci involved in the genetic determination of the disease. The MLS showed no evidence for linkage after taking into account the fact that multiple tests were performed. Even when stratifying the sample according to the presence of E1, no additional loci could be detected. Given the simulated models, 100 sib pairs are too low a sample size for a systematic screening of the genome, which in this case was an analysis of 300 markers.

Chromosome 17q22-q24 and multiple sclerosis genetic susceptibility. American-French Multiple Sclerosis Genetic Group.

Recently, genome-wide searches for multiple sclerosis (MS) susceptibility genes have suggested that the chromosome 17q22-q24 region might contain susceptibility genes in two sets of families of different ethnic backgrounds (Finnish and British). Therefore, we decided to test this region in two sets of families of different ethnic backgrounds (American and French), but collected according to the same diagnostic criteria. All lod-score values were non-significant. Moreover, we could exclude that the 17q22-24 region might contain a gene increasing the sibling recurrence risk of MS over 1.4, rendering the existence of such a gene very unlikely, at least in the group of tested families.

A systematic study of oligodendrocyte growth factors as candidates for genetic susceptibility to MS. French Multiple Sclerosis Genetics Group.

OBJECTIVE: To test 23 genes coding for growth factors and their receptors as candidates for MS genetic susceptibility in 84 multiplex families of French origin by linkage analysis. BACKGROUND: Epidemiologic studies have indicated that genetic susceptibility in MS exists. To identify MS susceptibility genes, association and linkage studies were performed with candidate genes suggested by the pathology of MS. The most consistent result was genetic association and linkage of MS to human leukocyte antigen (HLA) DR15. Recent advances in the knowledge of MS pathology have suggested that the oligodendrocyte, the myelin-forming cell in the CNS, and its growth factors might play a crucial role in MS. METHODS: Fifty-two polymorphic markers within or flanking 23 candidate genes were used. Data were analyzed with the maximum likelihood score (MLS) approach. We also searched for a genetic interaction with HLA. RESULTS: Negative results were obtained for all candidate genes. The lower limits of the relative risk (Xs) possibly excluded for any candidate gene ranged from 1.3 to 2.8. Positive MLS values (up to 0.93) were observed for transforming growth factor beta 3 (TGFbeta3) in HLA DR15-associated families, suggesting a possible role for this growth factor in interaction with HLA. CONCLUSIONS: Oligodendrocyte growth factors do not play a significant role in MS genetic susceptibility, at least in the tested sample. TGFbeta3, the only gene highlighted by this study, deserves further analysis.

Heterogeneity of marker allele frequencies hinders interpretation of linkage analysis: illustration on chromosome 18 markers.

In the first part of our study we tested linkage with chromosome 18 markers in a sample of bipolar I sib pairs. We did not obtain evidence for linkage but showed that we could not exclude the presence of a disease locus (having even a non-negligible effect). The limitation of the sib-pair sample size, and consequently of the conclusions, was a result of our care in assuring that the linkage analysis was free of possible errors in the marker allele frequencies. In the second part, we illustrated the possible impact of such heterogeneity in a single data set when applying the multipoint (APM) method. An Amish pedigree included in the study of Berrettini et al. was analyzed under two sets of marker allele frequencies. One set corresponds to estimates from the entire data set and the second to estimates from the Amish pedigree only. Very different values for the APM statistics were obtained. Although the real frequencies are unknown for this family belonging to an isolated population, this example illustrates that heterogeneity in the populations from which familial data are collected may artificially increase evidence for linkage and hinder interpretation of the analysis.

Caution in the interpretation of MLS.

We study the statistical properties of the maximum likelihood score (MLS) test. We show that the criteria for reaching conclusions about linkage are not the same for single point analysis as for multipoint, where the maximization is performed over an additional parameter, the position in the marker interval where the MLS is computed. In addition, this test is shown to be very sensitive to errors in allele frequencies and recombination fraction.