RESUMO
Obesity is a global epidemic that results in significant morbidity and mortality. Mutations in the melanocortin 4 receptor (MC4R) gene, which codes for a G-protein-coupled receptor responsible for postprandial satiety signaling, have been associated with monogenic obesity. The prevalence of obesity is on the increase in South Africa, and it is hypothesized that mutations in MC4R are a contributing factor. The aim of this study was to perform a retrospective assessment of the relationship between allelic variants of MC4R and BMI in a South African study cohort. DNA was isolated from a demographically representative cohort of 297 individuals and the entire MC4R gene sequenced by Sanger sequencing. Eight previously reported MC4R variants were identified in 42 of the 297 (14.1%) study participants. The most frequently observed MC4R alleles were V103I (4.0%), I170V (1.5%), and I198I (1.2%), while the remaining five variants together constituted 1.18%. Five compound heterozygotes were also detected. Although MC4R variants were rare, the majority of variation was observed in individuals of Black African ancestry. No statistically significant associations with BMI were reported. Given that lifestyle interventions have limited success in decreasing obesity, there is an urgent need to perform large-scale population studies to further elucidate the molecular underpinnings of this disease.
RESUMO
OBJECTIVE: Lower lipid and insulin levels are found during a glucose-tolerance test in obese black than obese white South African women. Therefore, beta-cell function and lipid metabolism were compared in these populations during a mixed meal. RESEARCH METHODS AND PROCEDURES: Blood concentrations of glucose, free fatty acids (FFAs), insulin, lipograms, and in vivo FFA oxidation were determined at fasting and for 7 hours after oral administration of a mixed emulsion containing glucose-casein-sucrose-lipid and [1-(13)C] palmitic acid in 8 lean black women (LBW), 10 obese black women (OBW), 9 lean white women (LWW), and 10 obese white women (OWW). Subcutaneous and visceral fat mass was assessed by computerized tomography. RESULTS: Visceral fat area was higher in OWW (152.7 +/- 17.0 cm(2)) than OBW (80.0 +/- 6.7 cm(2); p < 0.01). In OBW, 30-minute insulin levels were higher (604.3 +/- 117.6 pM) than OWW (311.0 +/- 42.9 pM; p < 0.05). Total triglyceride was higher in OWW (706.7 +/- 96.0 mM x 7 hours) than OBW (465.7 +/- 48.2 mM x 7 hours; p < 0.05) and correlated with visceral fat area (beta = 0.38, p = 0.05). Palmitate oxidation was higher in lean than obese women in both ethnic groups and correlated negatively with fat mass (beta = -0.58, p < 0.005). DISCUSSION: The higher 30-minute insulin response in OBW may reflect a higher insulinotropic effect of FFAs or glucose. The elevated triglyceride level of OWW may be due to their higher visceral fat mass and possibly reduced clearance by adipose tissue.
