Evidence for an influence of TCF7L2 polymorphism rs7903146 on insulin resistance and sensitivity indices in overweight children and adolescents during a lifestyle intervention

Reinehr, Thomas; Friedel, Susann; Mueller, T.; Toschke, André Michael

doi:10.1038/ijo.2008.146

Cited by 31 publications

(32 citation statements)

References 22 publications

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“…In our study population, the T-allele at rs7903146 in TCF7L2 was associated with a significant negative dosage effect per allele on the improvement of insulin resistance and sensitivity indices such as HOMA-IR and QUICKI after the lifestyle intervention, independently of degree of weight loss, age and gender (68) .…”

Section: Genetic Backgroundmentioning

confidence: 70%

Effectiveness of lifestyle intervention in overweight children

Reinehr

2011

Proc. Nutr. Soc.

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Therapy of choice in obese children and adolescents is lifestyle intervention based on nutrition education, behavioural treatment and exercise treatment. Its efficacy even after the end of intervention has been proven by several randomised-controlled trials and meta-analyses including a recent Cochrane review. However, randomised-controlled trials are likely to overestimate the effectiveness. Studies under normal day-to-day circumstances demonstrated only a very moderate effect on weight loss (<10% success rate 2 years after the onset of intervention). A reduction of >0·5 SDS-BMI (which means a stable weight over 1 year in growing children) is associated with an improvement of cardiovascular risk factors, while improvements of quality of life seem independent of the degree of weight loss. Younger children and less overweight children particularly profit from lifestyle interventions in contrast to extremely obese adolescents. Recent studies demonstrated that involving parents is crucial for success, suggesting that parents and children and not children alone should be the primary target of interventions. Failures in weight reduction are attributed not only to a lack of motivation but also to other aspects particular to the genetic background. The techniques, more than the contents, of an intervention influence the treatment outcome. Besides behavioural therapy, systemic and solution-focused treatments are important. Future longitudinal research should focus on the identification of which children and adolescents profit from which kind of intervention, in order to be able to tailor specific treatment approaches. Studies under normal day-to-day circumstances are necessary to prove the benefit of this kind of intervention.

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Section: Genetic Backgroundmentioning

confidence: 70%

Effectiveness of lifestyle intervention in overweight children

Reinehr

2011

Proc. Nutr. Soc.

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“…13,37 Obesity-related genes having a role in childhood overweight populations have been also identified, such as FTO, 38 MC4R 39 or TCF7L2. 40 Therefore, genetically increased susceptibility to different obesity risk factors in overweight children might explain the higher increase in BMI in overweight children exposed to these risk factors. For instance, a recent study showed that overweight children with a specific MC4R variant were not able to maintain their weight loss achieved during a lifestyle intervention, in contrast to children without these mutations.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for childhood overweight: shift of the mean body mass index and shift of the upper percentiles: results from a cross-sectional study

2010

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Background:The worldwide increasing prevalence of childhood overweight seems to be due to an increasing proportion of extremely high body mass index (BMI) values rather than to a shift of the entire BMI distribution. These findings might be attributed to incremental exposure to risk factors particularly affecting overweight children. Objective: To assess the possible differences in associations of several risk factors by subgroups of children's BMI distribution. Methods: We applied quantile regression to cross-sectional data on 9698 German preschoolers (5-6 years) collected in 1999 and 2002. Sex-and age-specific BMI standard deviation scores (BMI-SDSs) were used as the outcome variable, and maternal BMI, maternal smoking during pregnancy, exclusive formula feeding, child's weight gain from birth to 2 years of life and low parental education as explanatory variables. Results: All risk factors except formula feeding contributed to a positive shift in mean BMI-SDS. The estimated effects of all risk factors on BMI-SDS were greatest for children with the highest BMI-SDS value. For example, high television (TV) viewing (42 h day À1 ) had an effect of 0.46 (95% confidence interval (CI): 0.46, 0.46) SDS units on overweight children (90th percentile), but only a 0.22 (95% CI: 0.11, 0.33) SDS effect on normal-weight children (50th percentile). Conclusions: For well-known risk factors of childhood overweight, stronger associations in children with higher BMI values were observed. These findings might possibly help to explain the secular shift in the upper BMI percentiles in children.

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“…The effect of the risk-conferring TT genotype was mitigated by behavioral interventions (4,5). Other intervention studies have shown that this genotype has a negative effect on the improvement of insulin resistance and sensitivity after weight reduction in children and adolescents (7). Diets rich in whole grains (8) and dietary weight-loss programs (9) can decrease TCF7L2 expression in subcutaneous adipose tissue, which suggests that nutrients may be involved in the expression of this gene.…”

Section: Introductionmentioning

confidence: 96%