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Gene Variants for Obesity and Type 2 Diabetes – A Shared Aetiology?

Published Online: June 6th 2011 European Endocrinology, 2009; 5:27-30; DOI: http://doi.org/10.17925/EE.2009.05.00.27
Authors: Clara C Elbers, Timon W van Haeften, Marcel GM Wolfs
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Abstract
The incidence of type 2 diabetes is rising rapidly worldwide, mainly due to the increase in the incidence of obesity. Both obesity and type 2 diabetes are complex genetic traits, but they share some non-genetic risk factors. Hence, it is tempting to speculate that susceptibility to type 2 diabetes and obesity may also involve shared underlying genetic factors acting on common molecular mechanisms. Recent genome-wide association (GWA) studies identified 17 common loci for obesity and 19 common loci for type 2 diabetes. This article explores whether the susceptibility loci for type 2 diabetes and obesity can indicate potential overlapping mechanisms in the disorders. In addition, we touch on the challenges regarding follow-up of confirmed GWA signals, as well as alternative approaches to analysing GWA data to a fuller potential.

Keywords
Genetics, type 2 diabetes, diabetes genes, obesity genes, genome-wide association studies, complex genetic traits

Disclosure and Acknowledgements: This review was financially supported by SenterNovem (IOP genomics grant IGE05012). We thank Jackie Senior for critically reading the manuscript. The authors have no conflicts of interest to declare.
Received: 5 May 2009 Accepted: 22 June 2009
Correspondence: Clara C Elbers, Complex Genetics Section, Department of Medical Genetics – DBG, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Mailbox Str. 2.112, PO Box 85060, 3508 AB Utrecht, The Netherlands. E: c.c.elbers@umcutrecht.nl

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The incidence of type 2 diabetes is rising rapidly worldwide, and there are already more than 180 million diabetic subjects. Type 2 diabetes risk factors include ethnic background, age, hypertension, overweight, increased abdominal fat and lack of physical exercise. Obesity is considered to be the most important risk factor for type 2 diabetes and the main factor driving the current epidemic, as 90% of type 2 diabetes patients are obese.

The incidence of type 2 diabetes is rising rapidly worldwide, and there are already more than 180 million diabetic subjects. Type 2 diabetes risk factors include ethnic background, age, hypertension, overweight, increased abdominal fat and lack of physical exercise. Obesity is considered to be the most important risk factor for type 2 diabetes and the main factor driving the current epidemic, as 90% of type 2 diabetes patients are obese. Worldwide, obesity has also reached epidemic proportions, with 300 million adults classified as clinically obese (based on data from the World Health Organization). Up to 50% of these obese individuals will develop type 2 diabetes at some stage in their life, depending on the age at which they became obese.

Type 2 diabetes and obesity are multifactorial disorders in which both genetic and non-genetic (environmental and lifestyle) factors play a role. Although the lifetime risk for type 2 diabetes in the western world is around 10%, first-degree relatives of patients have a 20–40% risk of the disease, and concordance rates for identical twins have been estimated to be 57% or higher (up to 90%) for type 2 diabetes in male twins.1 These observations clearly indicate that there is a genetic component to the disease. However, the model seems to be more complex, involving multiple genes and environmental factors.

Common obesity and type 2 diabetes share some non-genetic factors, as both are influenced by diet and physical inactivity. Both conditions are characterised by insulin resistance, suggesting a shared pathology. It has been proposed that susceptibility to developing type 2 diabetes and obesity is, in part, due to shared underlying genetic factors involved in common molecular mechanisms. This article explores the genes recently identified for type 2 diabetes and obesity by genome-wide association studies (GWAS) and evaluates their functions in an effort to determine whether there is any support for the hypothesis that type 2 diabetes and obesity share some underlying mechanism(s).

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