Polikistik over sendromlu hastalarda enerji kısıtlı diyetin FTO ve MC4R gen polimorfizmi ile ilişkisi

Year 2024, Volume: 49 Issue: 3, 580 - 591, 30.09.2024

Ayçıl Özturan Şirin , Yasemin Akdevelioğlu

https://doi.org/10.17826/cumj.1447513

Abstract

Amaç: PKOS'lu aşırı kilolu/obez hastalarda enerji-kısıtlanmış diyetin vücut kompozisyonu ve biyokimyasal parametreler üzerine etkisinin MC4R rs17782313 ve FTO rs9939609 polimorfizmi olan gruplarda, gen polimorfizmi olmayanlardan farklı olup olmadığını belirlemek amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya 18-45 yaş arası (30.4±8.66 yıl) toplam 48 kadın alınmıştır. Hastalara 8 haftalık diyet müdahalesi uygulanmış ve çalışma öncesi ve sonrasında hastaların antropometrik ölçümleri, biyokimyasal parametreleri ve besin tüketimleri belirlenmiştir. Ayrıca FTO geni rs9939609 ve MC4R geni rs17782313 polimorfizmleri saptanmıştır.
Bulgular: FTO ve MC4R gen polimorfizmi insidansı sırasıyla %72.9 ve %68.8 olarak bulunmuştur. Bel/boy oranındaki değişim, FTO gen polimorfizmi olmayan grupta (-0,03±0,015 cm), gen polimorfizmi olan gruba (-0,02 ±0,016 cm) göre daha yüksektir. Antropometrik ölçümlerdeki değişim (Δ) açısından MC4R gen polimorfizmi olan ve olmayan gruplar arasında istatistiksel olarak anlamlı fark yoktur. İstatistiksel olarak anlamlı olmamakla birlikte MC4R gen polimorfizmi olmayan grupta, olan gruba göre vücut ağırlığı (kg) ve BKİ'de (kg/m2) daha fazla azalma vardır (polimorfizm olmayan gruptaki değişimler -2.2±1.83 kg; -0.9±0.69 kg/m2). Gen polimorfizmi olan ve olmayan gruplar arasında biyokimyasal parametreler açısından istatistiksel olarak anlamlı fark bulunmamıştır.
Sonuç: FTO ve MC4R gen polimorfizmi gruplarında enerji kısıtlamalı zayıflama diyetinin biyokimyasal parametrelerde istatistiksel olarak anlamlı bir değişiklik oluşturmadığı, ancak gen polimorfizmi varlığının antropometrik ölçümlerde iyileşmeyi zorlaştırdığı görülmüştür.

Keywords

Polikistik Over Sendromu, Obezite, Polimorfizm, Genetik

Ethical Statement

Bu çalışma için; Aydın Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dekanlığı Etik Kurulu’nun 9.1.2019 tarihli ve 92340882-050.04.04 sayılı Kurul Onayı alınmıştır.

The relationship of energy-restricted diet with FTO and MC4R gene polymorphism in patients with polycystic ovary syndrome

Abstract

Purpose: The aim of this study was to determine whether the effects of an energy-restricted diet on overweight/obese patients with PCOS on body composition and biochemical parameters in groups with MC4R rs17782313 and FTO rs9939609 polymorphisms differ from those without gene polymorphism.
Materials and Methods: A total of 48 women aged 18-45 were accepted. An 8-week diet intervention was applied, and anthropometric measurements, biochemical parameters and food consumption of the patients were determined before and after the intervention. In addition, FTO gene rs9939609 and MC4R gene rs17782313 polymorphisms were determined.
Results: The incidence of FTO and MC4R gene polymorphism was 72.9% and 68.8% respectively. Change in waist/height ratio was found to be higher in the group without FTO gene polymorphism (-0.03±0.015 cm) compared to the group with gene polymorphism (-0.02 ±0.016 cm). There was no statistically significant difference between the groups with and without MC4R gene polymorphism in terms of change (Δ) in anthropometric measurements. Although not statistically significant, there was a greater decrease in body weight (kg) and BMI (kg/m2) in the group without MC4R gene polymorphism compared to the group with it (without polymorphism group -2.2±1.83 kg; -0.9±0.69 kg/m2). There was no statistically significant difference between the groups with and without gene polymorphism in terms of biochemical parameters.
Conclusion: We found that the energy-restricted weight loss diet did not detect a statistically significant change in biochemical parameters in the FTO and MC4R gene polymorphism groups, but the presence of gene polymorphism made it difficult to improve in anthropometric measurements.

Keywords

polycystic ovary syndrome, obesity, polymorphism, genetic

References

• Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol. 2014;6:1-13.
• Yıldız BO, Bozdağ G, Yapıcı Z, Esinler I, Yaralı H. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod. 2012;27:3067-73.
• Aydos A, Öztemur Y, Bala G. Polycystic ovary syndrome and molecular approaches. Turk Hij Den Biyol Derg. 2016;73:81-8.
• Dai HJ, Wu JCY, Tsai RTH, Pan WH, Hsu WL. T-HOD: a literature-based candidate gene database for hypertension, obesity and diabetes. Database (Oxford). 2013;2013:bas061.
• Castro GV, Latorre AFS, Korndorfer FP, de Carlos Back LK, Lofgren SE. The impact of variants in four genes: MC4R, FTO, PPARG and PPARGC1A in overweight and obesity in a large sample of the Brazilian population. Biochem Genet. 2021;59:1666-79.
• Takahashi I, Ohseto H, Ueno F, Onuma T, Narita A, Obara T et al. Genome genome-wide association study based on clustering by obesity-related variables shed light on a genetic architecture of obesity in the Japanese and UK population. medRxiv, 2023;doi: 10.1101/2023.03.06.23286876.
• Batarfi AA, Filimban N, Bajouh OS, Dallol A, Chaudhary AG, Bakhashab S. MC4R variants rs12970134 and rs17782313 are associated with obese polycystic ovary syndrome patients in the Western region of Saudi Arabia. BMC Med Genet. 2019;20:144.
• Almawi WY, Nemr R, Atazhanova T, Malalla ZH, Sarray S, Mustafa FE et al. Differential association of FTO gene variants and haplotypes with the susceptibility to polycystic ovary syndrome according to obesity in women with PCOS. Reprod Sci. 2023;30:2166-76.
• Branavan U, Muneeswaran K, Wijesundera S, Jayakody S, Chandrasekharan V, Wijeyaratne C. Identification of selected genetic polymorphisms in polycystic ovary syndrome in Sri Lankan women using low cost genotyping techniques. PloS One. 2018;13:0209830.
• Yuan H, Zhu G, Wang F, Wang X, Guo H, Shen M. Interaction between common variants of FTO and MC4R is associated with risk of PCOS. Reprod Biol Endocrinol. 2015;13:55.
• Chmurzynska A, Muzsik A, Krzyżanowska-Jankowska P, Mądry E, Walkowiak J, Bajerska J. PPARG and FTO polymorphism can modulate the outcomes of a central European diet and a Mediterranean diet in centrally obese postmenopausal women. Nutr Res. 2019;69:94-100.
• Di Renzo L, Cioccoloni G, Falco S, Abenavoli L, Moia A, Sinibaldi Salimei P et al. Influence of FTO rs9939609 and Mediterranean diet on body composition and weight loss: a randomized clinical trial. J Transl Med. 2018;16:308.
• Dorling JL, Belsky DW, Racette SB, Das SK, Ravussin E, Redman LM et al. Association between the FTO rs9939609 single nucleotide polymorphism and dietary adherence during a 2-year caloric restriction intervention: Exploratory analyses from CALERIE™ phase 2. Exp Gerontol. 2021;155:111555.
• Huang T, Zheng Y, Hruby A, Williamson DA, Bray GA, Shen Y et al. Dietary protein modifies the effect of the MC4R genotype on 2-year changes in appetite and food craving: the POUNDS Lost Trial. J Nutr. 2017;147:439-444.
• Zheng Y, Huang T, Zhang X, Rood J, Bray GA, Sacks F et al. Dietary fat modifies the effects of FTO genotype on changes in insulin sensitivity. J Nutr. 2015;145:977-82.
• Wehr E, Schweighofer N, Möller R, Giuliani A, Pieber TR, Obermayer-Pietsch B. Association of FTO gene with hyperandrogenemia and metabolic parameters in women with polycystic ovary syndrome. Metabolism. 2010;59:575-80.
• Ministry TS, Turkey Nutrition Guide TUBER 2015. Ankara, TR Ministry of Health, 2016.
• Raynor HA, Champagne CM. Position of the Academy of Nutrition and Dietetics: Interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet. 2016;116:129-47.
• Wang X, Wang K, Yan J, Wu M. A meta-analysis on associations of FTO, MTHFR and TCF7L2 polymorphisms with polycystic ovary syndrome. Genomics. 2020;112: 1516-21.
• Abbasi S, Mohebbi M, Mousavi Vahed SH, Dadgar Moghaddam M, Afiat M, Nematy M et al. Comparison of magnesium status using 24-h urine magnesium content and magnesium fraction excretion in PCOS with Non-PCOS control women: a cross-sectional study. Biol Trace Elem Res. 2023;201:5601-06.
• Shahid R, Mahnoor Awan KA, Iqbal MJ, Munir H, Saeed I. Diet and lifestyle modifications for effective management of polycystic ovarian syndrome (PCOS). J Food Biochem. 2022;46:14117.
• Moran LJ, Ko H, Misso M, Marsh K, Noakes M, Talbot M et al. Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. J Acad Nutr Diet. 2013;113:520-45.
• Barrea L, Verde L, Camajani E, Cernea S, Frias-Toral E, Lamabadusuriya D et al. Ketogenic diet as medical prescription in women with polycystic ovary syndrome (PCOS). Curr Nutr Rep. 2023;12:56-64.
• Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C et al. Adherence to the mediterranean diet, dietary patterns and body composition in women with polycystic ovary syndrome (PCOS). Nutrients. 2019;11:2278.
• Gu Y, Zhou G, Zhou F, Wu Q, Ma C, Zhang Y et al. Life modifications and PCOS: old story but new tales. Front Endocrinol (Lausanne). 2022;13:808898.
• Shang Y, Zhou H, Hu M, Feng H. Effect of diet on insulin resistance in polycystic ovary syndrome. J Clin Endocrinol Metab. 2020;105:3346-60.
• Nadjarzadeh A, Ghadiri-Anari A, Ramezani-Jolfaie N, Mohammadi M, Salehi-Abargouei A, Namayande SM et al. Effect of hypocaloric high-protein, low-carbohydrate diet supplemented with fennel on androgenic and anthropometric indices in overweight and obese women with polycystic ovary syndrome: a randomized placebo-controlled trial. Complement Ther Med. 2021;56:102633.
• Toscani MK, Mario FM, Radavelli-Bagatini S, Wiltgen D, Cristina Matos M, Spritzer PM. Effect of high-protein or normal-protein diet on weight loss, body composition, hormone, and metabolic profile in southern Brazilian women with polycystic ovary syndrome: a randomized study. Gynecol Endocrinol. 2011;27:925-30.
• Marnani EH, Ghadiri-Anari A, Ramezani-Jolfaie N, Mohammadi M, Namayandeh SM, Mozaffari-Khosravi H et al. Effect of fennel supplementation along with high-protein, low-carbohydrate weight-loss diet on insulin resistance and percentage of fat and muscle mass in overweight/obese women with polycystic ovary syndrome. J Funct Foods. 2020;67:103848.
• Sørensen LB, Søe M, Halkier KH, Stigsby B, Astrup A. Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome. Am J Clin Nutr. 2012;95:39-48.
• Wang F, Dou P, Wei W, Liu PJ. Effects of high-protein diets on the cardiometabolic factors and reproductive hormones of women with polycystic ovary syndrome: a systematic review and meta-analysis. Nutr Diabetes. 2024;14,6.
• Ornstein RM, Copperman NM, Jacobson MS. Effect of weight loss on menstrual function in adolescents with polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2011;24:161-65.
• Wong JM, Gallagher M, Gooding H, Feldman HA, Gordon CM, Ludwig DS et al. A randomized pilot study of dietary treatments for polycystic ovary syndrome in adolescents. Pediatr Obes. 2016;11:210-20.
• Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med. 2020;18:104.
• Wong JMW, Gallagher M, Gooding H, Feldman HA, Gordon CM, Ludwig DS et al. A randomized pilot study of dietary treatments for polycystic ovarian syndrome in adolescents. Pediatr Obes. 2016;11:210-20.
• Shishehgar F, Mirmiran P, Rahmati M, Tohidi M, Ramezani Tehrani F. Does a restricted energy low glycemic index diet have a different effect on overweight women with or without polycystic ovary syndrome? BMC Endocr Disord. 2019;19:93.
• Zhang X, Qi Q, Zhang C, Smith SR, Hu FB, Sacks F et al. FTO genotype and 2-year change in body composition and fat distribution in response to weight-loss diets: the POUNDS LOST Trial. Diabetes. 2012;61:3005-11.
• Huang T, Qi Q, Li Y, Hu FB, Bray GA, Sacks FM et al. FTO genotype, dietary protein, and change in appetite: the preventing overweight using novel dietary strategies trial. Am J Clin Nutr. 2014;99:1126-30.
• Labayen I, Margareto J, Maldonado-Martin S, Gorostegi I, Illera M, Medrano M et al. Independent and combined influence of the FTO rs9939609 and MC4R rs17782313 polymorphisms on hypocaloric diet induced changes in body mass and composition and energy metabolism in non-morbid obese premenopausal women. Nutr Hosp. 2015;31:2025-32.
• Xiang L, Wu H, Pan A, Patel B, Xiang G, Qi L et al. FTO genotype and weight loss in diet and lifestyle interventions: a systematic review and meta-analysis. Am J Clin Nutr. 2016;103:1162-70.
• Gulati S, Misra A, Tiwari R, Sharma M, Pandey RM, Upadhyay AD. The influence of polymorphisms of fat mass and obesity (FTO, rs9939609) and vitamin D receptor (VDR, BsmI, TaqI, ApaI, FokI) genes on weight loss by diet and exercise interventions in non-diabetic overweight/obese Asian Indians in North India. Eur J Clin Nutr. 2020;74:604-12.