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Comment on: A single FTO gene variant rs9939609 is associated with weight change and insulin resistance improvement in response to a robotic sleeve gastrectomy in subjects with severe obesity

Published:November 07, 2022DOI:https://doi.org/10.1016/j.soard.2022.10.031
      Obesity is a multifactorial disease and its etiology encompasses environmental, molecular, genetic, and epigenetic components [
      • Barness L.A.
      • Opitz J.M.
      • Gilbert-Barness E.
      Obesity: genetic, molecular, and environmental aspects.
      ]. Therapeutic strategies to promote weight management include lifestyle modification (diet and physical exercise), pharmacotherapy, and surgical procedures. In this context, bariatric and metabolic surgery promotes substantial and long-term weight loss and improvement of related diseases such as hypertension, diabetes, and dyslipidemia [
      • Ruban A.
      • Stoenchev K.
      • Ashrafian H.
      • Teare J.
      Current treatments for obesity.
      ]. However, despite the beneficial effect of surgical procedures, some studies reported interindividual variation and different patterns of response among individuals with obesity. Depending on the phenotypic response to treatment, patients may be classified as normo-responders, hypo-responders, or hyper-responders [
      • Nicoletti C.F.
      • Cortes-Oliveira C.
      • Pinhel M.A.S.
      • Nonino C.B.
      Bariatric surgery and precision nutrition.
      ]. In line with this, single nucleotide polymorphisms (SNPs) have been associated with weight loss after different types of bariatric procedures [
      • Nicoletti C.F.
      • Cortes-Oliveira C.
      • Pinhel M.A.S.
      • Nonino C.B.
      Bariatric surgery and precision nutrition.
      ]. The obesity-associated SNPs are also related to weight changes after obesity management and are mainly involved in metabolic pathways related to energy intake, thermogenesis, adipogenesis, and lipid metabolism [
      • Joffe Y.T.
      • Houghton C.A.
      A novel approach to the nutrigenetics and nutrigenomics of obesity and weight management.
      ]. To date, fat mass and obesity (FTO) locus is the gene most strongly related to obesity phenotype (body weight, body mass index, and body composition) [
      • Doaei S.
      • Mosavi Jarrahi S.A.
      • Sanjari Moghadam A.
      • et al.
      The effect of rs9930506 FTO gene polymorphism on obesity risk: a meta-analysis.
      ] and currently with bariatric surgery outcomes. The authors of the present study [
      • de Luis D.
      • Izaola O.
      • Primo D.
      • López J.J.
      • Pacheco D.
      A single FTO gene variant rs9939609 is associated with weight change and insulin resistance improvement in response to a robotic sleeve gastrectomy in subjects with severe obesity.
      ] evaluated a possible association of a single SNP (rs9939609) in FTO gene with anthropometric and metabolic changes 6 to 12 months after robotic sleeve gastrectomy and observed a bigger reduction of weight, waist circumference, and serum insulin levels in those non-A allele carrier’s (TT) patients. These very important results suggest that a genetic variant of the FTO gene influences longitudinal bariatric surgery outcomes. Moreover, although the authors evaluated only 12 months of postoperative time, other authors have elucidated the association of this SNP with weight regain after long-term postoperative time, evidencing significant weight regain in A allele carriers (AA or AT) after 3 years of follow-up [
      • Rodrigues G.K.
      • Resende C.M.
      • Durso D.F.
      • Rodrigues L.A.
      • Silva J.L.
      • Reis R.C.
      • et al.
      A single FTO gene variant rs9939609 is associated with body weight evolution in a multiethnic extremely obese population that underwent bariatric surgery.
      ]. An individual genetic profile may predict obesity treatment outcomes and guide new approaches and strategies to bariatric surgery management. Personalized medicine may be used to individualize strategies that promote health and quality of life by tailoring weight-loss interventions according to specific DNA signatures.
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