OBJECTIVE:The effects of alpha-2A (A2A)-, beta-2 (B2)-and beta-3 (B3)-adrenergic receptor (ADR) gene polymorphisms on adiposity, fat distribution and plasma insulin and leptin changes in response to long-term overfeeding were explored. METHODS: Twenty four men (mean ( AE s.d.) age 21 AE 2 y) who constituted 12 pairs of identical twins ate a 4.2 MJ=day energy surplus, 6 days a week, for a period of 100 days. Total body fat was assessed by hydrodensitometry and total subcutaneous fat by the sum of eight skinfolds. Abdominal fat areas were measured by computerized tomography (CT). Plasma glucose and insulin during fasting and in response to an oral glucose tolerance test (OGTT) were assayed. The insulin and glucose areas were computed using the trapezoidal method. Plasma leptin was measured with an enzyme-linked immunosorbent assay. The ADR polymorphisms were identified by PCR or Southern blot technique. RESULTS: The ADRB2 Gln27Gln genotype (n ¼ 10) was associated with a larger gain (percentage change) in weight (P < 0.001) and total subcutaneous (P < 0.005) fat than the Glu27Glu=Gln27Glu genotype (n ¼ 14). In addition, overfeeding induced greater increases in the insulin areas under the curve during the OGTT and the fasting plasma level of leptin (P < 0.01 and < 0.03, respectively) among Gln27Gln than in the Glu27Glu=Gln27Glu subjects. The body composition and metabolic changes among the ADRB2 BanI 3.7=3.4 kb subjects (n ¼ 10) were similar to those of Gln27Gln subjects. ADRA2A DraI (n ¼ 4) 6.3=6.3 kb subjects experienced a decrease (78%) while 6.7=6.3 kb subjects (n ¼ 20) registered an increase ( þ 10%; P ¼ 0.017) of OGTT glucose area after the 100-day caloric surplus. The four carriers of the ADRB3 variant (Trp64Arg) experienced the same magnitude of changes as the 20 homozygotes for the Trp allele. In general, comparisons based on the 24 subjects considered as unrelated men and the mean values for each of the 12 pairs yielded similar results. CONCLUSION: The ADRB2 Gln27Gln subjects gained more weight and total subcutaneous fatness and also experienced a greater increase in insulin resistance than Glu27Glu=Gln27Glu subjects with exposure to long-term overfeeding. Similar differences were observed between carriers and non-carriers of the ADRB2 3.7=3.4 kb BanI variant. Genetic variation at the ADRB2 locus could thus be one of the factors responsible for the large inter-individual differences observed in the response to long-term alterations in energy balance and should be further investigated.