Type 2 Diabetes Remission in Patients with Heterozygous Variants in the Leptin-Melanocortin Pathway after Roux-en-Y Gastric Bypass: A Matched Case–Control Study

Anazco, Diego; Ghusn, Wissam; Campos, Alejandro; Cifuentes, Lizeth; Fansa, Sima; Tama, Elif; Bublitz, Joshua T.; Gala, Khushboo; Hurtado, Maria D.; Olson, Janet E.; Acosta, Andres

doi:10.1007/s11695-023-06859-x

Cited by 2 publications

(1 citation statement)

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“…The study suggested incorporating genetic testing into the preoperative protocols prior to bariatric surgery, especially for patients with severe early‐onset obesity. With a broader overview of mutations affecting components along the MC4R pathway, a study included 50 carriers, who were matched based on sex, age, BMI, and years since surgery with 100 non‐carriers 122,123 . The study showed that individuals with heterozygous variants experienced progressive and significant weight regain in the mid and long term following RYGB.…”

Section: Treatment Of Monogenic Obesitymentioning

confidence: 99%

The melanocortin‐4 receptor pathway and the emergence of precision medicine in obesity management

Fansa,

Acosta

2024

Diabetes Obesity Metabolism

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Over the past few decades, there has been a global surge in the prevalence of obesity, rendering it a globally recognized epidemic. Contrary to simply being a medical condition, obesity is an intricate disease with a multifactorial aetiology. Understanding the precise cause of obesity remains a challenge; nevertheless, there seems to be a complex interplay among biological, psychosocial and behavioural factors. Studies on the genetic factors of obesity have revealed several pathways in the brain that play a crucial role in food intake regulation. The best characterized pathway, thus far, is the leptin–melanocortin pathway, from which disruptions are responsible for the majority of monogenic obesity disorders. The effectiveness of conservative lifestyle interventions in addressing monogenic obesity has been limited. Therefore, it is crucial to complement the management strategy with pharmacological and surgical options. Emphasis has been placed on developing drugs aimed at replacing the absent signals, with the goal of restoring the pathway. In both monogenic and polygenic forms of obesity, outcomes differ across various interventions, likely due to the multifaceted nature of the disease. This underscores the need to explore alternative therapeutic strategies that can mitigate this heterogeneity. Precision medicine can be regarded as a powerful tool that can address this concern, as it values the understanding of the underlying abnormality triggering the disease and provides a tailored treatment accordingly. This would assist in optimizing outcomes of the current therapeutic approaches and even aid in the development of novel treatments capable of more effectively managing the global obesity epidemic.

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Section: Treatment Of Monogenic Obesitymentioning

confidence: 99%