On the Futility of Screening for Genes That Make You Fat 英文参考文献.docVIP

Perspective OntheFutilityofScreeningforGenesThatMakeYouFat J.LennertVeerman* SchoolofPopulationHealth,TheUniversityofQueensland,Brisbane,Queensland,Australia An impressively large meta-analysis in this issue of PLoS Medicine shows that physical activity modifies the effect of a commongenetictraitonbodymass.Itwas alreadyknownthatcertainvariantsofthe ‘‘fat mass and obesity associated’’ (FTO) gene predispose to weight gain, but this article shows that this effect is weaker amongphysicallyactivepersons[1]. forcommonobesity,itspenetranceislow. A single copy is associated with a 23% increasedriskofobesityandacorrespond- ingly modest effect on body mass of 0.36kg/m2(about1kg)onaverage.Mod- elling studies have shown that even when testingformultiplegenetictraitswithsuch lowpredictivepower,screeningisunlikely to be worthwhile [3,4]. And since genetic traitswiththehighestpredictivepowerare mostlikelytobethefirstonesfound,itis unlikely that genetic traits with larger impactonbodymasswilleverbefound. LinkedResearchArticle This Perspective discusses the fol- lowingnewstudypublishedinPLoS Medicine: Kilpela¨inen TO,QiL,BrageS,Sharp SJ,SonestedtE,etal.(2011)Physical ActivityAttenuatestheInfluenceof FTO Variants on Obesity Risk: A Meta-Analysis of 218,166 Adults and 19,268 Children. PLoS Med 8(11):e1001116.doi:10.1371/journal. pmed.1001116 Theauthorsarguethatthisisimportant because many people have a determinist view of genes and may think that when somethingiswritteninyourgeneticcode, nothingcanbedonetoalterthecourseof fate.Thestudyshowsthatviewtobeoverly simplistic:genesmaypredisposetoweight gain, but this weight can be lost by extra physicalactivity.Andintime,studiesinto thecausesofthisgene–behaviourinterac- tionmayleadtonewtreatmentsforobesity. NoChangeinTherapeutic Options Ruth Loos and colleagues report findingsfromameta-analysisofmul- tiplestudiesexaminingtheextentto which physical activity attenuates effects of a specific gene variant, FTO, on obesity in adults and c