Genetische Ursachen der Adipositas und ihre therapeutischen Implikationen

Zusammenfassung

Adipositas ist eine komplexe Störung, die von Umweltfaktoren und genetischen Varianten beeinflusst wird. Basierend auf den genetischen Grundlagen wird zwischen zwei Formen der Adipositas unterschieden. Die monogene (und syndromale) Adipositas ist selten und wird von Mutationen in jeweils einem Gen bedingt. Zur Manifestation einer extremen Adipositas mit Hyperphagie kommt es bereits in den ersten Lebensjahren. Abhängig vom betroffenen Gen können zudem weitere phänotypische Ausprägungen hinzukommen. Die polygene Adipositas dagegen ist weitaus häufiger. Ursächlich für diese Form ist eine Vielzahl von genetischen Varianten, die jeweils einen geringen, aber additiven Effekt auf das Körpergewicht haben. Frühzeitige genetische Diagnostik kann die vorliegende Form der Adipositas identifizieren und die Wahl einer geeigneten Therapieoption, ob Lebensstilintervention, bariatrische Chirurgie oder pharmakologische Behandlung, unterstützen. Wir stellen aktuelle Erkenntnisse der Forschung über die genetischen Ursachen der Adipositas dar. Zudem werden therapeutische und diagnostische Optionen, die teils auf genetischen Befunden basieren, beleuchtet.

Abstract

Obesity is a complex disorder influenced by environmental factors and genetic variants. A classification into two forms of obesity is based on the genetic basis. Monogenic (and syndromal) obesity is rare and caused by mutations in a single gene each. The manifestation of extreme obesity with hyperphagia occurs in the first years of life. Depending on the gene affected, other phenotypic manifestations may occur. Polygenic obesity, on the other hand, is much more common. This form is caused by several genetic variants, each of which has a small but additive effect on the body weight. Early genetic diagnosis can identify the present form of obesity and support the choice of an appropriate therapeutic option, whether lifestyle intervention, bariatric surgery, or pharmacological treatment. We present current research findings on the genetic causes of obesity. In addition, therapeutic and diagnostic options, some of which are based on genetic findings, are highlighted.

Schlüsselwörter

Genetik - Varianten - Mutationen - Monogene Adipositas - Polygene Adipositas

Key words

Obesity - genetics - mutation - variants - monogenic obesity - polygenic obesity

Publikationsverlauf

Artikel online veröffentlicht:
04. Dezember 2023

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