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Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2006-2316
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The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 11 4403-4409
Copyright © 2007 by The Endocrine Society

Genetic Study of the Melanin-Concentrating Hormone Receptor 2 in Childhood and Adulthood Severe Obesity

Maya Ghoussaini, Vincent Vatin, Cécile Lecoeur, Victor Abkevich, Adib Younus, Chantal Samson, Christophe Wachter, Barbara Heude, Maïté Tauber, Patrick Tounian, Serge Hercberg, Jacques Weill, Claire Levy-Marchal, Catherine Le Stunff, Pierre Bougnères, Philippe Froguel and David Meyre

Centre National de la Recherche Scientifique Unité Mixte de Recherche 8090-Institute of Biology (M.G., V.V., C.L., C.S., C.W., P.F., D.M.), Pasteur Institute, 59000 Lille, France; Myriad Genetics Incorporated (V.A., A.Y.), Salt Lake City, Utah; Institut National de la Santé et de la Recherche Médicale U780-IFR69 (B.H.), Paris XI University Villejuif, 94800 Villejuif, France; Institut National de la Santé et de la Recherche Médicale U563 (M.T.), Children’s Hospital, 31000 Toulouse, France; Department of Pediatric Gastroenterology and Nutrition (P.T.), Trousseau Hospital, 75012 Paris, France; Institut National de la Santé et de la Recherche Médicale U557/Institut National de la Recherche Agronomique U1125 (S.H.), L’Institut Scientifique et Technique de la Nutrition et de l’Alimentation, 75003 Paris, France; Pediatric Endocrine Unit (J.W.), Jeanne de Flandre Hospital, 59000 Lille, France; Institut National de la Santé et de la Recherche Médicale Units 457 and 690 (C.L.-M.), Robert Debre Hospital, 75019 Paris, France; Institut National de la Santé et de la Recherche Médicale Pediatrics Endocrinology and U561 (C.L.S., P.B.), Saint Vincent de Paul Hospital, Paris V University, 75014 Paris, France; and Genomic Medicine (P.F.), Hammersmith Hospital, Imperial College London, London W12 0NN, United Kingdom

Address all correspondence and requests for reprints to: Philippe Froguel, P. Section of Genomic Medicine, Hammersmith Hospital, Du Cane Road, Imperial College London, London W12 0NN, United Kingdom. E-mail: p.froguel{at}imperial.ac.uk.


   Abstract
Top
 Abstract
Introduction
 Patients and Methods
 Results
 Discussion
 References
 
Context: The melanin-concentrating hormone receptor 2 (MCHR2) is a G protein-coupled receptor for melanin-concentrating hormone, a neuropeptide that plays an important role in feeding behaviors. MCHR2 maps on chromosome 6q16.3, in a susceptibility locus for childhood obesity.

Objective: The aim of this study was to investigate the association between MCHR2 variation and human obesity.

Design: Case control and family-based studies were performed.

Participants: A total of 141 obese children and 24 nonobese adult subjects was sequenced, and case-control analyses were conducted using 628 severely obese children and 1401 controls.

Results: There were 11 single nucleotide polymorphisms (SNPs) identified. We showed nominal association among –38,245 ATG A/G SNP (P = 0.03; 95% confidence interval 1.02–1.34; odds ratio 1.17), A76A T/C SNP (P = 0.03; 95% confidence interval 0.58–0.97; odds ratio 0.75), and childhood obesity. Analysis of 645 trios with childhood obesity supported further the A76A T/C association, showing an overtransmission to obese children of the at risk T allele (59.0%; P = 0.01), especially in children with most severe forms of obesity (Z score of body mass index > 4) (67.0%; P = 0.003). The A76A at risk T allele was also associated with overeating during meals (P = 0.02) in an additional group of 102 nonobese children. None of the MCHR2 variants, including the A76A SNP, showed association with adult severe obesity, although a trend for association of the T allele of this variant with food disinhibition (P = 0.06) and higher hunger (P = 0.09) was found. This variant was not associated with childhood obesity in an independent case-control study, including 1573 subjects (P = 0.98). Moreover, the A76A SNP did not explain the linkage on the 6q locus.

Conclusion: Our results altogether suggest that MCHR2 is not a major contributor to polygenic obesity and support a modest effect of the A76A SNP on food intake abnormalities in childhood.


   Introduction
Top
 Abstract
 Introduction
Patients and Methods
 Results
 Discussion
 References
 
IF THE CURRENT EPIDEMIC of obesity clearly reflects the environmental and behavior changes during the past half century, genetic background remains important, especially in the severe forms of obesity, as assessed by ethnic (1), familial (2, 3), or linkage (4) studies. We previously identified in the French population a linkage with childhood obesity on chromosome 6q16.3-q24.2 with a Lod score of 4.06 (5). Recently, we reported that variation in ectonucleotide pyrophosphatase phosphodiesterase 1 (ENPP1) partly contributed to the observed linkage (6). Indeed, if we remove the 15 affected sibling pairs from a total of 135 sibling pairs sharing the ENPP1 at risk haplotype, the Multipoint Lod Score drops from 4.06–1.6 at marker D6S287, and a new maximal score of 2.63 is obtained 16-Mb centromeric to the original linkage peak, at marker D6S301.

The melanin-concentrating hormone receptor 2 (MCHR2) is an obvious candidate gene lying under this new peak. The orphan G coupled-protein MCHR2 consists of 340 amino acids, with a coding sequence distributed over six exons (7, 8, 9) and showing 38% homology with the melanin-concentrating hormone receptor 1 (MCHR1) (10). MCHR2 displays high-affinity binding to melanin-concentrating hormone (MCH) (11), which is known to increase food intake and body weight in rodents after its central administration (12, 13, 14). MCH acts as a functional antagonist of the {alpha}-MSH in a complex central network involving the melanocortin pathways (15). MCH overexpression leads to obesity and insulin resistance in mice (16). In contrast, mice that lack the MCH gene or targeted inactivation of MCH gene in neurons cause a phenotype of leanness as a consequence of hypophagia and increased metabolic rate (17). Expression of MCHR2 is restricted to several regions in the brain, including the arcuate nucleus and the ventral medial nucleus, areas involved in regulation of food intake (18). Consistently, these two nuclei have been recently implicated in mediating the MCH effect via activation or inhibition of feeding circuits (19).

Tan et al. (10) showed that functional expression of the MCHR2 gene is not conserved during the evolution. In contrast to MCHR1, the functional MCHR2 is only expressed in humans, primates, and carnivores, but not in rodents. Thus, little is known about the physiological role of MCHR2, and human genetics offers a unique opportunity to evaluate the contribution of this receptor to appetite regulation and associated diseases in humans. This paper investigates the implication of variation in MCHR2 in polygenic and monogenic forms of childhood obesity and its related quantitative and eating disorders traits.


   Patients and Methods
Top
 Abstract
 Introduction
 Patients and Methods
Results
 Discussion
 References
 
Population used for association studies

Association studies with childhood and adulthood obesity were performed for variants with minor allele frequency (MAF) more than or equal to 5% using a set of 628 unrelated obese children chosen from the cohort of 849 obese children available [male/female 402/447, age 10.7 ± 3.60 yr, body mass index (BMI) 28.84 ± 6.56 kg/m2, and Z score of BMI 4.16 ± 1.32), 696 unrelated class III obese adults (male/female 176/520, mean age 45.95 ± 12.06 yr, and BMI 47.69 ± 7.22 kg/m2), and 1401 nonobese normoglycemic adults (male/female 564/837, age 41.32 ± 15.07 yr, and BMI 22.42 ± 2.31 kg/m2). The study protocol was approved by all local ethic committees, and informed consent was obtained from each subject before participating in the study.

Obese children cohort. The pool of obese children used for case/control analysis was constituted of a first set of 424 unrelated obese children collected from 424 pedigrees with at least one obese child at the Centre National de la Recherche Scientifique (CNRS)-Unité Mixte de Recherche (UMR) 8090 Unit in Lille, and at the Jeanne de Flandres Hospital in Lille, a second set of 93 unrelated obese children recruited at the Children’s Hospital, Toulouse, a third set of 24 unrelated obese children recruited through the "Fleurbaix-Laventie Ville Santé" study, and a fourth set of 87 unrelated children collected from the Trousseau Hospital. We genotyped the A76A T/C single nucleotide polymorphism (SNP) in 148 additional obese children collected at the CNRS UMR8090 and in 439 obese children collected at the Saint Vincent de Paul Hospital. Children with a BMI greater than the 97th percentile for age and sex reported on the tables of Rolland-Cachera et al. (20) (French general population) were defined as obese, as recommended by the European Childhood Obesity Group (21).

Obese adult cohort. The class III obese adult subgroup was constituted by 696 class III obese adults collected at the Department of Nutrition of the Hôtel Dieu Hospital in Paris or at the CNRS-Institut Pasteur Unit in Lille. Class III obesity status was defined as BMI more than or equal to 40 kg/m2 in adults.

Control adult cohort. The same adult control group was used for both association studies in obese children and adults because this group had a longer environmental exposure and still remains nonobese. This group consisted of 1401 nonobese (BMI < 27 kg/m2) normoglycemic (fasting glycemia < 5.56 mmol/liter) French Caucasian adults pooled from four separate studies; 360 unrelated nonobese and nondiabetic subjects were recruited at the CNRS-Institut Pasteur Unit in Lille, 235 were recruited by the "Fleurbaix-Laventie Ville Santé" study (22), 396 from the HAGUENEAU study (23), and 410 from the SUpplementation en VItamines et Minéraux AntioXydants (SUVIMAX) study (24). Absence of stratification among all the different studied cohorts was verified using 26 neutral polymorphic markers disseminated across the genome (data not shown). We genotyped the A76A T/C SNP in 986 additional lean adult subjects (BMI < 27 kg/m2) issued from the SUVIMAX cohort. The genetic study was approved by the ethical committees of Hôtel Dieu Hospital in Paris and Centre Hospitalier Régional Universitaire de Lille.

We used 424 pedigrees with childhood obesity (645 childhood obesity trios: two parents and one obese child) and 102 nonobese childhood trios (BMI < 97th percentile for gender and age) and 158 pedigrees with adulthood obesity, including 514 individuals (303 obese, 72 overweight, and 139 lean) for Transmission Disequilibrium Test (TDT) analysis for obesity status and eating behavior traits.

Eating behavior traits

Food behavior in obese adults was assessed by the Three Factor Eating Questionnaire (TFEQ) (25), which evaluates the cognitive restraint of eating, disinhibition, and hunger. Scores for the TFEQ were available for 500 class III obese patients with familial history of obesity. Because the TFEQ is not a validated questionnaire in children, food intake behavior in 102 young nonobese children (46 girls and 56 boys; BMI < 97th percentile for gender and age) was assessed by an in-house questionnaire administrated by a trained physician. Seven questions were asked. Two questions were related to food intake behavior during a meal (presence or absence of hyperphagia and rapidity of food ingestion) and between meals (presence or absence of snacking).

Sequencing and genotyping

The screening of the MCHR2 gene was done using overlapping PCR fragments that cover all exons of the MCHR2 gene, exon/intron junctions, and a part of the putative promoter and the 3'untranslated region (UTR). Primer details and PCR optimization conditions are available from the authors. PCR amplifications were inspected for single bands of expected sizes on agarose gels before purification with Montage PCR384 Multiscreen S384PCR (Millipore, Billerica, MA). Sequencing was performed using the automated ABI Prism 3730 DNA sequencer in combination with the Big Dye Terminator Cycle Sequencing Ready Reaction Kit (Applied Biosystems, Foster City, CA) and purification sequencing reaction with MultiScreen SEQ384 filter plates (Millipore).

To cover the intronic regions of the MCHR2 gene, genotypes of nine intronic SNPs have been extracted from a whole-genome association search performed in 325 obese children and 425 control subjects (unpublished results), using DNA pooling strategy, as detailed elsewhere (26). Genotyping was performed by labeling genomic DNA and hybridizing it to Illumina Infinium Human1 and Hap300 BeadArrays (Illumina Inc., San Diego, CA), which interrogated 109,365 and 317,503 SNPs, respectively. The nine SNPs were in Hardy-Weinberg equilibrium (HWE) (P > 0.01) in both case and control subjects.

The four SNPs with a MAF of more than 5% were then genotyped in all case and control groups using direct sequencing for –38,245 ATG A/G and –38,244 ATG T/C and Light-Cycler/Typer technology (Roche Diagnostics, Laval, Québec, Canada) for –26,780 ATG C/T and A76A T/C. Genotyping error rates calculated from duplicate genotypes of 250 individuals were 0% for –38,245 ATG A/G, –26,780 ATG C/T, A76A T/C, and 0.9% for –38,244 ATG T/C. No recurrent mendelian inconsistencies were detected in the 608 pedigrees for the two analyzed SNPs (–38,245 ATG A/G, A76A T/C) using the PEDCHECK 1.1 program (35).

Statistical analysis

Tests for deviation from HWE and for association were performed with the De Finetti program (http://ihg.gsf.de/cgi-bin/hw/hwa1.pl). All SNPs were in HWE. We compared all cases against all control individuals, as well as class III obese adults and obese children separately against the control group. These analyses were done by comparing allelic frequencies of the SNPs between cases and controls. ANOVA and the t test were performed for the studying of quantitative traits in obese and control adults. Haplotype frequencies were determined and compared between groups with the UNPHASED software (http://www.mrc-bsu.cam.ac.uk/personal/frank/). Familial analysis on binary and quantitative traits was performed by the TDTPHASE and QPDTPHASE methods implemented in the UNPHASED software. To evaluate the effect of the T at risk allele of the A76A variant on linkage, we used the Genotype Identical-by-Descent Sharing Test procedure. SPSS 10.1 software (SPSS, Inc., Chicago, IL) was used for general statistical analysis.


   Results
Top
 Abstract
 Introduction
 Patients and Methods
 Results
Discussion
 References
 
Screening of the gene

All exons of the MCHR2 gene, exon/intron junctions, 870 bp of the putative promoter, and 1095 bp in the 3'UTR were sequenced in 47 obese children from families with evidence for linkage of childhood obesity to 6q, 94 obese children with early obesity onset (Z score of BMI > 4.5, obesity onset before 5 yr old), and in 24 nonobese normoglycemic adults. We identified six SNPs in the promoter region, one nonsynonymous mutation, two synonymous mutations, and two SNPs in the 3'UTR (Figs. 1Go and 2Go). Among these SNPs, three were frequent (–38,245 ATG A/G, –38,244 ATG T/C, and A76A T/C) with minor allele frequencies more than 5%, and linkage disequilibrium (LD) analysis showed that these SNPs were in incomplete LD (R2 < 0.8). Therefore, the three SNPs were selected to be typed in all our samples, which can be found in supplemental Fig. 1, and is published as supplemental data on The Endocrine Society’s Journals Online web site at http://jcem.endojournals.org).


Figure 1
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  		FIG. 1. Location of the 20 SNPs in the MCHR2 gene. Exons 1–6 are represented in gray. The 11 SNPs shown below the figure are those identified after the screening of the MCHR2 gene. Three variants, –38,245 ATG A/G, –38,244 ATG T/C, and A76A T/C, had a MAF more than 5% and were studied in case/control analysis. The eight remaining SNPs had a MAF less than 5% and were found in both obese and control subjects excluding a contribution in monogenic form of obesity. The nine additional SNPs shown above the figure are the intronic tagged SNPs that were included from the whole genome scan study of childhood obesity to cover the MCHR2 genetic variation in introns.

 

Figure 2
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  		FIG. 2. Schematic representation of the structure of the seven-helix transmembrane protein MCHR2. Positions of the three coding variations (two synonymous and one nonsynonymous), identified after the MCHR2 screening, are indicated as gray circles. These three mutations were also identified in the study of Hawes et al. (34 ). The bold circles indicate the amino acid delimiting the transmembrane domain from both sides of the protein. The dotted circles indicate the nonsynonymous mutation R63K that was found in the study of Hawes et al. (34 ) but was not found through our initial screened set.

 
The eight remaining rare variants, including the nonsynonymous variant R152Q G/A (minor allele frequencies < 5%; Table 1Go), were found in both obese and control subjects. These results excluded a potential implication of these variants in monogenic forms of obesity in our studied population.


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  		TABLE 1. Positions, base or amino acid changes, rs number (if known), and frequencies of the 11 SNPs identified within the MCHR2 gene in the initial screened set

 
Association studies of frequent SNPs with childhood obesity

Case/control analysis was performed for the three SNPs in 2029 French Caucasians (628 unrelated obese children and 1401 normoglycemic nonobese control adults). The A/G –38,245 G allele and the A76A T allele showed nominal evidence for association with childhood obesity [P = 0.03, 95% confidence interval (CI) 1.02–1.34, odds ratio (OR) 1.17; P = 0.03, 95% CI 0.58–0.97, OR 0.75; Table 2Go). The remaining SNP –38,244 ATG T/C was not associated with childhood obesity (P = 0.50).


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  		TABLE 2. Association (P ≤ 0.05) of genotypes and alleles of MCHR2 gene SNPs with obesity

 
Because our initial screening did not include intronic regions, we analyzed data concerning nine additional tagged SNPs covering the MCHR2 introns that were included in a whole-genome association scan of childhood obesity performed in a subset of obese children cohort (325 obese children compared with 425 control subjects; our unpublished results). The location of the intronic SNPs is shown in Fig. 1Go.

No intronic SNP showed significant (P < 0.05) association with childhood obesity, except for SNP –26,780 ATG C/T (rs9496085; P = 0.035), located in intron 1 of MCHR2. We then genotyped rs9496085 in our extended case control set of 2029 French Caucasians. This SNP showed only a modest trend toward association with childhood obesity (P = 0.055; 95% CI 0.75–1.00; OR 0.87; Table 2Go).

TDT analysis in trios with childhood obesity

TDT analysis of 424 pedigrees with childhood obesity was then performed for the two frequent SNPs significantly associated (P < 0.05) with childhood obesity in the case control design. The SNP –38,245 ATG A/G did not show an allelic transmission distortion in obese children (P > 0.05; data not shown). However, we found evidence of an overtransmission of the A76A at risk T allele in obese children (59.0%; P = 0.01; 120 transmitted vs. 85 nontransmitted), especially in children with the most severe forms of obesity (Z score of BMI > 4) (67.0%; P = 0.003; 52 transmitted vs. 26 nontransmitted; Fig. 3Go).


Figure 3
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  		FIG. 3. Familial association of the A76A T/C in pedigrees with childhood obesity. TDT analysis of 424 pedigrees (645 trios) with childhood obesity showed an overtransmission of the A76A at risk T allele in obese children (59.0%; P = 0.01) and in children with the more severe forms of obesity (Z score of BMI > 4) (67.0%; P = 0.003).

 
In an attempt to gain statistical power in our analysis, we then considered the phenotypes and genotypes of three available generations (children, parents, and grandparents) for the obesity threshold (97th percentile) for gender and age. We analyzed together the overtransmission of the at risk allele from the heterozygous grandparents to the obese parents and the overtransmission of the at risk allele from the heterozygous parents to the obese children. An overtransmission of the "at risk allele" to obese offspring was found (61.0%; P = 0.002).

To investigate whether the A76A variant could affect primarily eating behaviors and, thus, induce obesity, we restricted the TDT analysis of eating behavior phenotypes to a subgroup of 102 nonobese children, given that the T allele was overtransmitted to obese children. These nonobese children were issued from the initial 424 pedigrees with childhood obesity and showed no distortion of segregation for the T allele (53.8%; P = 0.69). Interestingly, the analysis of nonobese children with overeating during meal showed a systematic transmission of the T allele to these subjects (100%; P = 0.004; six transmitted vs. zero nontransmitted). Accordingly, 25% of the TT genotype carriers of the A76A variant showed overeating during meal, whereas none of the TC and CC genotype carriers harbored this disorder (P = 0.02).

Association studies with adulthood obesity

No association with adult class III obesity was found for any of the four SNPs (Table 2Go). However, pooled data from obese children and adults showed nominal evidence of association with obesity for the –38,245 A/G SNP (P = 0.02; 95% CI 1.02–1.28; OR 1.15) and a trend toward association for the A76A T/C SNP (P = 0.07; 95% CI 0.67–1.02; OR 0.83). In adults there was also a trend toward association of the T allele of the A76A variant with higher hunger (P = 0.09) and with disinhibition for food (P = 0.06; data not shown).

Haplotype analysis

To estimate the potential effect of the combination of the MCHR2 SNPs, we performed haplotype analysis in obese subjects and controls using the UNPHASED software. The haplotype, including the two associated SNPs or the four frequent SNPs, did not provide stronger evidence for association than SNPs analyzed independently (data not shown).

Linkage analysis

After exclusion of subjects carrying at least one risk haplotype of the ENPP1 gene, we tested the contribution of the –38,245 A/G and A76A T/C SNPs to the maximum of the linkage peak at marker D6S301 using the Genotype Identical-by-Descent Sharing Test procedure. Our results did not provide any evidence for participation of this SNP to the linkage observed on the 6q locus (dominant model, P = 0.16).

Replication study between A76A T/C and childhood obesity

In an attempt to replicate the association of the A76A T/C in an independent French cohort, we genotyped this polymorphism in two additional sets, including 986 lean adult subjects issued from the SUVIMAX cohort, and 587 obese children collected at the CNRS UMR8090 (n = 148) and the Saint Vincent de Paul Hospital (n = 439). We did not replicate the association between the A76A T allele and childhood obesity (P = 0.98; 95% CI 0.77–1.29; OR 0.99; data not shown).


   Discussion
Top
 Abstract
 Introduction
 Patients and Methods
 Results
 Discussion
References
 
This study is the first to investigate a possible role of MCHR2 SNPs in human polygenic severe obesity in a large population of French Caucasians. The initial case/control analysis gave nominal evidence for association between the two variants, 38,245 A/G and A76A T/C, and childhood obesity, but this result does not resist to multiple testing correction. Even if the TDT analysis supports the contribution of the A76A T/C SNP to childhood obesity, it is noteworthy to indicate that none of these two variants showed association with severe forms of obesity in adults. We were not able to replicate the association between A76A T/C SNP and childhood obesity in an independent case control design including 1573 subjects. Moreover, our results did not provide any evidence for participation of these variants to the linkage observed on the 6q locus. This underlines the need to carry on the search for other genetic variants contributing to the observed linkage with childhood obesity on chromosome 6q.

Our data suggest that the A76A T/C MCHR2 SNP may mediate modest eating behavior disorders in childhood, such as overeating during meals. However, this result should be interpreted with caution because we used a nonvalidated in-house questionnaire in children. We also found a trend for an effect of this SNP on food intake parameters in adults. The impact of genetic variants of the MCHR2 gene on food intake, if any, seems to be attenuated in adulthood, which could explain the lack of association of the A76A variant in severe adult obesity. Similar observations have been found for other key components of the central regulation of food intake. Farooqi et al. (27) showed an age-related decrease in hyperphagia in obese subjects with MC4R mutations that seems to occur with adulthood.

The observation that genetic variation in MCHR2 could modulate food intake is consistent with the proposed role of MCH/MCH receptor pathway in the literature (11). As MCHR1, MCHR2 is specifically activated by nanomolar concentrations of MCH but signals through Gq proteins to induce an increase in intracellular (Ca2+) and inositol phosphate 3 (7, 18). Because A76A is a synonymous coding variation, it seems unlikely that this variant could act by increasing the affinity and the binding of MCHR2 to its ligand, and thereby induce an enhancement in the orexigenic effect of MCH. A more plausible hypothesis could be that this variant confers increased RNA stability to MCHR2, which could affect the MCHR2 receptor density and the orexigenic effect of MCH. Several reports have highlighted the significance of synonymous mutations that affect mRNA secondary structure, which in some cases induce diseases (28, 29). In addition, it remains possible that the A76A genetic variant could affect exon skipping or disrupt the splicing process as previously documented in abundant examples of synonymous mutations (30, 31). Finally, we cannot exclude the possibility that this variant is in LD with the true functional variant located elsewhere in the MCHR2 gene. Unfortunately, this SNP was not genotyped in the Hapmap II, avoiding us to study the extensive LD with A76A in the 6q16 region. A detailed analysis of LD in the MCHR2 region by sequencing of large-sized population-based cohorts could be useful. If LD analysis and association studies revealed that the A76A variant is itself a primary variant determining obesity susceptibility, then functional analysis should be undertaken.

In our study the eight rare SNPs have been found in both obese and control individuals. This lack of implication of rare variants of the MCHR2 gene in monogenic forms of obesity in our studied population is consistent with the findings of Bell et al. (32) for the MCHR1 gene. A previous study performed in the United Kingdom population found two noncoding SNPs in the MCHR2 gene, which were not analyzed because they were rare (33). Screening of this gene in white and African-American individuals identified four noncoding SNPs and four coding mutations (34) that include the three coding mutations identified in our study. A fourth nonsynonymous mutation R63K was identified and was not detected in our initial sequenced set. Functional analysis of MCHR2 carrying each of the nonsynonymous mutations G152Q or R63Q demonstrated that this receptor binds MCH and couples to intracellular signaling pathways in a similar way to wild-type MCHR2 (34). The absence of functional effect, particularly of the MCHR2-carrying G152Q mutation, is consistent with our findings. This SNP was found in obese and control subjects at equal frequencies.

In conclusion, our results suggest that the MCHR2 gene is not a major contributor to polygenic and monogenic forms of childhood and adulthood obesity. However, the A76A T/C SNP of MCHR2 might have a modest effect on food intake abnormalities. These preliminary results need to be confirmed in additional populations.


   Acknowledgments
 
We thank all families who participated in this study. We also thank C. G. Bell for the helpful figure of melanin-concentrating hormone receptor 1, Christian Dina and Sophie Gallina for the statistical help, and Kirsten J. Ward for improvement of the paper. We also gratefully acknowledge Olfert Landt at Tib-Molbiol (www.tib-molbiol.com <http://www.tib-molbiol.com>) for his technical assistance.


   Footnotes
 
This work was supported by "le Conseil National de la Recherche Scientifique Libanais," "le Conseil Régional Nord Pas de Calais/FEDER," "200 Familles pour Vaincre le Diabète et l’Obésite," and "Association Française des Diabétiques."

Disclosure Statement: The authors have nothing to declare.

First Published Online August 14, 2007

Abbreviations: BMI, Body mass index; CI, confidence interval; CNRS, Centre National de la Recherche Scientifique; ENPP1, ectonucleotide pyrophosphatase phosphodiesterase 1; HWE, Hardy-Weinberg equilibrium; LD, linkage disequilibrium; MAF, minor allele frequency; MCH, melanin-concentrating hormone; MCHR1, MCH receptor 1; MCHR2, MCH receptor 2; OR, odds ratio; SNP, single nucleotide polymorphism; SUVIMAX, SUpplementation en VItamines et Minéraux AntioXydants; TDT, Transmission Disequilibrium Test; TFEQ, Three Factor Eating Questionnaire; UMR, Unité Mixte de Recherche; UTR, untranslated region.

Received October 24, 2006.

Accepted August 2, 2007.


   References
Top
 Abstract
 Introduction
 Patients and Methods
 Results
 Discussion
 References
 

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F. Stutzmann, K. Tan, V. Vatin, C. Dina, B. Jouret, J. Tichet, B. Balkau, N. Potoczna, F. Horber, S. O'Rahilly, et al.
Prevalence of Melanocortin-4 Receptor Deficiency in Europeans and Their Age-Dependent Penetrance in Multigenerational Pedigrees
Diabetes, September 1, 2008; 57(9): 2511 - 2518.
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