Association of FTO rs9939609, MC4R rs17782313, and TMEM18 rs6548238 Variants with Body Mass Index and Body Composition in Young Indonesian Adults
Abstract
BACKGROUND: Obesity is partly driven by genetic variation, including single-nucleotide polymorphisms (SNPs) in the Fat Mass and Obesity-associated (FTO), Melanocorti-4 Receptor (MC4R), and Transmembran Protein 18 (TMEM18) genes. However, only few Indonesian studies have integrated body composition analysis using bioelectrical impedance analysis (BIA) to evaluate the relationship between these genotypes and body mass index (BMI). Therefore, this study was conducted to investigate the association of FTO rs9939609, MC4R rs17782313, and TMEM18 rs6548238 with BMI and BIA-derived body composition parameters.
METHODS: A cross-sectional study was conducted involving 111 healthy young adults aged 18–31 years olds. Subjects were examined for their body composition parameters using using the Quadscan 4000 BIA device, and then classified into obese (BMI≥25 kg/m2) and non-obese (BMI<25 kg/m2). Buccal rinse samples from each subjects were taken for the DNA extraction. Genotyping for FTO rs9939609, MC4R rs17782313, and TMEM18 rs6548238 were then performed using the Kompetitive Allele-Specific Polymerase Chain Reaction (KASPTM) method.
RESULTS: Among 3 SNPs, only the A allele of FTO rs9939609 showed a significant association with increased BMI (p=0.0115) and several BIA parameters, including higher fat percentage (p=0.022), greater fat mass (p=0.0071), higher muscle mass (p=0.0334), and lower muscle mass percentage (p=0.022). Mediation analysis indicated that fat mass, fat-free mass index, body fat mass index, and total body water mediated 72.7–94.3% of the FTO effect on BMI, with an insignificant direct effect.
CONCLUSION: FTO rs9939609 variant is significantly associated with higher BMI in Indonesia young adults, primarily mediated by alterations in fat and muscle mass. In contrast, MC4R rs17782313 and TMEM18 rs6548238 showed no significant associations. These findings underscore the value of integrating genetic profiling with BIA-based body composition measures to refine obesity risk assessment and clarify the regulatory role of the intronic FTO variant.
KEYWORDS: FTO, MC4R, TMEM18, obesity, bioelectrical impedance analysis, genetic association, Indonesia
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Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019; 92: 6-10, CrossRef.
Meiliana A, Dewi NM, Wijaya A. Adipose tissue, inflammation (meta-inflammation) and obesity management. Indones Biomed J. 2015; 7(3): 129-46, CrossRef.
Kementrian Kesehatan RI. Epidemi Obesitas: Fakta Data. Jakarta: Kementrian Kesehatan RI; 2023.
Ling C, Rönn T. Epigenetics in human obesity and type 2 diabetes. Cell Metab. 2019; 29(5): 1028-44, CrossRef.
Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: Revisiting an old relationship. Metabolism. 2019; 92: 98-107, CrossRef.
Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism. 2019; 92: 82-97, CrossRef.
Andarini S, Sargowo D. The differences of food compositions in adolescent metabolic syndrome in Malang. Indones Biomed J. 2010; 2(1): 45-53, CrossRef.
Akbarian S, Salehi-abargouei A, Pourmasoumi M. Advances in medical sciences association of brain-derived neurotrophic factor gene polymorphisms with body mass index : A systematic review and meta-analysis. Adv Med Sci. 2018; 63(1): 4356, CrossRef.
Lamiquiz-moneo I, Mateo-gallego R, Bea AM, Dehesa-garcía B, Pérez-calahorra S, Marco-benedí V, et al. Genetic predictors of weight loss in overweight and obese subjects. Sci Rep. 2019; 9(1): 10770, CrossRef.
Akhter D, Akter F, Rahman I, Munim A, Hossain S. Meta-analysis investigating the impact of the LEPR rs1137101 ( A > G ) polymorphism on obesity risk in Asian and Caucasian ethnicities. Heliyon. 2024; 10(6): e27213, CrossRef.
Ning N, Guan Z, Dong P, Wu W, Ling J, Rahim W, et al. FTO gene polymorphisms and obesity risk in Chinese population : A meta ‑ analysis. World J Pediatr. 2019; 15(4): 382-9, CrossRef.
Ali AHA. The common gene MC4R rs17782313 polymorphism associated with obesity: A meta-analysis. Hum Gene. 2022; 33: 201035, CrossRef.
Koj N, Grochowalski Ł, Jarczak J, Wójtowicz W, Sobalska-Kwapis M, Słomka M, et al. The association between polymorphisms near TMEM18 and the risk of obesity: a meta-analysis. BMC Med Genomics. 2021; 14(1): 179, CrossRef.
Ran S, Jiang ZX, He X, Liu Y, Zhang YX, Zhang L, et al. Replication of FTO gene associated with lean mass in a meta-analysis of Genome-Wide Association Studies. Sci Rep. 2020; 10(1): 5057, CrossRef.
Yu K, Li L, Zhang L, Guo L, Wang C. Association between MC4R rs17782313 genotype and obesity: A meta-analysis. Gene. 2020; 733: 144372, CrossRef.
Lubis SM, Fattah M, Damanik HA, Batubara JRL. Association of fat mass and obesity-associated gene (FTO) rs9939609 variant with early onset obesity among Bataknese and Chinese children in Indonesia: A case-control study. Indones Biomed J. 2017; 9(3): 147-52, CrossRef.
Daya M, Pujianto DA, Witjaksono F, Priliani L, Susanto J, Lukito W, et al. Obesity risk and preference for high dietary fat intake are determined by FTO rs9939609 gene polymorphism in selected Indonesian adults. Asia Pac J Clin Nutr. 2019; 28(1): 183-91, CrossRef.
Wu Y, Li D, Vermund SH. Advantages and limitations of the body mass index (BMI) to assess adult obesity. Int J Environ Res Public Health. 2024; 21(6): 757, CrossRef.
Ward LC. Bioelectrical impedance analysis for body composition assessment: reflections on accuracy, clinical utility, and standardisation. Eur J Clin Nutr. 2019; 73(2): 194-9, CrossRef.
Kang J, Guan R-C, Zhao Y, Chen Y. Obesity-related loci in TMEM18, CDKAL1 and FAIM2 are associated with obesity and type 2 diabetes in Chinese Han patients. BMC Med Genet. 2020; 21(1): 65, CrossRef.
Sergi G, Rui M De, Stubbs B, Veronese N, Manzato E. Measurement of lean body mass using bioelectrical impedance analysis : A consideration of the pros and cons. Aging Clin Exp Res. 2017; 29(4): 591-7, CrossRef.
Tomlinson DJ, Erskine RM, Morse CI, Winwood K, Onambélé-Pearson G. The impact of obesity on skeletal muscle strength and structure through adolescence to old age. Biogerontology. 2016; 17(3): 467-83, CrossRef.
Gene M, Hashim A, Ali A, Pavlovna T, Hafedh A. Association analysis of FTO gene polymorphisms rs9939609 and obesity risk among the adults: A systematic review and meta-analysis. Meta Gene. 2021; 27: 100832, CrossRef.
Zandoná MR, Sangalli CN, Campagnolo PDB, Vitolo MR, Almeida S, Mattevi VS. Validation of obesity susceptibility loci identified by genome-wide association studies in early childhood in South Brazilian children. Pediatr Obes. 2017; 12(1): 85-92, CrossRef.
Al-Jawadi AA, Priliani L, Oktavianthi S, Febinia CA, Daya M, Artika IM, et al. Association of FTO rs1421085 single nucleotide polymorphism with fat and fatty acid intake in Indonesian adults. BMC Res Notes. 2021; 14(1): 411, CrossRef.
Adamska-Patruno E, Goscik J, Czajkowski P, Maliszewska K, Ciborowski M, Golonko A, et al. The MC4R genetic variants are associated with lower visceral fat accumulation and higher postprandial relative increase in carbohydrate utilization in humans. Eur J Nutr. 2019; 58(7): 2929-41, CrossRef.
Rahati S, Qorbani M, Naghavi A, Pishva H. Association and interaction of the MC4R rs17782313 polymorphism with plasma ghrelin, GLP-1, cortisol, food intake and eating behaviors in overweight/obese Iranian adults. BMC Endocr Disord. 2022; 22(1): 234, CrossRef.
DOI: https://doi.org/10.18585/inabj.v17i6.3873
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