Thesis (PhD)--Stellenbosch University, 2012. / Includes bibliography / ENGLISH ABSTRACT: Background/Aims: Obesity has increased rapidly in South African children and adolescents with
significant variability observed among racial groups. Genes that regulate appetite have been studied in
different populations worldwide, but their role in obesity among South African adolescents is unknown.
The present study aimed at investigating the role of these genes, and their combined effect with
physical activity in the development of obesity among South African adolescents.
Methods: A total of 1564 South African school learners of Caucasian (n= 146), Mixed Ancestry (n=
872) and Black African (n= 537) ethnic groups were recruited for a research project that aimed to
elucidate diabetes and the metabolic syndrome in children and adolescents attending schools in periurban
areas of the Western Cape. The present case-control study included 227 obese-overweight
(115 Black Africans and 112 Mixed Ancestry), and 204 normal weight (94 Black Africans and 110
Mixed Ancestry) adolescents learners. The learners were genotyped for nine polymorphisms (LEP:
19G>A, Lys36Arg, Val94Met; LEPR: Lys109Arg; Gln223Arg, Lys656Asn; CART: c.160-33G>A,
c.499delA, and c.517A>G; GHRL: Leu72Met; and MC3R: Thr6Lys, Val81Ile) using allele-specific
restriction enzyme analysis and automated sequencing. Genotype and haplotype associations with
anthropometric variables such as body mass index (BMI), waist, hip, and mid-upper-arm
circumferences (WC, HC, MUAC), and metabolic traits (fasting blood glucose, high density lipoproteincholesterol,
total cholesterol), and blood pressure were further conducted. Furthermore, the type and
frequency of physical activity was assessed by means of structured questionnaires; and its effect on
obesity-related variables investigated in learners that were genotyped for the MC3R Thr6Lys and Val81Ile polymorphisms. Results: In a stepwise backward logistic regression analysis (containing age, gender, and LEP,
LEPR, CART and GHRL polymorphisms), CART c.517A>G was independently significantly associated
with obesity (OR= 5.98; 95%CI= 2.02, 21.27). CART c.517G carriers had higher MUAC (b coefficient=
1.88; 95%CI= 0.31, 3.44) while the LEPR 109Arg allele was significantly associated with decreased
BMI (b coefficient = -2.36; 95%CI= -4.24, -0.47), WC (b coefficient = -5.66; 95%CI= -9.89, -1.44) and
MUAC (b coefficient = -1.61; 95%CI= -3.00, -0.22); after adjusting for age, gender, and ethnicity. The
haplotype containing the three LEP polymorphisms (A-A-A compared to the reference G-A-G
haplotype) increased BMI (p= 0.0155), MUAC (p= 0.0146), and HC (p= 0.0128). The minor alleles of
the MC3R polymorphisms decreased BMI, HC, WC, MUAC and TC; whilst only the Thr6Lys was
associated with systolic and diastolic blood pressure (p= 0.0047 and 0.0027, respectively) in Mixed Ancestry learners. Doing house chores was associated with lower total cholesterol, independently
and in the presence of the 81Ile allele (b coefficient = -0.355; 95%CI= 0.148, 0.561).
Conclusion: To our knowledge, this is the first study that reports CART c.517A>G polymorphism as a
risk factor for obesity in adolescents. Furthermore, the present study demonstrated that the MC3R
polymorphisms had a positive effect on total cholesterol, which was further enhanced in physically
active individuals. Similar to other studies, LEPR Lys109Arg and LEP polymorphisms were associated
with variations in obesity-related variables among Black African and Mixed Ancestry South African learners. / AFRIKAANSE OPSOMMING: Agtergrond/Doelwitte: Vetsug het drasties toegeneem in Suid-Afrikaanse kinders en adelossente
met ‘n beduidende variasie opgemerk tussen verskillende rassegroepe. Gene verantwoordelik vir
regulering van eetlus is reeds wêreldwyd in verskillende bevolkingsgroepe bestudeer, maar hul rol in
oorgewig Suid-Afrikaanse adolessente is onbekend. Die huidige studie was daarop gerig om
ondersoek in te stel na die rol van hierdie gene en hul gekombineerde effek met fisiese aktiwiteit in die
ontwikkeling van vetsug onder Suid-Afrikaanse adolessente.
Metodes: ‘n Totaal van 1564 Suid-Afrikaanse leerders van Kaukasiese Afkoms (n=146), Gemengde
Afkoms (n=872) en Swart Afkoms (n= 537) was gewerf in die navorsingsprojek wat ten doel gehad het
om kinders en adolosente met diabetes en die metaboliese sindroom te identifiseer wat skole
bygewoon het in semi-voorstedelike gebiede van die Wes-Kaap. Die huidige gevalle studie het 227
vetsugtige-oorgewig (115 Swart Afkoms en 110 Gemengde Afkoms) en 204 normale gewig (94 Swart
Afkoms en 110 Gemengde Afkoms) leerders ingesluit. Die leerders was gegenotipeer vir nege
polimorfismes (LEP: 19G>A, Lys36Arg, Val94Met; LEPR: Lys109Arg; Gln223Arg, Lys656Asn; CART:
c.160-33G>A, c.499delA, and c.517A>G; GHRL: Leu72Met; and MC3R: Thr6Lys, Val81Ile) met die
gebruik van alleel-spesifieke restriksie ensiem analises en geoutomatiseerde DNA volgorde bepalings
tegnieke. Genotipiese en haplotipiese assosiasies met antropometriese veranderlikes soos
liggaamsmassa indeks (BMI), middel-, heup- en mid-boarm omtrek (WC, HC, MUAC), metaboliese
tendense (vastende bloed glukose, hoë-digtheid lipoproteïen-cholesterol, totale cholesterol) en
bloeddruk was ook uitgevoer. Die tipe en frekwensie fisiese aktiwiteit was geassesseer deur middel
van gestruktureerde vraelyste; en die uitwerking daarvan op vetsugverwante veranderlikes ondersoek
in leerders wat vir die MC3R Thr6Lys en Val81Ile polimorfismes gegenotipeer was. Resultate: Statistiese ontleding (‘‘stepwise backward logistic regression analysis”), wat ouderdom,
geslag en polimorfismes (LEP, LEPR, CART GHRL) ingesluit het, het getoon dat CART c.517A>G
betekenisvol onafhanklik geassosiasieer was met vetsug (OR= 5.98; 95% CI= 2.02, 21.27). CART
c.517G draers het ‘n hoër MUAC waarde gehad (b koeffisient = 1.88; 95%CI= 0.31, 3.44), terwyl die
LEPR 109Arg alleel betekenisvol geassosieer was met verlaagde BMI ((b koeffisient = -2.36; 95%CI=
-4.24, -0.47), WC (b koeffisient = -5.66; 95%CI= -9.89, -1.44) en MUAC (b koeffisient = -1.61; 95%CI=
-3.00, -0.22) na die aanpassing van ouderdom, geslag en etnisiteit. Die haplotipe met die drie LEP
polimorfismes (A-A-A teenoor die G-A-G verwysingshaplotipe) het die BMI (p= 0.0155), MUAC (p=
0.0146) en HC (p= 0.0128) verhoog. Die mindere allele van die MC3R polimorfismes het die BMI, HC,
WC, MUAC en TC verlaag; terwyl slegs die Thr6Lys polymorfisme met sistolies en diastolies bloeddruk (p= 0.0047 en p= 0.0027, onderskeidelik) geassosieer was in Gemengde Afkoms leerders.
Die verrigting van algemene huistake was geassosieer met laer totale kolesterol vlakke, onafhanklik
en in die teenwoordigheid van die 81lle alleel (b koeffisient= -0.355; 95%CI= 0.148, 0.561).
Gevolgtrekking: Na ons wete is hierdie die eerste studie wat die CART c.517A>G polimorfisme as ‘n
risikofaktor vir vetsug in adolessente aantoon. Die huidige studie toon ook dat die MC3R polimorfisme
‘n positiewe effek op totale kolesterol gehad het, wat ook verder versterk was in fisiese aktiewe
individue. Soortgelyk aan ander studies, was die LEPR Lys109Arg en LEP polimorfismes geassosieer
met variasies in vetsug-verwante veranderlikes onder Suid-Afrikaanse Swart en Gemengde Afkoms
leerders. / This research was supported by a grant from the University Research Fund of the Cape Peninsula
University of Technology, Harry Crossley, University of Stellenbosch, Faculty of Health Sciences,
Medical Research Council, and the National Health Laboratory Services, South Africa.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/71644 |
| Date | 12 1900 |
| Creators | Yako, Yandiswa Yolanda |
| Contributors | Erasmus, Rajiv, Matsha, Tandi, Janse van Rensburg, Susan, Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology. Chemical Pathology. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
| Format | xv., 231 p. : col. ill. |
| Rights | Stellenbosch University |
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