Macronutrient Intake-Associated FGF21 Genotype Modifies Effects of Weight-Loss Diets on 2-Year Changes of Central Adiposity and Body Composition: The POUNDS Lost Trial

Diabetes Care. 2016 Nov;39(11):1909-1914. doi: 10.2337/dc16-1111. Epub 2016 Aug 31.

Abstract

Objective: Fibroblast growth factor 21 (FGF21) is involved in the regulation of energy balance and adipose metabolism. Our previous genome-wide association study identified genetic variants in the FGF21 region associated with macronutrient intake preference. We investigated whether the FGF21 genotype modified effects of weight-loss diets varying in macronutrient intake on changes in adiposity in a 2-year randomized diet intervention trial.

Research design and methods: We genotyped FGF21 rs838147 in 715 overweight or obese individuals who were assigned to one of four diets varying in macronutrient contents. A DEXA scan was performed to evaluate body composition.

Results: We observed a significant interaction between the FGF21 genotype and carbohydrate/fat intake on 2-year changes in waist circumference (WC), percentage of total fat mass, and percentage of trunk fat (P = 0.049, P = 0.001, and P = 0.003 for interaction, respectively). In response to the low-carbohydrate/high-fat diet, carrying the carbohydrate intake-decreasing C allele of rs838147 was marginally associated with less reduction in WC (P = 0.08) and significantly associated with less reduction of total fat mass (P = 0.01) and trunk fat (P = 0.02). Opposite genetic associations with these outcomes were observed among the high-carbohydrate/low-fat diet group; carrying the C allele was associated with a greater reduction of WC, total body fat mass, and trunk fat.

Conclusions: Our data suggest that FGF21 genotypes may interact with dietary carbohydrate/fat intake on changes in central adiposity and body fat composition. A low-calorie, high-carbohydrate/low-fat diet was beneficial for overweight or obese individuals carrying the carbohydrate intake-decreasing allele of the FGF21 variant to improve body composition and abdominal obesity.

Trial registration: ClinicalTrials.gov NCT00072995.

MeSH terms

  • Adiposity / genetics*
  • Adult
  • Alleles
  • Body Composition / genetics*
  • Caloric Restriction
  • Diet, Fat-Restricted
  • Diet, High-Fat
  • Diet, Reducing*
  • Dietary Carbohydrates
  • Dietary Fats
  • Energy Intake
  • Female
  • Fibroblast Growth Factors / genetics*
  • Genome-Wide Association Study
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Obesity / diet therapy*
  • Obesity, Abdominal / genetics
  • Overweight / diet therapy
  • Polymorphism, Single Nucleotide
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Waist Circumference
  • Weight Loss / genetics*

Substances

  • Dietary Carbohydrates
  • Dietary Fats
  • fibroblast growth factor 21
  • Fibroblast Growth Factors

Associated data

  • ClinicalTrials.gov/NCT00072995