ORGINAL ARTICLE Relation of Trp64Arg Polymorphism of b3-Adrenoreceptor Gene with Cardiovascular Risk Factors in Presurgical Morbidly Obese Patients Daniel A. de Luis, Rocio Aller, Olatz Izaola, Manuel Gonzalez-Sagrado, and Rosa Conde Institute of Endocrinology and Nutrition, School of Medicine and Unit of Investigation, Hospital Rio Hortega, University of Valladolid, Valladolid Spain RD-056/0013 RETICEF Received for publication July 28, 2008; accepted September 8, 2008 (ARCMED-D-08-00332). Background. Genetic background of presurgical morbidly obese patients may have an inﬂuence on follow-up and outcome. A genetic variant is the Trp64Arg missense muta- tion in the b3-adrenoreceptor (b3-AR) gene. Methods. We investigated the inﬂuence of the Trp64Arg polymorphism in the b3-AR gene on adipocytokines and cardiovascular risk factors in presurgical morbidly obese patients. A population of 56 presurgical morbidly obese patients was analyzed. Indirect calorimetry, tetrapolar bioimpedance, blood pressure, serial assessment of nutritional intake with a 3-day written food record, and biochemical parameters were measured. Genotype of b3-AR gene polymorphism (Trp64Arg) was studied. Results. Mean age was 50.2  4.2 years and mean BMI was 46.8  4.7 with 11 males (19.6%) and 45 females (80.4%). There were 45 patients (9 males/36 females) (80.4%) who had the genotype Trp64/Trp64 (wild-type group) with an average age of 53.2  14 years, and there were 11 patients (2 males/9 females) Trp64/Arg64 (19.6%) (mutant group) with an average age of 47.7  15.6 years. In the mutant group, body mass index (BMI), weight, fat mass, waist circumference, total cholesterol, low-density lipoprotein (LDL) cho- lesterol, triglycerides, ﬁbrinogen, and C-reactive protein (CRP) were higher than wild-type group. Adipocytokine levels were similar in both groups. Conclusions. In the mutant group of b3-AR gene (Trp64/Arg64), presurgical morbidly obese patients have a poorer inﬂammatory proﬁle, lipid proﬁle and fat distribution than wild-type group. Perhaps a future presurgical evaluation of morbidly obese patients would be necessary for genetic proﬁling. Ó 2008 IMSS. Published by Elsevier Inc. Key Words: Adipocytokines, Cardiovascular risk factors, Trp64Arg b3-adrenoreceptor, Morbid obesity. Introduction Obesity has multiple causes and is determined by the interaction between genetic and environmental factors (1). In particular, gene defects showing no or only minor effects when expressed alone may inﬂuence phenotype. Bariatric surgery is the most effective long-term treatment for morbid obesity, reducing obesity-associated comorbidities (2). Genetic background of these patients may be inﬂuential in follow-up and outcome (3,4). Perhaps a future presurgi- cal evaluation of morbidly obese patients would include a genetic proﬁle. A genetic variant is the tryptophan/arginine (Trp64Arg) missense mutation in the b3-adrenoreceptor (b3-AR) gene. b3-AR is the principle mediator of catecholamine-stimulated thermogenesis and lipolysis, which mainly occur at subcuta- neous and visceral sites (5). Trp64Arg variant in this receptor has been reported to be associated with increased body weight and insulin resistance (6). Adipose tissue is considered an active secretory organ, sending out and responding to signals that modulate appetite, insulin sensitivity, energy expenditure, and inﬂammation. Adipocytokines are proteins produced mainly by adipocytes. These molecules have been shown to be involved in the Address reprint requests to: Dr. D.A. de Luis, Associate Professor of Nutrition, Executive Director of Institute of Endocrinology and Nutrition, School of Medicine, Valladolid University, C/Los perales 16, Simancas 47130, Valladolid, Spain; E-mail: dadluis@yahoo.es 0188-4409/08 $esee front matter. Copyright Ó 2008 IMSS. Published by Elsevier Inc. doi: 10.1016/j.arcmed.2008.09.004 Archives of Medical Research 39 (2008) 791e795