Sequencing of 14 Genes From Leptin Melanocortin Pathway in Severe Obesity in Childhood. (OBEGEN)

Central Hospital, Nancy, France

Status: Not yet enrolling

Conditions: Obesity, Child

Treatments: Genetic: sequencing of a panel of 14 genes in leptin melanocortin pathway

Study type: Interventional

Funder types: Other

Identifiers

NCT05938335

2023PI

Details and patient eligibility

About

About 380 million children and adolescents suffer from overweight and obesity at the global level. Obesity results from the interplay between biological (sex, age, fetal programming, gut microbiota, epigenetics, and genetics) and environmental factors (e.g., unhealthy diet, physical inactivity, stress). Mutations in genes from leptin melanocortin pathway are involved in "non syndromic monogenic obesity", characterized by severe early onset obesity, hyperphagia and endocrine deficiencies. Exact frequencies of mutation in these genes are not precisely evaluated in french children with severe obesity. Moreover new treatment, such seltmelanotide are avalaible in case of certain mutation, leading to a significative weight loss in treated patients.

Full description

Obesity is a global health concern that affected more than 650 million adult people and more than 380 million children and adolescents worldwide, with no signs of slowing down despite major investments in health policy. Obestiy is a multifactorial disease, but 40 to 75% of body mass index (BMI) variation is explained by genetic factors.

Mutations in genes from leptin melanocortin pathway lead to "non syndromic monogenic obesity", characterized by severe early onset obesity, hyperphagia and endocrine deficiencies. This pathway plays a central role in regulating mammalian food intake, energy expenditure and body weight regulation. Somes genes are well characterized such LEP gene, LEPR gene, or MC4R but others have been recently described as ADCY3, SIM1, SH2B1, NTRK2, BDNF, KSR2.

The frequency of these mutations are not precisely estimated in a group of french children with severe obesity.

Moreover, a precocious identification of these mutations, could afford, in certain case the possibility of a efficient treatment with setmelanotide, leading to a significant weight loss in treated patients.

Enrollment: 100 estimated patients

Sex: All

Ages: 6 months to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• severe obesity with BMI > 3SDS

Exclusion criteria

• genetic obesity (Prader Willi syndrome, Bardet Biedl syndrome, X fragile syndrome, Alstrom syndrome)
• BMI < 3 SDS
• age < 6 months
• monogenic non syndromic obesity, with mutation in genes of leptin melanocortin pathway previously diagnosed
• cushing syndrome

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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100 participants in 1 patient group

severe obese children

Experimental group

Description:

children with severe obesity with BMI \> 3sds

Treatment:

Genetic: sequencing of a panel of 14 genes in leptin melanocortin pathway