title: Education modulates the association of the FTO rs9939609 polymorphism with body mass index and obesity risk in the Mediterranean population.
abstract: OBJECTIVE
  To define whether the rs9939609 FTO (fat mass and obesity associated) single nucleotide polymorphism (SNP) is associated with anthropometric measurements and its modulation by educational level in a Mediterranean population.
  
  
  METHODS
  We studied 3 independent adult samples: a random sample (n = 1580) from the general population (GP), obese hospital patients (OHP) (n = 203) and elderly subjects (n = 1027) with high cardiovascular risk (HCR). Weight and height were directly measured. Education and physical activity (PA) were measured using questionnaires.
  
  
  RESULTS
  The rs9939609 presented heterogeneous associations with BMI. In the GP, the minor A-allele was significantly associated with greater BMI, following a co-dominant pattern (P = 0.009), whereas in the OHP this association was recessive (P = 0.004). Conversely, we did not find a significant association with BMI in the HCR group (P < 0.596). In the GP we found a significant interaction between the FTO SNP and education (P = 0.048). In the stratified analysis, no association of the FTO SNP with greater BMI in university subjects was detected (P = 0.786), whereas the association was observed in non-university subjects (P = 0.001). The FTO × education interaction (P = 0.020) was also observed in determining obesity risk in the GP. A-allele carriers had a greater risk of being obese only if they had no university education (OR: 1.56; 95%CI: 1.09-2.23 for TA and OR: 2.01; 95%CI: 1.27-3.26 for AA subjects). The interaction of the FTO with education remained significant even after adjustment for PA.
  
  
  CONCLUSIONS
  The association of the FTO SNP with greater BMI and obesity risk in the GP was strongly modulated by education.
authors.affiliation: Genetic and Molecular Epidemiology Unit, School of Medicine, University of Valencia, Blasco Ibañez, 15, 46010 Valencia, Spain. dolores.corella@uv.es
authors.forename: D
authors.initials: D
authors.lastname: Corella
authors.forename: P
authors.initials: P
authors.lastname: Carrasco
authors.forename: J V
authors.initials: JV
authors.lastname: Sorlí
authors.forename: O
authors.initials: O
authors.lastname: Coltell
authors.forename: C
authors.initials: C
authors.lastname: Ortega-Azorín
authors.forename: M
authors.initials: M
authors.lastname: Guillén
authors.forename: J I
authors.initials: JI
authors.lastname: González
authors.forename: C
authors.initials: C
authors.lastname: Sáiz
authors.forename: R
authors.initials: R
authors.lastname: Estruch
authors.forename: J M
authors.initials: JM
authors.lastname: Ordovas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000071516:Alpha-Ketoglutarate-Dependent Dioxygenase FTO; D000886:Anthropometry; D015992:Body Mass Index; D016009:Chi-Square Distribution; D004522:Educational Status; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D016017:Odds Ratio; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D015995:Prevalence; D011506:Proteins / Q000235:genetics*; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D011506:Proteins; D000071516:Alpha-Ketoglutarate-Dependent Dioxygenase FTO; C526492:FTO protein, human