title: An FTO variant is associated with Type 2 diabetes in South Asian populations after accounting for body mass index and waist circumference.
abstract: OBJECTIVE
  A common variant, rs9939609, in the FTO (fat mass and obesity) gene is associated with adiposity in Europeans, explaining its relationship with diabetes. However, data are inconsistent in South Asians. Our aim was to investigate the association of the FTO rs9939609 variant with obesity, obesity-related traits and Type 2 diabetes in South Asian individuals, and to use meta-analyses to attempt to clarify to what extent BMI influences the association of FTO variants with diabetes in South Asians.
  
  
  METHODS
  We analysed rs9939609 in two studies of Pakistani individuals: 1666 adults aged ≥40 years from the Karachi population-based Control of Blood Pressure and Risk Attenuation (COBRA) study and 2745 individuals of Punjabi ancestry who were part of a Type 2 diabetes case-control study (UK Asian Diabetes Study/Diabetes Genetics in Pakistan; UKADS/DGP). The main outcomes were BMI, waist circumference and diabetes. Regression analyses were performed to determine associations between FTO alleles and outcomes. Summary estimates were combined in a meta-analysis of 8091 South Asian individuals (3919 patients with Type 2 diabetes and 4172 control subjects), including those from two previous studies.
  
  
  RESULTS
  In the 4411 Pakistani individuals from this study, the age-, sex- and diabetes-adjusted association of FTO variant rs9939609 with BMI was 0.45 (95%CI 0.24-0.67) kg/m(2) per A-allele (P=3.0 × 10(-5) ) and with waist circumference was 0.88 (95% CI 0.36-1.41) cm per A-allele (P=0.001). The A-allele (30% frequency) was also significantly associated with Type 2 diabetes [per A-allele odds ratio (95%CI) 1.18 (1.07-1.30); P=0.0009]. A meta-analysis of four South Asian studies with 8091 subjects showed that the FTO A-allele predisposes to Type 2 diabetes [1.22 (95%CI 1.14-1.31); P=1.07 × 10(-8) ] even after adjusting for BMI [1.18 (95%CI 1.10-1.27); P=1.02 × 10(-5) ] or waist circumference [1.18 (95%CI 1.10-1.27); P=3.97 × 10(-5) ].
  
  
  CONCLUSIONS
  The strong association between FTO genotype and BMI and waist circumference in South Asians is similar to that observed in Europeans. In contrast, the strong association of FTO genotype with diabetes is only partly accounted for by BMI.
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: S D
authors.initials: SD
authors.lastname: Rees
authors.forename: M
authors.initials: M
authors.lastname: Islam
authors.forename: M Z I
authors.initials: MZ
authors.lastname: Hydrie
authors.forename: B
authors.initials: B
authors.lastname: Chaudhary
authors.forename: S
authors.initials: S
authors.lastname: Bellary
authors.forename: S
authors.initials: S
authors.lastname: Hashmi
authors.forename: J P
authors.initials: JP
authors.lastname: O'Hare
authors.forename: S
authors.initials: S
authors.lastname: Kumar
authors.forename: D K
authors.initials: DK
authors.lastname: Sanghera
authors.forename: N
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: A H
authors.initials: AH
authors.lastname: Barnett
authors.forename: A S
authors.initials: AS
authors.lastname: Shera
authors.forename: M N
authors.initials: MN
authors.lastname: Weedon
authors.forename: A
authors.initials: A
authors.lastname: Basit
authors.forename: T M
authors.initials: TM
authors.lastname: Frayling
authors.forename: M A
authors.initials: MA
authors.lastname: Kelly
authors.forename: T H
authors.initials: TH
authors.lastname: Jafar
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000235:genetics*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D055105:Waist Circumference / Q000235:genetics*; D055815:Young Adult