title: Weight loss after bariatric surgery in morbidly obese adolescents with MC4R mutations.
abstract: OBJECTIVE
  To determine the frequency of Melanocortin 4 Receptor (MC4R) mutations in morbidly obese adolescents undergoing bariatric surgery and compare weight loss outcomes in patients with and without mutations.
  
  
  METHODS
  In this prospective cohort study, 135 adolescent patients evaluated for bariatric surgery were screened for MC4R mutations; 56 had 12-month postoperative data available for analysis.
  
  
  RESULTS
  MC4R mutations were detected in five of the 135 patients (3.7%); four underwent restrictive bariatric surgery. For the three patients with gastric banding, percent excess weight loss (%EWL) postoperatively was 36.0% at 5 years in one, 47% at 4 years in the second, and 85% at 1 year in the third. For the patient with gastric sleeve resection, %EWL of 96% was attained at 1 year postoperatively. The four MC4R cases had a higher, although nonsignificant, %EWL compared to 52 nonmatched controls at 12 months postoperatively (48.6% vs. 23.4%; P < 0.37). When matched by age, sex, and race to 14 controls, there was no significant difference in %EWL (P < 0.31), BMI change (P < 0.27), or absolute weight loss (P < 0.20).
  
  
  CONCLUSIONS
  The frequency of MC4R mutations is similar to prior studies, with affected patients showing beneficial weight loss outcomes.
authors.affiliation: Department of Pediatrics Division of Pediatric Endocrinology, Columbia University Medical Center, New York, USA.
authors.forename: Marisa
authors.initials: M
authors.lastname: Censani
authors.forename: Rushika
authors.initials: R
authors.lastname: Conroy
authors.forename: Liyong
authors.initials: L
authors.lastname: Deng
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Oberfield
authors.forename: Donald J
authors.initials: DJ
authors.lastname: McMahon
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Zitsman
authors.forename: Rudy L
authors.initials: RL
authors.lastname: Leibel
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Chung
authors.forename: Ilene
authors.initials: I
authors.lastname: Fennoy
mesh_terms: D000293:Adolescent; D050110:Bariatric Surgery; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D009154:Mutation; D009767:Obesity, Morbid / Q000235:genetics* / Q000601:surgery*; D011182:Postoperative Care; D011446:Prospective Studies; D044105:Receptor, Melanocortin, Type 4 / Q000235:genetics*; D017422:Sequence Analysis, DNA; D015431:Weight Loss
chemical_list: C470072:MC4R protein, human; D044105:Receptor, Melanocortin, Type 4