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Dear editor:
I have read with interest the study by Yoo et al.,1 on the “Genetic Contributions to Childhood Obesity: Association of Candidate Gene Polymorphisms and Overweight/Obesity in Korean Preschool Children”. The authors reported that their data suggest that overweight children exhibited a higher frequency of the A allele in the AT2 C3123A polymorphism compared to the controls (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.03–2.88; P = 0.038), and the frequency of C allele in the transforming growth factor beta-1 (TGF-β1, OMIM: 190180) T869C polymorphism (OR, 1.93; 95% CI, 1.15–3.21; P = 0.010) was also higher in obese or overweight children than in control subjects.1
However, I have three comments on this study. First, the authors used AT2 for gene symbol, while the symbol of angiotensin II type 2 receptor (OMIM: 300034) is AGTR2. Second the AGTR2 gene has been mapped to the human X chromosome band q22–23.23 We know that females have two X chromosome and males have only one X chromosome. Therefore, there were quite different patterns for genotypes of genes located on X chromosome. In females, we can observed three genotypes (AA, AC, and CC) and in males we can determine subjects carrying the A or C alleles (AY and CY). Therefore, for such polymorphisms, investigators should report the genotypes in each gender group separately. Unfortunately, the authors report the genotypes in the pooled samples.
I mentioned in my previous letters that unfortunately, in some genetic association studies, the observed genotypic frequencies showed significant deviations from the expected values based on the Hardy-Weinberg equilibrium (HWE).345678 It is strongly recommended by STrengthening the REporting of Genetic Association studies (STREGA) that authors should investigate the HWE in their samples.9 Using data presented in the above mentioned article, we can find that the observed genotypic frequencies of the TGF-β1 T869C (χ2 = 4.21; df = 1; P = 0.040) polymorphisms showed statistical significant deviation from the expected frequencies based on the HWE. The significant difference between the observed and expected frequencies of the study genotypes may be interpreted by occurring errors in genotyping determination and/or by occurring errors during selection of the participants. Therefore, the results presented by Yoo et al.,1 should interpret with caution.
References
1. Yoo KH, Yim HE, Bae ES, Hong YS. Genetic contributions to childhood obesity: association of candidate gene polymorphisms and overweight/obesity in Korean preschool children. J Korean Med Sci. 2017; 32(12):1997–2004.
2. Chassagne C, Beatty BG, Meloche S. Assignment of the human angiotensin II type 2 receptor gene (AGTR2) to chromosome Xq22-q23 by fluorescence in situ hybridization. Genomics. 1995; 25(2):601–603.
3. Tissir F, Rivière M, Guo DF, Tsuzuki S, Inagami T, Levan G, et al. Localization of the genes encoding the three rat angiotensin II receptors, Agtr1a, Agtr1b, Agtr2, and the human AGTR2 receptor respectively to rat chromosomes 17q12, 2q24 and Xq34, and the human Xq22. Cytogenet Cell Genet. 1995; 71(1):77–80.
5. Saadat M. Significance of the Hardy-Weinberg equilibrium in genetic association studies. Psychiatry Res. 2011; 190(1):165.
6. Saadat M. Presence of evolutionary pressures or genotyping error. J Korean Med Sci. 2012; 27(3):335.
7. Saadat M. Haplotype analysis of the C677T and A1298C polymorphisms of MTHFR and susceptibility to chronic myeloid leukemia. Med Oncol. 2014; 31(3):871.
8. Saadat M. Corrections of frequencies of cytochrome P450 2B6 and 2C8 allelic variants in the Mozambican population. Malays J Med Sci. 2016; 23(5):100–101.
9. Little J, Higgins JP, Ioannidis JP, Moher D, Gagnon F, von Elm E, et al. STrengthening the REporting of Genetic Association studies (STREGA)--an extension of the STROBE statement. Eur J Clin Invest. 2009; 39(4):247–266.