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Evaluation of association of DRD2 TaqIA and -141C InsDel polymorphisms with food intake and anthropometric data in children at the first stages of development

Abstract

The reward sensation after food intake may be different between individuals and variants in genes related to the dopaminergic system may indicate a different response in people exposed to the same environmental factors. This study investigated the association of TaqIA (rs1800497) and -141C InsDel (rs1799732) variants in DRD2/ANKK1 gene with food intake and adiposity parameters in a cohort of children. The sample consisted of 270 children followed until 7 to 8 years old. DNA was extracted from blood and polymorphisms were detected by PCR-RFLP analysis. Food intake and nutritional status were compared among individuals with different SNP genotypes. Children carrying the A1 allele (TaqIA) had higher energy of lipid dense foods (LDF) when compared with A2/A2 homozygous children at 7 to 8 years old (GLM p=0.004; Mann Whitney p=0.005). No association was detected with -141C Ins/Del polymorphism. To our knowledge, this is the first association study of the DRD2 TaqIA and -141C Ins/Del polymorphism with food intake and anthropometric parameters in children. DRD2 TaqIA polymorphism has been associated with a reduction in D2 dopamine receptor availability. Therefore, the differences observed in LDF intake in our sample may occur as an effort to compensate the hypodopaminergic functioning.

Keywords:
Child obesity; DRD2 polymorphisms; food intake

Introduction

The prevalence of childhood overweight and obesity had a dramatic increase between 1990 and 2010, rising from 4.2% to 6.7%, and it is estimated that in 2020 the rate will be 9.1%, or approximately 60 million children (de Onis et al., 2010de Onis M, Blossner M and Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92:1257-1264.). The obesity prevalence in developed countries is twice higher than in developing countries. However, most of the affected children (35 million) live in developing countries (de Onis et al., 2010de Onis M, Blossner M and Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92:1257-1264.). Moreover, the relative increase rate of obesity in recent decades was higher in developing countries (+65%) than in developed countries (+48%) (de Onis et al., 2010de Onis M, Blossner M and Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92:1257-1264.; Oggioni et al., 2014Oggioni C, Lara J, Wells JC, Soroka K and Siervo M (2014) Shifts in population dietary patterns and physical inactivity as determinants of global trends in the prevalence of diabetes: An ecological analysis. Nutr Metab Cardiovasc Dis 24:1105-1111.). Obese children are more likely to become obese adults, and have higher risk of developing coronary heart diseases and other related diseases, which diminish life expectancy (Must, 1996Must A (1996) Morbidity and mortality associated with elevated body weight in children and adolescents. Am J Clin Nutr 63(3 Suppl):445S-447S.; Rossner, 1998Rossner S (1998) Childhood obesity and adulthood consequences. Acta Paediatr 87:1-5.; Berenson, 2012Berenson GS (2012) Health consequences of obesity. Pediatr Blood Cancer 58:117-121.). Insulin resistance, metabolic syndrome, and type 2 diabetes are also consequences of childhood obesity (Gupta et al., 2012Gupta N, Goel K, Shah P and Misra A (2012) Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev 33:48-70.).

Some factors contribute to overweight and obesity, such as low physical activity, high intake of high fat and sugar foods, change from the rural lifestyle to the urban, sociocultural factors, age, gender, and genetic factors (Popkin, 2006Popkin BM (2006) Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr 84:289-298.; Gupta et al., 2012Gupta N, Goel K, Shah P and Misra A (2012) Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev 33:48-70.; Oggioni et al., 2014Oggioni C, Lara J, Wells JC, Soroka K and Siervo M (2014) Shifts in population dietary patterns and physical inactivity as determinants of global trends in the prevalence of diabetes: An ecological analysis. Nutr Metab Cardiovasc Dis 24:1105-1111.). The sensation of reward after food intake, especially of palatable foods, may be different among individuals and might cause different amounts of food ingestion (Berridge et al., 2010Berridge KC, Ho CY, Richard JM and DiFeliceantonio DM (2010) The tempted brain eats: Pleasure and desire circuits in obesity and eating disorders. Brain Res 1350:43-64.). The dopaminergic system regulates food intake through a reward system, and although its function in eating disorders is poorly understood, it is known that the use of dopamine D2 receptors agonists decreases food intake in rats (Terry et al., 1995Terry P, Gilbert DB and Cooper SJ (1995) Dopamine receptor subtype agonists and feeding behavior. Obes Res 3 (Suppl 4):515S-523S.). A study that analyzed images via Positron Emission Tomography (PET) scans shows that obese individuals have low concentration of striatal D2 dopamine receptors as a mechanism of downregulation due to high levels of dopamine, indicating that the reduction of these receptors could be associated with an addictive behavior also observed in drug users (Wang et al., 2001Wang GJ, Volkow ND, Logan J, Pappas NR, Wong CT, Zhu W, Netusil N and Fowler JS (2001) Brain dopamine and obesity. Lancet 357:354-357.). DRD2/ANKK1 gene polymorphisms alter the density of dopamine receptors, and thus may explain the different food intake levels in individuals exposed to the same environmental factors (Stelzel et al., 2010Stelzel C, Basten U, Montag C, Reuter M and Fiebach CJ (2010) Frontostriatal involvement in task switching depends on genetic differences in d2 receptor density. J Neurosci 30:14205-14212.).

Several studies have associated the TaqIA (rs1800497) polymorphism with obesity, body mass index (BMI), and food intake (Barnard et al., 2009Barnard, ND, Noble EP, Ritchie T, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Green AA and Ferdowsian H (2009) D2 dopamine receptor Taq1A polymorphism, body weight, and dietary intake in type 2 diabetes. Nutrition 25:58-65.; Winkler et al., 2012Winkler JK, Woehning A, Schultz JH, Brune M, Beaton N, Challa TD, Minkova S, Roeder E, Nawroth PP, Friederich HC, et al. (2012) TaqIA polymorphism in dopamine D2 receptor gene complicates weight maintenance in younger obese patients. Nutrition 28:996-1001.; Cameron et al., 2013Cameron JD, Riou ME, Tesson F, Goldfield GS, Rabasa-Lhoret R, Brochu M and Doucet E (2013) The TaqIA RFLP is associated with attenuated intervention-induced body weight loss and increased carbohydrate intake in post-menopausal obese women. Appetite 60:111-116.; Carpenter et al., 2013Carpenter CL, Wong AM, Li Z, Noble EP and Heber D (2013) Association of dopamine D2 receptor and leptin receptor genes with clinically severe obesity. Obesity 21:E467-473.). However, to our knowledge, there is no study linking the -141C Ins/Del (rs1799732) polymorphism to obesity, although it was associated with other pathologies such as alcoholism and schizophrenia (Jonsson et al., 1999aJonsson EG, Nothen MM, Neidt H, Forslund K, Rylander G, Mattila-Evenden M, Asberg M, Propping P and Sedvall GC (1999a) Association between a promoter polymorphism in the dopamine D2 receptor gene and schizophrenia. Schizophr Res 40:31-36.; Johann et al., 2005Johann M, Putzhammer A, Eichhammer P and Wodarz N (2005) Association of the -141C Del variant of the dopamine D2 receptor (DRD2) with positive family history and suicidality in German alcoholics. Am J Med Genet B Neuropsychiatr Genet 132B:46-49.; Lafuente et al., 2008aLafuente A, Bernardo M, Mas S, Crescenti A, Aparici M, Gasso P, Goti J, Sanchez V, Catalan R and Carne X (2008a) -141C Ins/Del polymorphism of the dopamine D2 receptor gene is associated with schizophrenia in a Spanish population. Psychiatr Genet 18:122-127.,bLafuente A, Bernardo M, Mas S, Crescenti A, Aparici M, Gasso P, Deulofeu R, Mane A, Catalan R and Carne X (2008b) Polymorphism of dopamine D2 receptor (TaqIA, TaqIB, and-141C Ins/Del) and dopamine degradation enzyme (COMT G158A, A-278G) genes and extrapyramidal symptoms in patients with schizophrenia and bipolar disorders. Psychiatry Res 161:131-141.). Therefore, the objective of the present study was to analyze the association of TaqIA and -141C Ins/Del polymorphisms with adiposity parameters and food intake of children.

Materials and Methods

Subjects

The sample consisted of 270 children followed until 7 to 8 years old on average. The nutritional and anthropometrics data were collected at 12 to 16 months, 3 to 4 and 7 to 8 years. The children included in the present study participated in a randomized controlled trial of dietary counseling on breast feeding and diet during the first year of life. The trial consisted of 500 children, randomized in a control or intervention group, of which mothers received a dietary advice about breastfeeding and complementary feeding during home visits in children’s first year of life. This dietary advice was based on the “Ten steps to Healthy Feeding”, a Brazilian national health policy for primary care, supported by World Health Organization (2006)World Health Organization (2006) The WHO Child Growth Standards. from http://www.who.int/childgrowth/standards/en/.
http://www.who.int/childgrowth/standards...
. More information of the first phase of the study can be found elsewhere (Vitolo et al., 2010Vitolo MR, Rauber F, Campagnolo PD, Feldens CA and Hoffman DJ (2010) Maternal dietary counseling in the first year of life is associated with a higher healthy eating index in childhood. J Nutr 140:2002-2007.), but in Table 1 we described the main characteristics of the sample. A substantial reduction of the sample occurred throughout the study and the main reason for the losses was the inability to locate the participants’ homes, usually due to the family moving to another city. Other reasons for losses were refusal to continue and children or maternal death. This intervention was not the primary objective of the present research and the participation in the intervention or control group was used as a confounding factor in statistical analyses.

Table 1
Main characteristics of the sample.

Ethnicity was defined by the interviewer by skin color (i.e., whites and non-whites). More details of the traits studied are described elsewhere (Galvão, 2012Galvão AC, Krüger RC, Campagnolo PDB, Mattevi VS, Vitolo MR and Almeida S (2012) Association of MAOA and COMT gene polymorphisms with palatable food intake in children. J Nutr Biochem 23:272 - 277.; Louzada et al., 2012Louzada ML, Campagnolo PD, Rauber F and Vitolo MR (2012) Long-term effectiveness of maternal dietary counseling in a low-income population: A randomized field trial. Pediatrics 129:e1477-1484.; Fontana et al., 2015Fontana C, Vitolo MR, Campagnolo PD, Mattevi VS, Genro JP and Almeida S (2015) DRD4 and SLC6A3 gene polymorphisms are associated with food intake and nutritional status in children in early stages of development. J Nutr Biochem 26: 1607-1612.; Miranda et al., 2015Miranda RC, Vetter SB, Genro JP, Campagnolo PD, Mattevi VS, Vitolo MR and Almeida S (2015) SLC6A14 and 5-HTR2C polymorphisms are associated with food intake and nutritional status in children. Clin Biochem 48:1277-1282.). This study was conducted according to the guidelines of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of the Universidade Federal de Ciências da Saúde de Porto Alegre (n. 286/06), and all participants provided written informed consent before commencing the study.

Nutritional status assessment

At 12 to 26 months, children were weighted using a portable digital scale (Techline, São Paulo, Brazil) and length was measured by an infant stadiometer (Serwital Inc, Porto Alegre, Brazil). At 3 to 4 and 7 to 8 years, children were weighted using a digital scale (Techline), and height was measured using a stadiometer (SECA, Hamburg, Germany). BMI was calculated [weight (kg)/height2(m2)], and the values were transformed into Z-scores.

Dietary data assessment

One 24-hour dietary recall was collected for each child at 12 to 16 months, and two 24-hour dietary recalls, on two nonconsecutive days, were collected for each child at the ages of 3 to 4 and 7 to 8 years. The 24-hour dietary recall was carried out by a trained undergraduate nutrition student, and the child’s food intake was recorded on the day before the last home visit. A food portion measurement device and the common household measures (e.g. teaspoons, tablespoons, cups) were used to quantify portion sizes.

Dietary information was entered into the Nutrition Support Program software from the Escola Paulista de Medicina, Federal University of São Paulo, based on the United States Department of Agriculture chemical composition tables. The energy intake was calculated using only one dietary recall or the average of two dietary recalls. The items listed in the response were classified as sugar-dense foods (SDF) if the percentage of simple carbohydrates was higher than 50% (e.g., soda, Jell-O, candies, and artificially flavored juice) and as lipid-dense foods (LDF) if there was more than 30% fat (e.g. fried pastries, cookies with fillings, cold cuts and sausages, fried foods, and chocolate).

DNA analyses

Blood samples for DNA extraction were collected in EDTA tubes (6 mL). Genomic DNA was extracted from peripheral blood leukocytes by the Lahiri and Nurnberger procedure (Lahiri and Nurnberger, 1991Lahiri DK and Nurnberger Jr JI (1991) A rapid non-enzymatic method for the preparation of HMW DNA from blood for RFLP studies. Nucleic Acids Res 19:5444.). DRD2/ANKK1 TaqIA (rs1800497) and -141C InsDel (rs1799732) polymorphisms were detected by PCR-RFLP analysis using primer sequences and conditions described by Grandy et al. (1993)Grandy DK, Zhang Y and Civelli O (1993) PCR detection of the TaqA RFLP at the DRD2 locus. Hum Mol Genet 2:2197. and Ohara et al. (1998)Ohara K, Nagai M, Tani K, Nakamura Y, Ino A and Ohara K (1998) Functional polymorphism of -141C Ins/Del in the dopamine D2 receptor gene promoter and schizophrenia. Psychiatry Res 81:117-123., respectively. Primers sequences (IDT Coralville, IA, USA) were as follows: TaqIA, forward primer 5’- CACCTTCCTGAGTGTCAT CAA -3’ and reverse primer 5’-AGACAACTTGGCCAG CCGTG-3’; -141C InsDel, forward primer 5’-ACTGGC GAGCAGACGGTGAGG and reverse primer 5’-TGCGCGCGTGAGGCTGCCGGT. PCR products were digested separately with either TaqI (TaqIA polymorphism) or MvaI (-141C InsDel polymorphism) enzyme (Fermentas, Glen Burnie, MD, USA), according to the manufacturer’s instructions. Genotypes were determined after electrophoresis in 2 or 3% agarose gels that had been stained with ethidium bromide. For the DRD2/ANKK1 TaqIA polymorphism, the C allele contains a TaqI restriction site and is designated as the A2 allele, while the T allele is designated as the A1 allele. For the -141C InsDel polymorphism, the -141C*Ins allele contains a restriction site for MvaI while the -141C*Del allele does not.

Statistical analyses

Allele frequencies were estimated by gene counting. A chi-square test for goodness-of-fit was used to determine whether the observed genotype frequency distributions agreed with those expected under Hardy-Weinberg equilibrium. Linkage disequilibrium was estimated using the Haploview software Version 4.2 (Broad Institute, Barrett et al., 2005Barrett JC, Fry B, Maller J and Daly MJ (2005) Haploview: Analysis and visualization of LD and haplotype maps. Bioinformatics 21:263-265.).

Pearson’s chi-squared or Fisher’s Exact Test was used to compare genotype or allele frequencies between white and non-white children. Since the first publication of an association study with the TaqIA polymorphism (Blum et al., 1990Blum K, Noble EP, Sheridan PJ, Montgomery A, Ritchie T, Jagadeeswaran P, Nogami H, Briggs AH and Cohn JB (1990) Allelic association of human dopamine D2 receptor gene in alcoholism. JAMA 263:2055-2060.), and because of the rare occurrence of the A1 allele, genotypes are normally grouped as A1 allele presence or A1 allele carriers (A1/A1 and A1/A2, n=102), versus A2/A2 homozygotes (n=116). Similarly, due to low frequencies of the Del allele, genotypes of the -141C InsDel polymorphism were grouped by Del allele presence or Del allele carriers (Del/Del and Ins/Del, n=61), versus Ins/Ins homozygotes (n=157). All data are presented as mean and standard deviation. Statistical analysis of SDF and LDF variables were performed on natural logarithm transformed data to normalize their distribution. This allowed including these variables in multivariate analysis; non-transformed values are shown in Table 2. Means of food intake (average daily energy intake, SDF, LDF and average daily energy intake per kilogram) and adiposity (BMI Z-score) parameters were compared among genotype groups by a multivariate general linear model (GLM). The multivariate GLM was performed including all dependent continuous variables in one model, using the categorical variables (1) the control or intervention variable of the randomized trial, (2) sex, and (3) ethnicity as covariates, and genotypes of -141C InsDel (rs1799732) and TaqIA (rs1800497) polymorphisms as fixed factors (see Table 2). This first step of the analysis verified whether the group of dependent continuous variables was significantly affected by the group of independent categorical variables. Only LDF intake at 7 to 8 years old was associated with TaqIA polymorphism, and the covariates did not influence this dependent variable. Therefore, to test the association of TaqIA polymorphism alone with LDF intake at 7 to 8 years, we performed a Mann-Whitney test. A p-value of < 0.05 was considered significant. All tests and transformations were performed using the Statistical Package for Social Sciences, Version 20.0 (SPSS®, Chicago, IL, USA).

Table 2
Food intake and anthropometrics parameters according to polymorphisms in DRD2/ANKK1 gene (-141C Ins/Del and TaqIA) in children at 1, 3 to 4, and 7 to 8 years old.

Results

This longitudinal survey sample was composed of 270 children, 149 (55.2%) boys and 121 (44.8%) girls, followed up from 12 to 16 months until 7 to 8 years old (Table 1). Minor allele frequencies (MAF) of the DRD2/ANKK1 gene variants observed in the sample were 0.14 of Del allele of the -141C InsDel (rs1799732) polymorphism and 0.28 of A1 allele of the TaqIA (rs1800497) polymorphism, which were intermediary to those described in the 1000 Genomes Project database for European (MAF 0.08 (Del) and 0.19 (A1)) and African (MAF 0.57 (Del) and 0.38 (A1)) populations. All genotype frequencies in this sample were in agreement with those expected under the Hardy-Weinberg equilibrium. The two gene variants were not in linkage disequilibrium (D’=0.3, r=0).

In Table 2, anthropometric and food intake variables are shown according to the analyzed polymorphisms. As some children could not be found at the third home visit at 7 to 8 years, and some samples could not be analyzed in the laboratory, the total number of children included in the multivariate analysis is different from the initial sample size. Children carrying the A1 allele (TaqIA rs1800497) had higher energy of LDF when compared with A2/A2 homozygous children at 7 to 8 years old (multivariate GLM p=0.004; Mann-Whitney test p=0.005). No association was detected among DRD2 -141C Ins/Del polymorphism with food intake and anthropometric parameters.

Discussion

The dopaminergic pathway has been associated with midbrain reward circuit activation (Roth et al., 2013Roth CL, Hinney A, Schur EA, Elfers CT and Reinehr T (2013) Association analyses for dopamine receptor gene polymorphisms and weight status in a longitudinal analysis in obese children before and after lifestyle intervention. BMC Pediatr 13:197.), and individual differences in D2 receptor expression are hypothesized to contribute to differences in motivated behaviors, such as the motivation to eat (Gluskin and Mickey, 2016Gluskin BS and Mickey BJ (2016) Genetic variation and dopamine D2 receptor availability: A systematic review and meta-analysis of human in vivo molecular imaging studies. Transl Psychiatry 6:e747.). Therefore, polymorphisms of the ANKK1/DRD2 gene are frequently associated with altered perception of food reward and weight gain (Ariza et al., 2012Ariza M, Garolera M, Jurado M, Garcia-Garcia I, Hernan I, Sanchez-Garre C, Vernet-Vernet M, Sender-Palacios MJ, Marques-Iturria I , Pueyo R, et al. (2012) Dopamine genes (DRD2/ANKK1-TaqA1 and DRD4-7R) and executive function: their interaction with obesity. PLoS One 7:e41482.; Muller et al., 2012Muller DJ, Zai CC, Sicard M, Remington E, Souza RP, Tiwari AK, Hwang R, Likhodi O, Shaikh S, Freeman N, et al. (2012) Systematic analysis of dopamine receptor genes (DRD1-DRD5) in antipsychotic-induced weight gain. Pharmacogenomics J 12156-164.; Roth et al., 2013Roth CL, Hinney A, Schur EA, Elfers CT and Reinehr T (2013) Association analyses for dopamine receptor gene polymorphisms and weight status in a longitudinal analysis in obese children before and after lifestyle intervention. BMC Pediatr 13:197.). TaqIA is the most commonly tested polymorphism, and is characterized by a single nucleotide change [C(A2)/T(A1)] located downstream of the termination codon of DRD2 gene at the ankyrin repeat and kinase domain containing 1 (ANKK1) gene (Dubertret et al., 2004Dubertret C, Gouya L, Hanoun N, Deybach JC, Ades J, Hamon M and Gorwood P (2004) The 3’ region of the DRD2 gene is involved in genetic susceptibility to schizophrenia. Schizophr Res 67:75-85.; Neville et al., 2004Neville MJ, Johnstone EC and Walton RT (2004) Identification and characterization of ANKK1: a novel kinase gene closely linked to DRD2 on chromosome band 11q23.1. Hum Mutat 23:540-545.; Li et al., 2015Li H, Wang X, Zhou Y, Ni G, Su Q, Chen Z, Chen Z, Li J, Chen X, Hou X, et al. (2015) Association of LEPR and ANKK1 gene polymorphisms with weight gain in epilepsy patients receiving valproic acid. Int J Neuropsychopharmacol 18:pyv021.; Ponce et al., 2016Ponce G, Quinones-Lombrana A, Martin-Palanco MG, Rubio-Solsona E, Jimenez-Arriero MA, Palomo T and Hoenicka J (2016) The addiction-related gene Ankk1 is oppositely regulated by D1R- and D2R-like dopamine receptors. Neurotox Res 29:345-350.). This SNP produces a Glu713-to-Lys (E713K) substitution in the ANKK1 amino acid sequence, at the eleventh ankyrin, which may alter the affinity of the ANKK1 protein and its substrate (Neville et al., 2004Neville MJ, Johnstone EC and Walton RT (2004) Identification and characterization of ANKK1: a novel kinase gene closely linked to DRD2 on chromosome band 11q23.1. Hum Mutat 23:540-545.). It is not clear by which molecular mechanisms the ANKK1 protein could be associated with the dopaminergic system and how ANKK1 polymorphic alleles would impact addiction vulnerability. However, ANKK1 and DRD2 genes belong to the same gene cluster, the NTAD cluster, an ancient cluster of which genes are apparently co-regulated and may have emerged when the central nervous system became more complex (Mota et al., 2012Mota NR, Araujo-Jr EV, Paixao-Cortes VR, Bortolini MC and Bau CH (2012) Linking dopamine neurotransmission and neurogenesis: The evolutionary history of the NTAD (NCAM1-TTC12-ANKK1-DRD2) gene cluster. Genet Mol Biol 35:912-918.). Since genes of related function are sometimes found in the same cluster, it is possible that ANKK1 is somehow involved in the dopaminergic reward processes via a signal transduction pathway (or other cellular response) (Neville et al., 2004Neville MJ, Johnstone EC and Walton RT (2004) Identification and characterization of ANKK1: a novel kinase gene closely linked to DRD2 on chromosome band 11q23.1. Hum Mutat 23:540-545.). A few in vitro studies with ANKK1 gene mRNAs and proteins were able to show a potential connection between this gene and the dopaminergic system (Hoenicka et al., 2007Hoenicka J, Ponce G, Jimenez-Arriero MA, Ampuero I, Rodriguez-Jimenez R, Rubio G, Aragues M, Ramos JA and Palomo T (2007) Association in alcoholic patients between psychopathic traits and the additive effect of allelic forms of the CNR1 and FAAH endocannabinoid genes, and the 3’ region of the DRD2 gene. Neurotox Res 11:51-60.; Garrido et al., 2011Garrido E, Palomo T, Ponce G, Garcia-Consuegra I, Jimenez-Arriero MA and Hoenicka J (2011) The ANKK1 protein associated with addictions has nuclear and cytoplasmic localization and shows a differential response of Ala239Thr to apomorphine. Neurotox Res 20:32-39.).

In our sample, the A1 allele (TaqIA rs1800497) was found associated with higher intake of LDF when compared with children A2/A2 homozygous at 7 to 8 years. This allele has been associated with a reduction in D2 receptor availability (Pohjalainen et al., 1998Pohjalainen T, Rinne JO, Nagren K, Lehikoinen P, Anttila K, Syvalahti RK and Hietala J (1998) The A1 allele of the human D2 dopamine receptor gene predicts low D2 receptor availability in healthy volunteers. Mol Psychiatry 3:256-260.; Ritchie and Noble, 2003Ritchie T and Noble EP (2003) Association of seven polymorphisms of the D2 dopamine receptor gene with brain receptor-binding characteristics. Neurochem Res 28:73-82.; Eisenstein et al., 2016Eisenstein SA, Bogdan R, Love-Gregory L, Corral-Frias NS, Koller JM, Black KJ, Moerlein SM, Perlmutter JS, Barch DMc and Hershey T (2016). Prediction of striatal D2 receptor binding by DRD2/ANKK1 TaqIA allele status. Synapse 70:418-431.). Stice et al. (2008)Stice E, Spoor S, Bohon C and Small DM (2008) Relation between obesity and blunted striatal response to food is moderated by TaqIA A1 allele. Science 322:449-452. found that the dorsal striatum is less responsive to food reward in obese relative to lean individuals, probably because obese individuals have reduced D2 receptor density that compromises dopamine signaling. This hypodopaminergic functioning or reward deficiency syndrome may induce obese patients to overeat in an effort to compensate for this reward deficit; several studies are consistent with this theory (van Strien et al., 2010van Strien T, Snoek HM, van der Zwaluw CS and Engels RC (2010) Parental control and the dopamine D2 receptor gene (DRD2) interaction on emotional eating in adolescence. Appetite 54:255-261.; Duran-Gonzalez et al., 2011Duran-Gonzalez J, Ortiz I, Gonzales E, Ruiz N, Ortiz M, Gonzalez A, Sanchez EK, Curet E, Fisher-Hoch S, Rentfro A, et al. (2011) Association study of candidate gene polymorphisms and obesity in a young Mexican-American population from South Texas. Arch Med Res 42:523-531.; Winkler et al., 2012Winkler JK, Woehning A, Schultz JH, Brune M, Beaton N, Challa TD, Minkova S, Roeder E, Nawroth PP, Friederich HC, et al. (2012) TaqIA polymorphism in dopamine D2 receptor gene complicates weight maintenance in younger obese patients. Nutrition 28:996-1001.; Cameron et al., 2013Cameron JD, Riou ME, Tesson F, Goldfield GS, Rabasa-Lhoret R, Brochu M and Doucet E (2013) The TaqIA RFLP is associated with attenuated intervention-induced body weight loss and increased carbohydrate intake in post-menopausal obese women. Appetite 60:111-116.). van Strien et al. (2010)van Strien T, Snoek HM, van der Zwaluw CS and Engels RC (2010) Parental control and the dopamine D2 receptor gene (DRD2) interaction on emotional eating in adolescence. Appetite 54:255-261. associated the A1 allele with an increase in emotional eating in Dutch adolescents. The A1 allele was also most frequent in young obese Mexican-American subjects than in non-obese, as well as subjects with central-obesity versus subjects with no central-obesity (Duran-Gonzalez et al., 2011Duran-Gonzalez J, Ortiz I, Gonzales E, Ruiz N, Ortiz M, Gonzalez A, Sanchez EK, Curet E, Fisher-Hoch S, Rentfro A, et al. (2011) Association study of candidate gene polymorphisms and obesity in a young Mexican-American population from South Texas. Arch Med Res 42:523-531.). Winkler et al. (2012)Winkler JK, Woehning A, Schultz JH, Brune M, Beaton N, Challa TD, Minkova S, Roeder E, Nawroth PP, Friederich HC, et al. (2012) TaqIA polymorphism in dopamine D2 receptor gene complicates weight maintenance in younger obese patients. Nutrition 28:996-1001. observed in an intervention study that carriers of the A1 allele had a higher BMI at all time-points (baseline, after weight loss, and after weight maintenance), and showed less overall weight loss. Similarly, Cameron et al. (2013)Cameron JD, Riou ME, Tesson F, Goldfield GS, Rabasa-Lhoret R, Brochu M and Doucet E (2013) The TaqIA RFLP is associated with attenuated intervention-induced body weight loss and increased carbohydrate intake in post-menopausal obese women. Appetite 60:111-116. observed that post-menopausal women carriers of the A1 allele lost significantly less body weight and fat mass than women with the A2/A2 genotype after undergoing an intervention-induced weight loss and increased carbohydrate intake. Some studies were not able to find any association of the DRD2 TaqIA polymorphism with adiposity parameters (Hardman et al., 2014Hardman CA, Rogers PJ, Timpson NJ and Munafo MR (2014) Lack of association between DRD2 and OPRM1 genotypes and adiposity. Int J Obes 38:730-736.).

In the present study, no association was detected between DRD2 -141C Ins/Del polymorphism with food intake and anthropometric parameters, despite previous findings relating Del carriers of the DRD2 -141C Ins/Del polymorphism with higher D2 receptor density (Jonsson et al., 1999bJonsson EG, Nothen MM, Grunhage F, Farde L, Nakashima Y, Propping P and Sedvall GC (1999b) Polymorphisms in the dopamine D2 receptor gene and their relationships to striatal dopamine receptor density of healthy volunteers. Mol Psychiatry 4:290-296.). The DRD2 -141C Ins/Del polymorphism corresponds to a deletion of one cytosine from a run of two cytosines at position -141 of the DRD2 gene (Arinami et al., 1997Arinami T, Gao M, Hamaguchi H and Toru M (1997) A functional polymorphism in the promoter region of the dopamine D2 receptor gene is associated with schizophrenia. Hum Mol Genet 6:577-582.). This polymorphism has been associated with risk of schizophrenia in different populations (Arinami et al., 1997Arinami T, Gao M, Hamaguchi H and Toru M (1997) A functional polymorphism in the promoter region of the dopamine D2 receptor gene is associated with schizophrenia. Hum Mol Genet 6:577-582.; Ohara et al., 1998Ohara K, Nagai M, Tani K, Nakamura Y, Ino A and Ohara K (1998) Functional polymorphism of -141C Ins/Del in the dopamine D2 receptor gene promoter and schizophrenia. Psychiatry Res 81:117-123.; Jonsson et al., 1999aJonsson EG, Nothen MM, Neidt H, Forslund K, Rylander G, Mattila-Evenden M, Asberg M, Propping P and Sedvall GC (1999a) Association between a promoter polymorphism in the dopamine D2 receptor gene and schizophrenia. Schizophr Res 40:31-36.; Himei et al., 2002Himei A, Koh J, Sakai J, Inada Y, Akabame K and Yoneda H (2002) The influence on the schizophrenic symptoms by the DRD2Ser/Cys311 and -141C Ins/Del polymorphisms. Psychiatry Clin Neurosci 56:97-102.; Wu et al., 2005Wu S, Xing Q, Gao R, Li X, Gu N, Feng G and He L (2005) Response to chlorpromazine treatment may be associated with polymorphisms of the DRD2 gene in Chinese schizophrenic patients. Neurosci Lett 376: 1-4.; Lafuente et al., 2008aLafuente A, Bernardo M, Mas S, Crescenti A, Aparici M, Gasso P, Goti J, Sanchez V, Catalan R and Carne X (2008a) -141C Ins/Del polymorphism of the dopamine D2 receptor gene is associated with schizophrenia in a Spanish population. Psychiatr Genet 18:122-127.,bLafuente A, Bernardo M, Mas S, Crescenti A, Aparici M, Gasso P, Deulofeu R, Mane A, Catalan R and Carne X (2008b) Polymorphism of dopamine D2 receptor (TaqIA, TaqIB, and-141C Ins/Del) and dopamine degradation enzyme (COMT G158A, A-278G) genes and extrapyramidal symptoms in patients with schizophrenia and bipolar disorders. Psychiatry Res 161:131-141.; Cordeiro et al., 2009Cordeiro Q, Siqueira-Roberto J, Zung S and Vallada H (2009) Association between the DRD2-141C Insertion/Deletion polymorphism and schizophrenia. Arq Neuropsiquiatr 67:191-194.; Saiz et al., 2010Saiz PA, Garcia-Portilla MP, Arango C, Morales B, Arias B, Corcoran P, Fernandez JM, Alvarez V, Coto E, Bascaran MT, et al. (2010) Genetic polymorphisms in the dopamine-2 receptor (DRD2), dopamine-3 receptor (DRD3), and dopamine transporter (SLC6A3) genes in schizophrenia: Data from an association study. Prog Neuropsychopharmacol Biol Psychiatry 34:26-31.; Xiao et al., 2013Xiao L, Shen T, Peng DH, Shu C, Jiang KD and Wang GH (2013) Functional -141C Ins/Del polymorphism in the dopamine D2 receptor gene promoter and schizophrenia in a Chinese Han population. J Int Med Res 41:1171-1178.; Wang et al., 2016Wang Y, Liu L, Xin L, Fan D, Ding N, Hu Y, Cai G, Wang L, Xia Q, Li X, et al. (2016) The -141C Ins/Del and Taq1A polymorphism in the dopamine D2 receptor gene may confer susceptibility to schizophrenia in Asian populations. J Clin Neurosci 30:1-7.; Zhao et al., 2016Zhao X, Huang Y, Chen K, Li D, Han C and Kan Q (2016) -141C insertion/deletion polymorphism of the dopamine D2 receptor gene is associated with schizophrenia in Chinese Han population: Evidence from an ethnic group-specific meta-analysis. Asia Pac Psychiatry 8:189-198.), as well as with weight gain (Lencz et al., 2010Lencz T, Robinson DG, Napolitano B, Sevy S, Kane JM, Goldman D and Malhotra AK (2010) DRD2 promoter region variation predicts antipsychotic-induced weight gain in first episode schizophrenia. Pharmacogenet Genomics 20:569-572.) and other responses due to schizophrenia drug treatment (Lencz et al., 2006Lencz T, Robinson DG, Xu K, Ekholm J, Sevy S, Gunduz-Bruce H, Woerner MG, Kane JM, Goldman D and Malhotra AK (2006) DRD2 promoter region variation as a predictor of sustained response to antipsychotic medication in first-episode schizophrenia patients. Am J Psychiatry 163:529-531.; Zhang et al., 2010Zhang JP, Lencz T and Malhotra AK (2010) Dopamine D2 receptor genetic variation and clinical response to antipsychotic drug treatment: A meta-analysis. Am J Psychiatry 167:763–772.). Associations have been described with propensity to alcohol dependence in different populations (Ishiguro et al., 1998Ishiguro H, Arinami T, Saito T, Akazawa S, Enomoto M, Mitushio H, Fujishiro H, Tada K, Akimoto Y, Mifune H, et al. (1998) Association study between the -141C Ins/Del and TaqI A polymorphisms of the dopamine D2 receptor gene and alcoholism. Alcohol Clin Exp Res 22:845-848.; Konishi et al., 2004aKonishi T, Calvillo M, Leng AS, Lin KM and Wan YJ (2004a) Polymorphisms of the dopamine D2 receptor, serotonin transporter, and GABA(A) receptor beta(3) subunit genes and alcoholism in Mexican-Americans. Alcohol 32:45-52.,bKonishi T, Luo HR, Calvillo M, Mayo MS, Lin KM and Wan YJ (2004b) ADH1B*1, ADH1C*2, DRD2 (-141C Ins), and 5-HTTLPR are associated with alcoholism in Mexican American men living in Los Angeles. Alcohol Clin Exp Res 28:1145-1152.; Johann et al., 2005Johann M, Putzhammer A, Eichhammer P and Wodarz N (2005) Association of the -141C Del variant of the dopamine D2 receptor (DRD2) with positive family history and suicidality in German alcoholics. Am J Med Genet B Neuropsychiatr Genet 132B:46-49.; Du and Wan, 2009Du Y and Wan YJ (2009) The interaction of reward genes with environmental factors in contribution to alcoholism in mexican americans. Alcohol Clin Exp Res 33:2103-2112.; Prasad et al., 2010Prasad P, Ambekar A and Vaswani M (2010) Dopamine D2 receptor polymorphisms and susceptibility to alcohol dependence in Indian males: A preliminary study. BMC Med Genet 11:24.; Lee et al., 2013Lee SH, Lee BH, Lee JS, Chai YG, Choi MR, Han DM, Ji H, Jang GH, Shin HE and Choi IG (2013) The association of DRD2 -141C and ANKK1 TaqIA polymorphisms with alcohol dependence in Korean population classified by the Lesch typology. Alcohol Alcohol 48:426-432.), suicide attempts (Suda et al., 2009Suda A, Kawanishi C, Kishida I, Sato R, Yamada T, Nakagawa M, Hasegawa H, Kato D, Furuno T and Hirayasu Y (2009) Dopamine D2 receptor gene polymorphisms are associated with suicide attempt in the Japanese population. Neuropsychobiology 59:130-134.), psychiatric disorders (Kishida et al., 2004Kishida I, Kawanishi C, Furuno T, Kato D, Ishigami T and Kosaka K (2004) Association in Japanese patients between neuroleptic malignant syndrome and functional polymorphisms of the dopamine D(2) receptor gene. Mol Psychiatry 9:293-298.; Ujike et al., 2009Ujike H, Katsu T, Okahisa Y, Takaki M, Kodama M, Inada T, Uchimura N, Yamada M, Iwata N, Sora I, et al. (2009) Genetic variants of D2 but not D3 or D4 dopamine receptor gene are associated with rapid onset and poor prognosis of methamphetamine psychosis. Prog Neuropsychopharmacol Biol Psychiatry 33:625-629.; Lencer et al., 2014Lencer R, Bishop JR, Harris MS, Reilly JL, Patel S, Kittles R, Prasad KM, Nimgaonkar VL, Keshavan MS and Sweeney JA (2014) Association of variants in DRD2 and GRM3 with motor and cognitive function in first-episode psychosis. Eur Arch Psychiatry Clin Neurosci 264:345-355.), different responses to medication and higher quit rates in smokers (Lerman et al., 2006Lerman C, Jepson C, Wileyto EP, Epstein LH, Rukstalis M, Patterson F, Kaufmann V, Restine S, Hawk L, Niaura R, et al. (2006) Role of functional genetic variation in the dopamine D2 receptor (DRD2) in response to bupropion and nicotine replacement therapy for tobacco dependence: results of two randomized clinical trials. Neuropsychopharmacology 31:231-242.). To the best of our knowledge, there is no other study that associated the DRD2 -141C Ins/Del polymorphism with anthropometric parameters or food intake.

The lack of associations in the two other phases of development (12 to 16 months and 3 to 4 years) may have occurred because children at these ages have restricted access to food, and depend on adults for meals, despite their own preferences. Notwithstanding, at 7 to 8 years, children have many opportunities to eat without parental supervision (Briefel et al., 2009Briefel RR, Crepinsek MK, Cabili C, Wilson A and Gleason PM (2009) School food environments and practices affect dietary behaviors of US public school children. J Am Diet Assoc 109(2 Suppl):S91-S107.), and the differences observed in LDF intake in our sample may have occurrred as an effort to compensate hypodopaminergic functioning.

Palatability is the induced sensitive response of foods that are usually rich in lipids and/or sugar (Cansell and Luquet, 2016Cansell C and Luquet S (2016) Triglyceride sensing in the reward circuitry: A new insight in feeding behaviour regulation. Biochimie 120:75-80.). The sense of taste during food ingestion is the most important aspect in the decision to consume or avoid foods (Besnard, 2016Besnard P (2016) Lipids and obesity: Also a matter of taste? Rev Endocr Metab Disord 17:159-170.). Contrary to sugar, oral fat perception was considered dependent only on its textural and olfactory cues, but recent identification of lipid-receptors in taste buds of both rodents and humans strongly suggests that lipids might also be perceived by the gustatory pathway (Besnard, 2016Besnard P (2016) Lipids and obesity: Also a matter of taste? Rev Endocr Metab Disord 17:159-170.). Stimulation of taste buds triggers a signaling cascade leading to subsequent neurotransmitter releases in different brain areas responsible for taste perception (e.g., anterior insula, frontal operculum, orbitofrontal cortex, and the mesolimbic system) (Besnard, 2016Besnard P (2016) Lipids and obesity: Also a matter of taste? Rev Endocr Metab Disord 17:159-170.). The exchange between these areas results in information of the hedonic experience related to the food’s taste (Berridge, 1996Berridge KC (1996) Food reward: Brain substrates of wanting and liking. Neurosci Biobehav Rev 20:1-25.). Therefore, not only sugar, but also lipids generate a hedonic experience, producing a positive reinforcement that stimulates dopamine secretion in the brain (Salamone, 1994Salamone JD (1994) The involvement of nucleus accumbens dopamine in appetitive and aversive motivation. Behav Brain Res 61:117-133., Volkow et al., 2002Volkow ND, Wang GJ, Fowler JS, Logan J, Jayne M, Franceschi D, Wong C, Gatley SJ, Gifford AN, Ding YS, et al. (2002) “Nonhedonic” food motivation in humans involves dopamine in the dorsal striatum and methylphenidate amplifies this effect. Synapse 44:175-180.), which is a stimulus associated with “wanting” (Berridge et al., 2010Berridge KC, Ho CY, Richard JM and DiFeliceantonio DM (2010) The tempted brain eats: Pleasure and desire circuits in obesity and eating disorders. Brain Res 1350:43-64.). “Wanting” is an incentive salience or motivation for reward triggered by reward-related cues, such as LDF (Berridge et al., 2010Berridge KC, Ho CY, Richard JM and DiFeliceantonio DM (2010) The tempted brain eats: Pleasure and desire circuits in obesity and eating disorders. Brain Res 1350:43-64.). The attribution of incentive salience makes a cue and its reward more attractive, or more “wanted”, without being necessarily more “liked” (Berridge et al., 2010Berridge KC, Ho CY, Richard JM and DiFeliceantonio DM (2010) The tempted brain eats: Pleasure and desire circuits in obesity and eating disorders. Brain Res 1350:43-64.). Consistent with our findings, other studies of our group detected associations of palatable food intake with another polymorphism related to the dopaminergic system in children of the same cohort at 12 to 16 months and 3 to 4 years old (Galvão et al., 2012Galvão AC, Krüger RC, Campagnolo PDB, Mattevi VS, Vitolo MR and Almeida S (2012) Association of MAOA and COMT gene polymorphisms with palatable food intake in children. J Nutr Biochem 23:272 - 277.; Fontana et al., 2015Fontana C, Vitolo MR, Campagnolo PD, Mattevi VS, Genro JP and Almeida S (2015) DRD4 and SLC6A3 gene polymorphisms are associated with food intake and nutritional status in children in early stages of development. J Nutr Biochem 26: 1607-1612.). However, further research is needed to confirm the association of DRD2 TaqIA polymorphism with LDF intake and its potential mechanisms.

In summary, our results showed that TaqIA polymorphism may have an influence on the children’s eating behavior, due to the presence of the A1 allele associated with lower D2 receptor density that may lead children to compensate the hypodopaminergic functioning with palatable foods. To our knowledge, this is the first association study of the DRD2 TaqIA and -141C Ins/Del polymorphism with food intake and anthropometric parameters in children at the first stages of development. Notwithstanding, it is necessary to replicate this findings in other populations and identify the mechanisms by which the dopaminergic system may influence food intake. Nevertheless, the investigation of other polymorphisms in this and other genes of the dopaminergic system and their relation to food intake and anthropometric parameters may be interesting.

Acknowledgments

This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil; grant number 471186/2009-0), Fundação de Amparo a Pesquisa do Estado do Rio Grande do Sul (FAPERGS, Brazil; grant number 070026-9), Programa de Bolsas CAPES and PIBIC/CNP, and PROAP-CAPES. The authors thank MSc. Ananda Galvão (in memoriam) for her crucial participation in this study.

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Internet Resources

  • Associate Editor: Angela M. Vianna-Morgante

Publication Dates

  • Publication in this collection
    23 July 2018
  • Date of issue
    July/Sept. 2018

History

  • Received
    04 July 2017
  • Accepted
    09 Jan 2018
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