Obesity and metabolic syndrome in adults with a 22q11.2 microdeletion

Copy number variations (CNVs) may contribute to medical conditions. However, research on the impact of individual CNVs on endocrine disease is limited. This study aimed to provide new data on obesity and metabolic syndrome (MetS) in adults with microdeletion 22q11.2, the pathogenic CNV associated with 22q11.2 deletion syndrome.

We examined prevalence rates of obesity and MetS in 103 adults with a typical 22q11.2 deletion (45.2% male, at median age 30.0 (range 17-71) years) and compared these rates with population-based data. Generalized obesity was defined by a body mass index (BMI) ≥ 30 kg/m², abdominal obesity by a waist circumference (WC) of ≥102 cm in males and ≥88 cm in females, and MetS by standard Joint Interim Statement criteria. General linear models were used to examine the independent associations of age, sex, congenital heart defect, smoking, and antipsychotic use with BMI, WC, and the presence of MetS.

Prevalence rates of generalized obesity (32.0%), abdominal obesity (51.5%), and MetS (33.0%) were significantly higher compared to a population-based cohort (15.7% (P < 0.0001), 36.1% (P = 0.002), and 15.2% (P < 0.0001), respectively). In antipsychotic naïve subjects, significant correlations were observed between age and BMI (r = 0.54, P < 0.001), and age and WC (r = 0.60, P < 0.001). These correlations were not present in individuals taking antipsychotic medication. The models predicting BMI (F(5, 97) = 3.083, R² = 0.137, P = 0.01) and WC (F(5, 92) = 5.985, R² = 0.245, P < 0.001) were significant. Only age was individually predictive of outcomes (P < 0.05 and P < 0.001). The model predicting MetS was also significant (P < 0.001), with higher age being the only factor associated with MetS (OR = 1.07, 95% CI = 1.03-1.12, P < 0.001).

Generalized and abdominal obesity, as well as MetS, appear to be common in adults with 22q11.2 deletion syndrome, emphasizing the importance of careful monitoring from a young age. These findings contribute to the limited knowledge about the association between pathogenic CNVs, obesity, and MetS.