Review

International Journal of Obesity (2012) 36, 1017–1024; doi:10.1038/ijo.2011.192; published online 11 October 2011

Causes and consequences of obesity: the contribution of recent twin studies

J Naukkarinen1,2,3, A Rissanen1, J Kaprio2,4,5 and K H Pietiläinen1,2,4

  1. 1Obesity Research Unit, Department of Medicine, Division of Internal Medicine and Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
  2. 2FIMM, Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
  3. 3Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
  4. 4Finnish Twin Cohort Study, Department of Public Health, University of Helsinki, Helsinki, Finland
  5. 5National Institute for Health and Welfare, Helsinki, Finland

Correspondence: Dr KH Pietiläinen, Obesity Research Unit, Department of Medicine, Division of Internal Medicine and Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland. E-mail: kirsi.Pietiläinen@helsinki.fi

Received 9 March 2011; Revised 29 August 2011; Accepted 4 September 2011
Advance online publication 11 October 2011

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Abstract

Obesity is a genetically complex disorder that produces a myriad of health problems. Most of the recognized complications of obesity are not only strongly influenced by lifestyle factors, but also present with independent genetic predispositions that are notoriously difficult to disentangle in humans. Most studies on the causes and consequences of acquired obesity are encumbered by the incomplete ability to control for genetic influences. However, utilizing a unique experiment of nature, namely monozygotic twins (MZ) discordant for obesity as ‘clonal controls’ of obese and non-obese individuals has enabled the fine characterization of the effects and possible antecedents of acquired obesity while controlling for the genetic background, as well as pointed to novel obesity predisposing candidate genes. This review is a distillation of the findings from more than 10 years of research done in an exceptionally well-characterized collection of MZ and dizygotic (DZ) twins, based on the Finnish Twin Cohorts. Topics covered include the nature of development of obesity from the childhood onwards, the role of exercise in modifying the genetic susceptibility, the resulting inflammatory, prediabetic and preatherosclerotic changes in whole body and adipose tissue physiology, as well as the newest insights provided by the omics revolution.

Keywords:

adipose tissue; inflammation; liver fat; insulin resistance; BMI; metabolic syndrome

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