Lack of Association of a Functional Polymorphism in the Serotonin Receptor Gene With Body Mass Index and Depressive Symptoms in a Large Meta-Analysis of Population Based Studies

The serotonin receptor 5-HTR2C is thought to be involved in the function of multiple brain structures. Consequently, the HTR2C gene has been studied extensively with respect to its association with a variety of phenotypes. One coding variant in the HTR2C gene, Cys23Ser (rs6318), has been associated with depressive symptoms. and adiposity; however, these findings have been inconsistent. The reasons for this mixed picture may be due to low statistical power or due to other factors such as failure to account for possible interacting environmental factors, such as psychosocial stress. Further, the literature around this polymorphism is marked by limited inclusion of persons of African ancestry. The present study sought to overcome these limitations and definitively determine the relationship of this polymorphism with depressive and obesity phenotypes in a large sample meta-analysis. Thus, we harmonized individual level data from 10 studies including the Women’s Health Initiative, CARDIA, ARIC, Framingham Offspring, and the Jackson Heart Study, resulting in a sample of 27,161 individuals (10,457 Black women, 2,819 Black men, 7,419 White women, and 6,466 White men). We conducted a random effects meta-analysis using individual level data to examine whether the Cys23Ser variant—either directly, or conditionally depending on the level of psychosocial stress—was associated with depressive symptoms and body mass index (BMI). We found that psychosocial stress was associated with both depression and BMI, but that Cys23Ser was not directly associated with, nor did it modify the associations of psychosocial stress with depression or BMI. Thus, in the largest study of this polymorphism, we have determined that rs6318 is not associated with depression, or BMI.

[1]  W. Kraus,et al.  Systolic Blood Pressure and Socioeconomic Status in a large multi-study population , 2019, SSM - population health.

[2]  W. Kraus,et al.  Developing a synthetic psychosocial stress measure and harmonizing CVD-risk data: a way forward to GxE meta- and mega-analyses , 2018, BMC Research Notes.

[3]  Warren W. Kretzschmar,et al.  Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression , 2017, Nature Genetics.

[4]  C. Tovilla-Zárate,et al.  The role of the Cys23Ser (rs6318) polymorphism of the HTR2C gene in suicidal behavior: systematic review and meta-analysis , 2017, Psychiatric genetics.

[5]  Jordan T. Quaglia,et al.  Nonsynonymous HTR2C polymorphism predicts cortisol response to psychosocial stress II: Evidence from two samples , 2016, Psychoneuroendocrinology.

[6]  S. Vrshek-Schallhorn,et al.  Nonsynonymous HTR2C polymorphism predicts cortisol response to psychosocial stress I: Effects in males and females , 2016, Psychoneuroendocrinology.

[7]  Gregory P. Samsa,et al.  Effects of exercise training alone vs a combined exercise and nutritional lifestyle intervention on glucose homeostasis in prediabetic individuals: a randomised controlled trial , 2016, Diabetologia.

[8]  A. D. Diez Roux,et al.  The Contribution of Psychosocial Stressors to Sleep among African Americans in the Jackson Heart Study. , 2016, Sleep.

[9]  A. Serretti,et al.  Pharmacogenetics of clozapine response and induced weight gain: A comprehensive review and meta-analysis , 2016, European Neuropsychopharmacology.

[10]  W. Kraus,et al.  Computing a Synthetic Chronic Psychosocial Stress Measurement in Multiple Datasets and its Application in the Replication of G × E Interactions of the EBF1 Gene , 2015, Genetic epidemiology.

[11]  W. Kraus,et al.  A Putatively Functional Polymorphism in the HTR2C Gene is Associated with Depressive Symptoms in White Females Reporting Significant Life Stress , 2014, PloS one.

[12]  C. Kuhn,et al.  A functional polymorphism in the HTR2C gene associated with stress responses: A validation study , 2014, Biological Psychology.

[13]  W. Kraus,et al.  Gene by stress genome-wide interaction analysis and path analysis identify EBF1 as a cardiovascular and metabolic risk gene , 2014, European Journal of Human Genetics.

[14]  Svati H Shah,et al.  A Functional Polymorphism in the 5HTR2C Gene Associated with Stress Responses Also Predicts Incident Cardiovascular Events , 2013, PloS one.

[15]  B. Yildirim,et al.  Systematic review, structural analysis, and new theoretical perspectives on the role of serotonin and associated genes in the etiology of psychopathy and sociopathy , 2013, Neuroscience & Biobehavioral Reviews.

[16]  B. Brummett,et al.  Systolic blood pressure and adiposity: examination by race and gender in a nationally representative sample of young adults. , 2012, American journal of hypertension.

[17]  M. Allison,et al.  The association between chronic stress type and C-reactive protein in the multi-ethnic study of atherosclerosis: does gender make a difference? , 2012, Journal of Behavioral Medicine.

[18]  W. Kraus,et al.  Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT. , 2011, American journal of physiology. Endocrinology and metabolism.

[19]  B. McEwen,et al.  Allostatic load biomarkers of chronic stress and impact on health and cognition , 2010, Neuroscience & Biobehavioral Reviews.

[20]  D. Cohen,et al.  Association between HTR2C gene polymorphisms and the metabolic syndrome in patients using antipsychotics: a replication study , 2010, The Pharmacogenomics Journal.

[21]  T. Haney,et al.  Caregiving, residence, race, and depressive symptoms , 2010, Aging & mental health.

[22]  J. Jackson,et al.  Race and unhealthy behaviors: chronic stress, the HPA axis, and physical and mental health disparities over the life course. , 2010, American journal of public health.

[23]  R. Becker,et al.  Associations of Depressive Symptoms, Trait Hostility, and Gender With C-Reactive Protein and Interleukin-6 Response After Emotion Recall , 2010, Psychosomatic medicine.

[24]  A. Serretti,et al.  Focus on HTR2C: A possible suggestion for genetic studies of complex disorders , 2009, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[25]  B. Franke,et al.  HTR2C Gene Polymorphisms and the Metabolic Syndrome in Patients With Schizophrenia: A Replication Study , 2009, Journal of clinical psychopharmacology.

[26]  K. Sirotkin,et al.  The NCBI dbGaP database of genotypes and phenotypes , 2007, Nature Genetics.

[27]  S. Kasper,et al.  A Cys 23-Ser 23 substitution in the 5-HT(2C) receptor gene influences body weight regulation in females with seasonal affective disorder: an Austrian-Canadian collaborative study. , 2005, Journal of psychiatric research.

[28]  T. Haney,et al.  Community Recruitment Process by Race, Gender, and SES Gradient: Lessons Learned from the Community Health and Stress Evaluation (CHASE) Study Experience , 2003, Journal of Community Health.

[29]  Tao Li,et al.  Association of the 5-HT2c gene with susceptibility and minimum body mass index in anorexia nervosa , 2003, Neuroreport.

[30]  K. Matthews,et al.  Chronic stress burden, discrimination, and subclinical carotid artery disease in African American and Caucasian women. , 2003, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[31]  R. Kronmal,et al.  Multi-Ethnic Study of Atherosclerosis: objectives and design. , 2002, American journal of epidemiology.

[32]  C. Gillberg,et al.  Association between a Polymorphism of the 5-HT2C Receptor and Weight Loss in Teenage Girls , 2002, Neuropsychopharmacology.

[33]  M. Rietschel,et al.  Variability of 5-HT2C receptor cys23ser polymorphism among European populations and vulnerability to affective disorder , 2000, Molecular Psychiatry.

[34]  J. Long,et al.  HTR2C Cys23Ser polymorphism in relation to CSF monoamine metabolite concentrations and DSM-III-R psychiatric diagnoses , 1999, Biological Psychiatry.

[35]  T. Manolio,et al.  Overview of the Jackson Heart Study: a study of cardiovascular diseases in African American men and women. , 1999, The American journal of the medical sciences.

[36]  D. Goldman,et al.  Identification, expression, and pharmacology of a Cys23-Ser23 substitution in the human 5-HT2c receptor gene (HTR2C). , 1995, Genomics.

[37]  Aric Invest The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators , 1989 .

[38]  A. Folsom,et al.  The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators. , 1989, American journal of epidemiology.

[39]  A. Appels,et al.  A questionnaire to assess premonitory symptoms of myocardial infarction. , 1987, International journal of cardiology.

[40]  L. Radloff The CES-D Scale , 1977 .

[41]  W. Kannel,et al.  The Framingham Offspring Study. Design and preliminary data. , 1975, Preventive medicine.

[42]  R. Marioni,et al.  Edinburgh Research Explorer Genome-wide association study of depression phenotypes in UK Biobank identifies variants in excitatory synaptic pathways , 2022 .

[43]  E. Benjamin,et al.  with The Framingham Offspring Study. , 2018 .

[44]  D. West,et al.  Stress, race, and body weight. , 2009, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[45]  D. Goldman,et al.  Modification of human 5-HT2C receptor function by Cys23Ser, an abundant, naturally occurring amino-acid substitution , 2004, Molecular Psychiatry.

[46]  J. Ware SF-36 health survey: Manual and interpretation guide , 2003 .

[47]  JoAnn E. Manson,et al.  Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group. , 1998, Controlled clinical trials.

[48]  S B Hulley,et al.  CARDIA: study design, recruitment, and some characteristics of the examined subjects. , 1988, Journal of clinical epidemiology.