Mirror extreme BMI phenotypes associated with gene dosage at the chromosome 16p11.2 locus
Open accessAbstract
Both obesity and being underweight have been associated with increased mortality. Underweight, defined as a body mass index (BMI) ≤ 18.5 kg per m(2) in adults and ≤ -2 standard deviations from the mean in children, is the main sign of a series of heterogeneous clinical conditions including failure to thrive, feeding and eating disorder and/or anorexia nervosa. In contrast to obesity, few genetic variants underlying these clinical conditions have been reported. We previously showed that hemizygosity of a ∼600-kilobase (kb) region on the short arm of chromosome 16 causes a highly penetrant form of obesity that is often associated with hyperphagia and intellectual disabilities. Here we show that the corresponding reciprocal duplication is associated with being underweight. We identified 138 duplication carriers (including 132 novel cases and 108 unrelated carriers) from individuals clinically referred for developmental or intellectual disabilities (DD/ID) or psychiatric disorders, or recruited from population-based cohorts. These carriers show significantly reduced postnatal weight and BMI. Half of the boys younger than five years are underweight with a probable diagnosis of failure to thrive, whereas adult duplication carriers have an 8.3-fold increased risk of being clinically underweight. We observe a trend towards increased severity in males, as well as a depletion of male carriers among non-medically ascertained cases. These features are associated with an unusually high frequency of selective and restrictive eating behaviours and a significant reduction in head circumference. Each of the observed phenotypes is the converse of one reported in carriers of deletions at this locus. The phenotypes correlate with changes in transcript levels for genes mapping within the duplication but not in flanking regions. The reciprocal impact of these 16p11.2 copy-number variants indicates that severe obesity and being underweight could have mirror aetiologies, possibly through contrasting effects on energy balance.
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16p11.2 deletions are associated with macrocephaly and obesity, while duplications often lead to microcephaly and low body weight/BMI.
“Deletions of 16p11.2 are associated with increased head circumference (macrocephaly) [10, 12, 17, 23] and obesity [10, 12, 16, 20], whereas duplications often result in below average head size (microcephaly) [10, 17, 23, 24] and low body weight/BMI [10, 24].”
From 16p11.2 Copy Number Variations and Neurodevelopmental Disorders (2020) · cites this paper as [24]
In individuals with neurodevelopmental disorders, genetic screenings find 16p11.2 deletions at rates of 0.25-2.9% and duplications at rates of 0.15-0.78%.
“Data compiled from eight studies [13, 15–17, 20, 24, 26, 33] screening individuals with either ASD, ID, developmental delay (DD), dysmorphic features (DF), multiple congenital anomalies (MCA), obesity, or seizures find 16p11.2 deletions at rates of 0.25–2.9%, and duplications at rates between 0.15–0.78% (Table 1).”
From 16p11.2 Copy Number Variations and Neurodevelopmental Disorders (2020) · cites this paper as [24]
Birth parameters for 16p11.2 duplication carriers are generally normal, indicating a postnatal effect.
“Birth parameters for 16p11.2 duplication carriers are generally normal [24], indicating a postnatal effect.”
From 16p11.2 Copy Number Variations and Neurodevelopmental Disorders (2020) · cites this paper as [24]
BMI of 16p11.2 duplication patients is significantly lower than controls.
“Conversely, BMI of 16p11.2 duplication patients is significantly lower than controls [10, 24].”
From 16p11.2 Copy Number Variations and Neurodevelopmental Disorders (2020) · cites this paper as [24]
Bipolar disorder is reported in 16p11.2 duplication carriers.
“Bipolar disorder is also reported in 16p11.2 duplication carriers [9, 14, 24].”
From 16p11.2 Copy Number Variations and Neurodevelopmental Disorders (2020) · cites this paper as [24]
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Self-citation
- Authors
- Jacquemont, S., Reymond, A., Zufferey, F., Harewood, L., Walters, R. G., Kutalik, Z., Martinet, D., Shen, Y., Valsesia, A., Beckmann, N. D., Thorleifsson, G., Belfiore, M., Bouquillon, S., Campion, D., de Leeuw, N., de Vries, B. B. A., Esko, T., Fernandez, B. A., Fernández-Aranda, F., Fernández-Real, J. M., Gratacòs, M., Guilmatre, A., Hoyer, J., Jarvelin, M.-R., Frank Kooy, R., Kurg, A., Le Caignec, C., Männik, K., Platt, O. S., Sanlaville, D., Van Haelst, M. M., Villatoro Gomez, S., Walha, F., Wu, B.-L., Yu, Y., Aboura, A., Addor, M.-C., Alembik, Y., Antonarakis, S. E., Arveiler, B., Barth, M., Bednarek, N., Béna, F., Bergmann, S., Beri, M., Bernardini, L., Blaumeiser, B., Bonneau, D., Bottani, A., Boute, O., Brunner, H. G., Cailley, D., Callier, P., Chiesa, J., Chrast, J., Coin, L., Coutton, C., Cuisset, J.-M., Cuvellier, J.-C., David, A., de Freminville, B., Delobel, B., Delrue, M.-A., Demeer, B., Descamps, D., Didelot, G., Dieterich, K., Disciglio, V., Doco-Fenzy, M., Drunat, S., Duban-Bedu, B., Dubourg, C., El-Sayed Moustafa, J. S., Elliott, P., Faas, B. H. W., Faivre, L., Faudet, A., Fellmann, F., Ferrarini, A., Fisher, R., Flori, E., Forer, L., Gaillard, D., Gerard, M., Gieger, C., Gimelli, S., Gimelli, G., Grabe, H. J., Guichet, A., Guillin, O., Hartikainen, A.-L., Heron, D., Hippolyte, L., Holder, M., Homuth, G., Isidor, B., Jaillard, S., Jaros, Z., Jiménez-Murcia, S., Joly Helas, G., Jonveaux, P., Kaksonen, S., Keren, B., Kloss-Brandstätter, A., Knoers, N. V. A. M., Koolen, D. A., Kroisel, P. M., Kronenberg, F., Labalme, A., Landais, E., Lapi, E., Layet, V., Legallic, S., Leheup, B., Leube, B., Lewis, S., Lucas, J., MacDermot, K. D., Magnusson, P., Marshall, C., Mathieu-Dramard, M., McCarthy, M. I., Meitinger, T., Antonietta Mencarelli, M., Merla, G., Moerman, A., Mooser, V., Morice-Picard, F., Mucciolo, M., Nauck, M., Coumba Ndiaye, N., Nordgren, A., Pasquier, L., Petit, F., Pfundt, R., Plessis, G., Rajcan-Separovic, E., Paolo Ramelli, G., Rauch, A., Ravazzolo, R., Reis, A., Renieri, A., Richart, C., Ried, J. S., Rieubland, C., Roberts, W., Roetzer, K. M., Rooryck, C., Rossi, M., Saemundsen, E., Satre, V., Schurmann, C., Sigurdsson, E., Stavropoulos, D. J., Stefansson, H., Tengström, C., Thorsteinsdóttir, U., Tinahones, F. J., Touraine, R., Vallée, L., van Binsbergen, E., Van der Aa, N., Vincent-Delorme, C., Visvikis-Siest, S., Vollenweider, P., Völzke, H., Vulto-van Silfhout, A. T., Waeber, G., Wallgren-Pettersson, C., Witwicki, R. M., Zwolinksi, S., Andrieux, J., Estivill, X., Gusella, J. F., Gustafsson, O., Metspalu, A., Scherer, S. W., Stefansson, K., Blakemore, A. I. F., Beckmann, J. S., & Froguel, P.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- University of Lausanne (CH)
- Imperial College London (GB)
- SIB Swiss Institute of Bioinformatics (CH)
- Boston Children's Hospital (US)
- Centre Hospitalier Universitaire de Lille (FR)
- Inserm (FR)
- University of Tartu (EE)
- Memorial University of Newfoundland (CA)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Lyon 1 Université (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Hôpital d'Hautepierre (FR)
- University Hospital of Geneva (CH)
- Centre Hospitalier Universitaire d'Angers (FR)
- Centre Hospitalier Universitaire de Reims (FR)
- Casa Sollievo della Sofferenza (IT)
- Antwerp University Hospital (BE)
- Radboud University Nijmegen (NL)
- Centre Hospitalier Universitaire de Bordeaux (FR)
- CHU Dijon Bourgogne (FR)
- Centre Hospitalier Universitaire de Grenoble (FR)
- Centre Hospitalier Universitaire de Nantes (FR)
- Groupe Hospitalier de l'Institut Catholique de Lille (FR)
- Université de Bordeaux (FR)
- Centre Hospitalier Universitaire Amiens-Picardie (FR)
- Centre Hospitalier de Béthune (FR)
- University of Siena (IT)
- Centre National de la Recherche Scientifique (FR)
- Centre for Life (GB)
- Innsbruck Medical University (AT)
- Helmholtz Munich (DE)
- Istituto Giannina Gaslini (IT)
- Universität Greifswald (DE)
- University of Oulu (FI)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- University Medical Center Utrecht (NL)
- Medical University of Graz (AT)
- Meyer Children's Hospital (IT)
- Groupe Hospitalier du Havre (FR)
- Düsseldorf University Hospital (DE)
- Centre Hospitalier Universitaire de Rennes (FR)
- Northwick Park Hospital (GB)
- Hospital for Sick Children (CA)
- Centre for Human Genetics (GB)
- TUM Klinikum (DE)
- GlaxoSmithKline (United States) (US)
- Karolinska Institutet (SE)
- Centre Hospitalier Universitaire de Caen Normandie (FR)
- University of Zurich (CH)
- University of Bern (CH)
- Instituto de Salud Carlos III (ES)
- Centre Hospitalier Universitaire de Saint-Étienne (FR)
- Centre for Genomic Regulation (ES)
- Massachusetts General Hospital (US)
- University of Toronto (CA)
- Corresponding author
- Beckmann, Jacques S.
- ORCID
- Jacquemont, Sébastien
- Reymond, Alexandre
- Harewood, Louise
- Walters, Robin G.
- Kutalik, Zoltán
- Shen, Yiping
- Valsesia, Armand
- Beckmann, Noam D.
- Campion, Dominique
- Esko, Tõnu
- Fernandez, Bridget A.
- Hoyer, Juliane
- Kurg, Ants
- Sanlaville, Damien
- Yu, Yongguo
- Addor, Marie-Claude
- Antonarakis, Stylianos E.
- Barth, Magalie
- Bednarek, Nathalie
- Bergmann, Sven
- Bernardini, Laura
- Blaumeiser, Bettina
- Bonneau, Dominique
- Bottani, Armand
- Brunner, Han G.
- Callier, Patrick
- Coin, Lachlan
- Coutton, Charles
- Delrue, Marie-Ange
- Demeer, Bénédicte
- Dieterich, Klaus
- Disciglio, Vittoria
- Drunat, Séverine
- Dubourg, Christèle
- Elliott, Paul
- Faas, Brigitte H. W.
- Faivre, Laurence
- Fellmann, Florence
- Ferrarini, Alessandra
- Forer, Lukas
- Gaillard, Dominique
- Gieger, Christian
- Grabe, Hans J.
- Homuth, Georg
- Isidor, Bertrand
- Jaillard, Sylvie
- Keren, Boris
- Knoers, Nine V. A. M.
- Koolen, David A.
- Kroisel, Peter M.
- Kronenberg, Florian
- Labalme, Audrey
- Leheup, Bruno
- Marshall, Christian
- McCarthy, Mark I.
- Meitinger, Thomas
- Merla, Giuseppe
- Mooser, Vincent
- Mucciolo, Mafalda
- Nauck, Matthias
- Nordgren, Ann
- Pasquier, Laurent
- Petit, Florence
- Pfundt, Rolph
- Rauch, Anita
- Ravazzolo, Roberto
- Renieri, Alessandra
- Rooryck, Caroline
- Rossi, Massimiliano
- Satre, Véronique
- Schurmann, Claudia
- Stavropoulos, Dimitri J.
- Tinahones, Francisco J.
- Touraine, Renaud
- Vallée, Louis
- Völzke, Henry
- Waeber, Gérard
- Estivill, Xavier
- Gusella, James F.
- Metspalu, Andres
- Scherer, Stephen W.
- Blakemore, Alexandra I. F.
- Beckmann, Jacques S.
- Froguel, Philippe
- Venue
- Nature
- Published
- 2011-08-31
- Volume
- 478
- Issue
- 7367
- Pages
- 97-102
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC3637175
- OpenAlex
- W2025159391
- Cited by
- 462
- References
- 89
- Citations by year
- 2026: 11 · 2025: 23 · 2024: 24 · 2023: 17 · 2022: 26 · 2021: 31 · 2020: 26 · 2019: 25 · 2018: 32 · 2017: 27 · 2016: 28 · 2015: 47 · 2014: 44 · 2013: 48 · 2012: 50
- FWCI
- 28.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- IRIS (submittedVersion)
- Site cant be reached (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Use Siena air (University of Siena) (submittedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- National Science Foundation
- Autism Speaks (AS2173)
- GlaxoSmithKline
- Genome Canada
- Ludwig Institute for Cancer Research
- Wellcome Trust (090532)
- Michael Smith Health Research BC
- National Institute for Health and Care Research
- Imperial College London
- Imperial College Healthcare NHS Trust
- European Commission (245536, SF0180142s08, 201413, 223423)
- Fondation Jérôme Lejeune
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (201413)
- Bundesministerium für Bildung und Forschung (01GS0823, 01GS08160)
- Fonds De La Recherche Scientifique - FNRS
- Fudan University
- University of Toronto
- Oesterreichische Nationalbank (13059)
- Hospital for Sick Children
- Fondation Leenaards
- Université de Lausanne
- Hersenstichting
- Vlaamse regering
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición
- National Institutes of Health (6r01hl087679-03, 5rl1mh083268-05, GM061354)
- Canadian Institutes of Health Research (MOP 74502)
- Medical Research Council
- Instituto de Salud Carlos III
- Direction de l’hospitalisation et de l’offre de Soins
- Münchner Zentrum für Gesundheitswissenschaften
- National Heart, Lung, and Blood Institute (5R01 HL087679-02)
- National Institute of Mental Health (R01MH063706, R01MH071425, 1RL1MH083268-01, 5R01 MH63706:02, MH071425)
- National Institute of General Medical Sciences (GM061354, P01GM061354)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomic variations and chromosomal abnormalities
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genome Rearrangement Algorithms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Syndromes and Imprinting
- Keywords
- 16p11.2, underweight, obesity, body mass index, gene dosage, hemizygosity, failure to thrive, intellectual disability, sex differences, head circumference, mRNA levels, energy balance, eating disorders, anorexia nervosa
- MeSH terms
- Adolescent, Adult, Aged, Aging, Mental Disorders, Body Height, Child, Developmental Disabilities, Child, Preschool, Chromosomes, Human, Pair 16, Energy Metabolism, Europe, Female, Head, Heterozygote, Humans, Infant, Infant, Newborn, Male, Middle Aged, Mutation, North America, Obesity, Phenotype, RNA, Messenger, Thinness, Transcription, Genetic, Cohort Studies, Body Mass Index, Case-Control Studies, Sequence Deletion, Gene Dosage, Genetic Predisposition to Disease, Gene Duplication, Gene Expression Profiling, Comparative Genomic Hybridization, Genome-Wide Association Study, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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