What is a gene mutation and how do mutations occur?
A gene mutation is a permanent change in the DNA sequence that makes up a gene. Mutations range in size from a single DNA building block (DNA base) to a large segment of a chromosome.
Gene mutations occur in two ways: they can be inherited from a parent or acquired during a person’s lifetime. Mutations that are passed from parent to child are called hereditary mutations or germline mutations (because they are present in the egg and sperm cells, which are also called germ cells). This type of mutation is present throughout a person’s life in virtually every cell in the body.
Mutations that occur only in an egg or sperm cell, or those that occur just after fertilization, are called new (de novo) mutations. De novo mutations may explain genetic disorders in which an affected child has a mutation in every cell, but has no family history of the disorder.
Acquired (or somatic) mutations occur in the DNA of individual cells at some time during a person’s life. These changes can be caused by environmental factors such as ultraviolet radiation from the sun, or can occur if a mistake is made as DNA copies itself during cell division. Acquired mutations in somatic cells (cells other than sperm and egg cells) cannot be passed on to the next generation.
Mutations may also occur in a single cell within an early embryo. As all the cells divide during growth and development, the individual will have some cells with the mutation and some cells without the genetic change. This situation is called mosaicism.
Some genetic changes are very rare; others are common in the population. Genetic changes that occur in more than 1 percent of the population are called polymorphisms. They are common enough to be considered a normal variation in the DNA. Polymorphisms are responsible for many of the normal differences between people such as eye color, hair color, and blood type. Although many polymorphisms have no negative effects on a person’s health, some of these variations may influence the risk of developing certain disorders.(from google)

This is not surprising to me.
In the early years of my practice before the era of Medicare DRG, (1970's), physicians were allowed to admit their patients to the hospital
to treat patients with morbid obesity or cardiac patients with severe obesity.
Typically I would admit patients with serious coronary heart disease and severe obesity and put them on 1000 calorie diet
and keep them for 10 to 14 days and monitor weight and calorie intake carefully.
I made sure that they were in euthyroid state.
To my surprise then some of them, especially women, would fail to lose weight, and
amazingly a few of them would gain weight. For those who failed to lose weight, I would cut the calorie intake to 800 calorie,
only then they all would lose weight to some degree.
I was always puzzled by this and was convinced that there must be some genetic variation among people besides
thyroid hormone level which influences metabolism.

Overweight? Maybe You Really Can Blame Your Genes

By GINA KOLATA
The mice were eating their usual chow and exercising normally, but they were getting fat anyway. The reason: researchers had deleted a gene that acts in the brain and controls how quickly calories are burned. Even though they were consuming exactly the same number of calories as lean mice, they were gaining weight.
So far, only one person — a severely obese child — has been found to have a disabling mutation in the same gene. But the discovery of the same effect in mice and in the child — a finding published Wednesday in the journal Science — may help explain why some people put on weight easily while others eat all they want and seem never to gain an ounce. It may also offer clues to a puzzle in the field of obesity: Why do studies find that people gain different amounts of weight while overeating by the same amount?
Scientists have long thought explanations for why some people get fat might lie in their genes. They knew body weight was strongly inherited. Years ago, for example, they found that twins reared apart tended to have similar weights and adoptees tended to have weights like their biological parents, not the ones who reared them. As researchers developed tools to look for the actual genes, they found evidence that many — maybe even hundreds — of genes may be involved, stoking appetites, making people voraciously hungry.
This rare gene-disabling mutation, though, is intriguing because it seems to explain something different, a propensity to pile on pounds even while eating what should be a normal amount of food. Investigators are now searching for other mutations of the same gene in fat people that may have a similar, but less extreme effect. The hope is that in the long term, understanding how this gene affects weight gain might lead to treatments for obesity that alter the rate at which calories are burned.
“The history of obesity for many many years has been one of blaming people for lack of self control,” said Dr. Joseph Majzoub, chief of endocrinology at Boston Children’s Hospital and lead author of the new paper. “If some of it is due to a slow metabolism, that would completely change the perspectives of parents and patients. It really would change the way we think of the disease.”
In their paper, Dr. Majzoub and his colleagues describe figuring out how the gene they deleted, known as MRAP2, acts in the brain to control weight. They discovered that it is a helper gene. It normally acts in the brain to signal another gene already known to be involved in controlling appetite. So they developed a hypothesis. If the helper gene was deleted, the brakes should come off the gene that controls appetite. Animals should eat voraciously.
The first thing they noticed was that the mice got fat, ending up weighing twice as much as their normal siblings, with most of that extra weight due to fat accumulation.
“During the mouse equivalent of childhood and adolescence they were becoming rapidly obese,” Dr. Majzoub said.
The surprise came when the researchers figured out why. When the mice were young, they had normal appetites. The researchers measured what they and their normal siblings ate and determined they were eating the same amount of food. Yet the mice with the deleted gene still gained weight. The only way the obesity-prone mice could be kept slim was to be fed 10 to 15 percent less than their siblings.
But as adults, the mice with the missing gene developed monstrous appetites. Given a chance, they ate much more than their siblings, exacerbating the effects of their tendency to turn food into fat.
That led the researchers to ask if the same genetic phenomenon could be making people obese. They contacted Dr. Sadaf Farooqui of the University of Cambridge, whose group has been mapping the genes of massively obese children, and studied the data on 500 of the children, searching for mutations that disabled the same gene they had deleted in mice.
One child clearly had a gene-disabling mutation and three others had mutations that the investigators suspect might render the gene nonfunctional. None of the normal-weight children who served as controls had a mutation in the helper gene.
“From a basic science point of view, this is really interesting and exciting,” said David Allison, an obesity researcher at the University of Alabama in Birmingham who was not involved in the study. Any discovery that helps fill in the details of how the brain controls eating and weight gain is important, he added.
Jeffrey Friedman, an obesity researcher at Rockefeller University, who also was not involved in the study, said, “It is another piece in a very important puzzle.”
The work fascinates Claude Bouchard, a genetics researcher at the Pennington Biomedical Research Center in Baton Rouge, La., because it might offer insight into an intriguing finding: there are genetic controls not just of how much people want to eat but also how much of what they eat turns into fat or is burned off and not used by the body. Although the common mantra is that a calorie is a calorie and 3,500 extra calories eaten equals a pound of fat on the body, that is not what happens in real life, he found.
For example, in one of his studies, Dr. Bouchard enlisted 12 pairs of lean identical twins to live in an enclosed area for 120 days so their food and exercise could be monitored while they ate 1,000 calories a day more than needed to maintain their weight. The twins in each pair gained about the same amount of weight, but the amount gained varied threefold among the pairs. Those who gained the most put on as much as 29 pounds while those who gained the least put on 9 ½ pounds.
“It is not a freak finding,” Dr. Bouchard said, adding that about 20 studies found the same threefold range in weight gain in response to excess calories. But it also is not clear why this occurs. The intriguing possibility, he said, is that the newly discovered gene might be among those involved. The level of its activity might help determine how quickly calories are burned.
Dr. Majzoub and his colleagues are now trying to determine whether additional mutations in the gene they discovered — ones that hinder its function but do not completely disable it — might explain why some people gain weight.
“All we can do is hope,” Dr. Majzoub said.
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PUBLISHED JULY 18, 2013


http://www.nytimes.com/2013/07/19/health/overweight-maybe-you-really-can-blame-your-metabolism.html