Education modulates the association of the FTO rs9939609 polymorphism with body mass index and obesity risk in the Mediterranean population

Nutr Metab Cardiovasc Dis. 2012 Aug;22(8):651-8. doi: 10.1016/j.numecd.2010.10.006. Epub 2010 Dec 24.


Objective: To define whether the rs9939609 FTO (fat mass and obesity associated) single nucleotide polymorphism (SNP) is associated with anthropometric measurements and its modulation by educational level in a Mediterranean population.

Methods: We studied 3 independent adult samples: a random sample (n = 1580) from the general population (GP), obese hospital patients (OHP) (n = 203) and elderly subjects (n = 1027) with high cardiovascular risk (HCR). Weight and height were directly measured. Education and physical activity (PA) were measured using questionnaires.

Results: The rs9939609 presented heterogeneous associations with BMI. In the GP, the minor A-allele was significantly associated with greater BMI, following a co-dominant pattern (P = 0.009), whereas in the OHP this association was recessive (P = 0.004). Conversely, we did not find a significant association with BMI in the HCR group (P < 0.596). In the GP we found a significant interaction between the FTO SNP and education (P = 0.048). In the stratified analysis, no association of the FTO SNP with greater BMI in university subjects was detected (P = 0.786), whereas the association was observed in non-university subjects (P = 0.001). The FTO × education interaction (P = 0.020) was also observed in determining obesity risk in the GP. A-allele carriers had a greater risk of being obese only if they had no university education (OR: 1.56; 95%CI: 1.09-2.23 for TA and OR: 2.01; 95%CI: 1.27-3.26 for AA subjects). The interaction of the FTO with education remained significant even after adjustment for PA.

Conclusions: The association of the FTO SNP with greater BMI and obesity risk in the GP was strongly modulated by education.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alpha-Ketoglutarate-Dependent Dioxygenase FTO
  • Anthropometry
  • Body Mass Index*
  • Chi-Square Distribution
  • Educational Status*
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Motor Activity
  • Multivariate Analysis
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Obesity / genetics*
  • Odds Ratio
  • Phenotype
  • Polymorphism, Single Nucleotide*
  • Prevalence
  • Proteins / genetics*
  • Risk Assessment
  • Risk Factors
  • Spain / epidemiology
  • Surveys and Questionnaires
  • Young Adult


  • Proteins
  • Alpha-Ketoglutarate-Dependent Dioxygenase FTO
  • FTO protein, human