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Comment & Response
April 5, 2021

Consideration of Sex Differences in Children With Obesity

Author Affiliations
  • 1Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
JAMA Pediatr. 2021;175(7):748. doi:10.1001/jamapediatrics.2021.0250

To the Editor We read with great interest the article entitled “Obesity Genes and Weight Loss During Lifestyle Intervention in Children With Obesity.”1 The authors concluded that the role of genes in weight reduction by lifestyle in children with obesity is less important than that of external factors.

We noticed that the authors did not divide the group by sex. Instead, the overall body weight and body mass index (BMI) of individuals was applied in deferent groups. It is a known fact that there are significant differences in body weight and BMI between boys and girls owing to physiologic or hormonal differences. It may lead to unreliable results when the sex factor is ignored. Previous studies have shown that obesity was associated with single-nucleotide variants (SNVs) of LMX1B and RPTOR between the sexes and between races/ethnicities.2 Furthermore, Zhu et al3 revealed that the AA genotype of LMX1B is a potential risk factor for obesity in Chinese girls but not in boys. All of this evidence exhibited significant heterogeneity in sex. It also confirmed that SNVs of LMX1B play a major role in sex. This determines that sex and race are the important factors affecting BMI and obesity. Although the measure of standardized BMI was used as an indicator in this research, the effect of sex was not considered in the body weight. Therefore, more factor enrollment is needed to verify the reliability of the results.

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