Research using data from a BRC-supported project has given an insight into how best to predict health and disease risk in the population.

The research used data from nearly 2,000 adult twins that were part of the TwinsUK registry. TwinsUK comprises almost 14,000 twins and is part of the NIHR BioResource, supported by the NIHR. Data from the registry are used to study the genetic and environmental factors behind a range of conditions.

The researchers wanted to understand how health outcomes were linked to genetics, BMI and the metabolome – the sum of all the small-molecule chemicals found in samples of blood plasma.

Just over a quarter of UK adults are classified as obese and in 2016/17, there were 617 thousand NHS hospital admissions where obesity was a factor – a figure that has risen over recent years.

BMI is currently the standard metric used by clinicians to understand a patient’s risk of disease, using their height and weight to measure if a patient is over or underweight, and therefore at higher risk of certain conditions.

The researchers studied samples and health outcomes in participants from the TwinsUK registry, and found that although BMI was a good predictor of health in most cases, it was not in all. Some obese patients were in good health, while some who were a healthy weight had health problems normally associated with being overweight.

The metabolome was identified a better indicator of health. In total, 49 metabolites were identified as strong indicators of health, which could form the basis of a more nuanced and reliable test to understand health risk.

Professor Tim Spector, who is Director of TwinsUK and a member of our Cluster 2 board, said the study underlined the importance of registries like TwinsUK.

“Problems like obesity and how it relates to health outcomes are incredibly complex and difficult. Registries like ours can be a vital resource for scientists trying to crack these important problems. We were able to reclassify some people who were lean as ‘metabolically unhealthy’.

“This study shows how having a range of data from throughout the population could help us understand the interactions between environmental and physical factors and hopefully have a positive effect on people’s health.”

Although scientists are still working to understand the metabolome, the authors of the study hope that it may one day be used in the clinic to help give patients a reliable indication of their risk.

Genetics was also a factor the researchers considered. They found that it wasn’t a good indicator of obesity or health problems in most cases. They did, however, identify one variation in the gene MC4R, which had a large effect on obesity in patients, and suggested these patients might be candidates for genetic analysis.