Leptin improves lipids and glycemic control in lipodystrophy patients
MedWire News: US researchers have discovered that leptin therapy can significantly improve the symptoms of patients with different forms of lipodystrophy.
Lipodystrophy is a rare condition that can be genetic or acquired and is characterized by loss of adipose tissue, low levels of leptin, dyslipidemia, severe insulin resistance, and diabetes.
In this study, Phillip Gordon and fellow researchers, from the National Institutes of Health in Bethesda, Maryland, carried out a prospective open-label study of leptin replacement therapy in 48 patients with acquired and inherited forms of lipodystrophy.
The median baseline age of the participants was 18 years, but ranged from 8 to 68 years, and 81% of the participants were female.
Recombinant methionyl human leptin was used to treat the patients at doses ranging from 0.04–0.24 mg/kg/day. The participants were treated for varying periods of time, with 43 patients continuing therapy for at least 4 months, and 35 patients for at least 12 months.
Writing in the journal Diabetologia, the authors report that 12 months treatment with leptin lead to significant improvements in serum triglycerides, total cholesterol, and glycated hemoglobin (HbA1c) levels. There was also a nonsignificant trend for improvement in low-density lipoprotein cholesterol concentration, but high-density lipoprotein cholesterol levels were unaffected.
In patients who were treated for 12 months or more, triglyceride levels fell by 6.02 mmol/l (533.19 mg/dl), total cholesterol by 1.78 mmol/l (68.83 mg/dl), and HbA1c decreased by 1.5% from baseline.
Of note, proteinuria was also reduced with leptin replacement, the researchers report.
“Lipodystrophy is a complex condition with many different etiologies, but the primary metabolic derangement in this condition appears to be caused by leptin deficiency,” comment Gordon et al.
“We confirm that leptin administration is effective in ameliorating the major metabolic abnormalities seen in lipodystrophy,” they conclude.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
By Helen Albert