{"id":2998,"date":"2006-10-08T09:24:15","date_gmt":"2006-10-08T08:24:15","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=2998"},"modified":"2013-12-06T15:40:40","modified_gmt":"2013-12-06T15:40:40","slug":"leptin-reduces-visceral-abdominal-tissue-vat-without-reducing-limb-fat","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/2998","title":{"rendered":"Leptin reduces visceral abdominal tissue (VAT) without reducing limb fat"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/strong><\/p>\n

Hootan Khatani and colleagues from University of California, San Francisco, presented results from an NIH funded, open-label, pilot study looking at the effects of leptin treatment on glucose and fat metabolism in patients with lipoatrophy and hypoleptinaemia.<\/strong> [1]<\/p>\n

While interest in leptin has been discussed at many of these workshops, research into a therapeutic role has been very slow. For an overview of the role of leptin and potential role in HIV-related lipodystrophy, see the HTB report from the Lipodystrophy Workshop four years ago. [2]<\/p>\n

The study enrolled eight HIV-positive men with lipoatrophy (5\/8 severe, and two patients also had fat accumulation) with leptin levels <3 ng\/ml (range 1.1-2.2ng\/ml), dyslipidaemia and insulin resistance. Recombinant human leptin was dosed subcutaneously at 0.1mg\/kg BID for the first 3 months and at 0.03 mg\/kg BID for a further 3 months.<\/p>\n

Treatment increased serum leptin to approximately mean 7 ng\/mL at month 3 and 20 ng\/mL at month 6 (p=0.03 and 0.008 respectively).<\/p>\n

Table 1: Effect of leptin on lipid metabolism<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n
<\/th>\nBaseline<\/th>\n6 months<\/th>\np-value<\/th>\n<\/tr>\n
Total cholesterol (mg\/dL)<\/td>\n229 \u00b116<\/td>\n187 \u00b112<\/td>\n0.001<\/td>\n<\/tr>\n
LDL cholesterol<\/td>\n140 \u00b18<\/td>\n117 \u00b18<\/td>\n0.002<\/td>\n<\/tr>\n
Non-HDL<\/td>\n204 \u00b115<\/td>\n158 \u00b112<\/td>\n0.001<\/td>\n<\/tr>\n
HDL<\/td>\n25 \u00b12<\/td>\n29 \u00b13<\/td>\n0.07<\/td>\n<\/tr>\n
Triglycerides<\/td>\n333 \u00b179<\/td>\n222 \u00b151<\/td>\n0.16<\/td>\n<\/tr>\n
Free fatty acids (mEq\/L)<\/td>\n0.40 \u00b10.04<\/td>\n0.30 \u00b10.04<\/td>\n0.04<\/td>\n<\/tr>\n
Lipolysis (mg\/kg\/min)<\/td>\n0.20 \u00b10.05<\/td>\n0.15 \u00b10.06<\/td>\n0.02<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Visceral adipose tissue measured by MRI (L4-L5) decreased significantly in all patients, from mean 183 +\/- 24 cm2 to 129 +\/-24 cm2 (p=0.001) compared to non-statistical changes in subcutaneous adipose tissue, 101 +\/-29 cm2 to 90 +\/-19 cm2 (p=0.45). The decrease in lipolysis suggested this was an effect in adipose tissue, and the lack of effect on lipoatrophy, that this may be a depot-specific effect.<\/p>\n

Leptin also had a generally beneficial effect on lipids (TC, LDL, HDL, non-HDL and TG), see Table 1. Although insulin sensitivity improved in the liver, whole body glucose uptake did not achieve significance.<\/p>\n

Comment<\/h3>\n

This small uncontrolled study clearly produced sufficiently optimistic results for this to be studied in larger trials. Similar questions may be as appropriate for leptin as for rHGH – ie cost, side effects, and particularly the durability of the effect after the treatment is stopped.<\/strong><\/p>\n

References:<\/p>\n

    \n
  1. Khatani H, Schwartz JM, Sakkas GK et al. Effects of leptin treatment on glucose and lipid metabolism and fat distribution in HIV+ patients with lipoatrophy and hypoleptinemia. 8th IWADRLH, September 2006, San Francisco. Abstract 22.<\/li>\n
  2. Leptin, lipodystrophy and insulin resistance. HIV Treatment Bulletin, November 2002.
    \nhttp:\/\/www.i-base.info\/3001<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base Hootan Khatani and colleagues from University of California, San Francisco, presented results from an NIH funded, open-label, pilot study looking at the effects of leptin treatment on glucose and fat metabolism in patients with lipoatrophy and …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[129],"class_list":["post-2998","post","type-post","status-publish","format-standard","hentry","category-conference-reports","tag-lipo-8th-2006"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2998","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=2998"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2998\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=2998"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=2998"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=2998"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}