Recombinant methionyl human leptin therapy in replacement doses improves insulin resistance and metabolic profile in patients with lipoatrophy and metabolic syndrome induced by the highly active antiretroviral therapy

The Journal of Clinical Endocrinology and Metabolism
Jennifer H LeeChristos S Mantzoros

Abstract

Highly active antiretroviral therapy (HAART) for HIV-1 infection has been associated with a metabolic syndrome characterized by insulin resistance, hyperlipidemia, and redistribution of body fat (lipodystrophy). A subset of patients with predominant lipoatrophy has low levels of the adipocyte-secreted hormone leptin. The objective of the study was to assess whether administration of recombinant methionyl human leptin (r-metHuLeptin) improves insulin resistance and other metabolic abnormalities in HIV+ leptin-deficient subjects with HAART-induced lipoatrophy. We conducted a randomized, placebo-controlled, double-blinded, crossover study from 2002 to 2004 in seven HIV+ men with HAART-induced lipoatrophy, serum leptin level less than 3 ng/ml, and fasting triglyceride level greater than 300 mg/dl, who were administered placebo for 2 months before or after administration of r-metHuLeptin at physiological doses for an additional 2 months. Insulin resistance, lipid levels, inflammatory markers, body composition, and HIV control were measured. Compared with placebo, r-metHuLeptin therapy improved fasting insulin levels, insulin resistance (as expressed by the homeostasis model assessment index and an insulin suppression test), and high...Continue Reading

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Citations

Jan 27, 2007·Current Diabetes Reports·Aoife M Brennan, Christos S Mantzoros
Dec 3, 2011·Endocrine·Absalon D Gutierrez, Ashok Balasubramanyam
Jun 7, 2013·Drugs·Ken Chou, Caroline M Perry
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