Changes in Satiety Hormones in Response to Leptin Treatment in a Patient with Leptin Deficiency

Roth, Christian; Schnurbein, Julia von; Elfers, Clinton; Moß, Anja; Wabitsch, Martin

doi:10.1159/000489884

Cited by 10 publications

(4 citation statements)

References 38 publications

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“…Treatment with recombinant human leptin (r-metHuLeptin; metreleptin) of patients with CLD entails an increased satiety and satiation within 7 days after its initiation; weight loss is pronounced over time [ 9 , 10 , 11 ]. A reduced irritability around eating was noted [ 11 ]. A 9-year-old female no longer secretly sought food or demanded food between meals [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

First Account of Psychological Changes Perceived by a Female with Congenital Leptin Deficiency upon Treatment with Metreleptin

Zorn¹,

Antel

Schnurbein³

et al. 2022

Obes Facts

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Two psychiatric interviews of a 39-year old female with congenital leptin deficiency were conducted to define psychological changes fourteen and 165 days after initiation of treatment with human recombinant leptin (metreleptin). The most pronounced initial experience related to the reduced preoccupation with food. An improved mood was reported by the patient, which she associated with this reduced preoccupation. Her mood remained elevated upon recontact, whereas she was no longer preoccupied with food. Overall, the interviews provides a vivid account of the subjective experiences upon initiation of treatment. Some of the findings bear resemblance to those reported recently in patients with anorexia nervosa who were treated with metreleptin for one to three weeks. This case report provides further evidence that metreleptin has strong psychophamacological effects in patients with absolute or relative leptin deficiency. We strongly recommend profound psychological examinations of patients with congenital leptin deficiency at baseline and after intitiation of treatment with human recombinant leptin to gain further insight into the functions affected by this hormone.

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Section: Introductionmentioning

confidence: 99%

First Account of Psychological Changes Perceived by a Female with Congenital Leptin Deficiency upon Treatment with Metreleptin

Zorn¹,

Antel

Schnurbein³

et al. 2022

Obes Facts

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“…However, a recent report of a patient with leptin deficiency receiving supplementation, highlights key interactions between gut hormones. Treatment with leptin led to significant rises in meal-stimulated GLP-1, PYY and insulin levels, whereas ghrelin levels decreased [49]. This effect highlights the regulatory effect of leptin on ghrelin secretion and the interplay between leptin, GLP-1 and PYY.…”

Section: Gut Hormones In Obesity Pathophysiology: Cause or Consequence?mentioning

confidence: 78%

The role of gut hormones in the pathogenesis and management of obesity

Makaronidis

Batterham

2019

Current Opinion in Physiology

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The growing obesity epidemic is driving the need for development of novel, effective therapeutic strategies for obesity and its complications. Increasing our understanding of the processes controlling body weight is therefore imperative. Gut hormones have emerged as essential regulators of energy homeostasis. Dysregulation of gut hormone physiology is increasingly implicated in obesity pathogenesis and the compensatory biological responses driving weight regain following energy restriction. Furthermore, gut hormones are among key mediators of the weight loss following Rouxen-Y gastric bypass and sleeve gastrectomy, the bariatric procedures which remain the most effective treatment for severe obesity. Therapeutic strategies targeting gut hormones and their receptors are driving a new pharmacotherapy era and constitute the most promising approach to addressing the obesity epidemic.

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“…A previous study of children with severe, early-onset obesity similarly found a strong negative correlation between BMI values and LEP-SDS [33]. The authors hypothesize that this finding might be a sign of relative leptin deficiency, probably driven through the development of strong insulin resistance, and suggested that these children may benefit from a substitution with human recombinant leptin [33,34]. Genetic obesity is rare; therefore, identifying and diagnosing cases of genetic obesity is quite challenging for pediatricians.…”

Section: Discussionmentioning

confidence: 90%

Genetic Obesity in Children: Overview of Possible Diagnoses with a Focus on <b><i>SH2B1</i></b> Deletion

Giannopoulou¹,

Zorn²,

Schirmer³

et al. 2021

Horm Res Paediatr

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Introduction: Genetic obesity is rare, and quite challenging for pediatricians in terms of early identification. SH2B1 is an important component in the leptin-melanocortin pathway and is found to play an important role in leptin and insulin signaling, and therefore in the pathogenesis of obesity and diabetes. Microdeletions in chromosome 16p11.2, encompassing the SH2B1 gene, are known to be associated with obesity, insulin resistance, hyperphagia and developmental delay. Aim of our study is to report on a case series of young individuals with 16p11.2 microdeletions, including the SH2B1 gene, and provide detailed information on BMI development and obesity-associated comorbidities. In this way, we want to raise awareness of this syndromic form of obesity as a differential diagnosis of genetic obesity. Methods: We describe the phenotype of 7 children (3 male; age range: 2.8 – 18.0 years) with 16p11.2 microdeletions, encompassing the SH2B1 gene, and present their BMI-trajectories from birth onwards. Screening for obesity-associated comorbidities was performed at time of genetic diagnosis. Results: All children presented with severe, early-onset obesity already at the age of 5 years combined with variable developmental delay. 5 patients presented with elevated fasting insulin levels, 1 patient developed diabetes mellitus type 2, 4 patients had dyslipidaemia and 4 developed non-alcoholic fatty liver disease. Discussion/Conclusion: Chromosomal microdeletions in 16p11.2, including the SH2B1 gene, in children are associated with severe, early-onset obesity and comorbidities associated with insulin resistance. Early genetic testing in suspicious patients and early screening for comorbidities is recommended.

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Changes in Satiety Hormones in Response to Leptin Treatment in a Patient with Leptin Deficiency

Cited by 10 publications

References 38 publications

First Account of Psychological Changes Perceived by a Female with Congenital Leptin Deficiency upon Treatment with Metreleptin

First Account of Psychological Changes Perceived by a Female with Congenital Leptin Deficiency upon Treatment with Metreleptin

The role of gut hormones in the pathogenesis and management of obesity

Genetic Obesity in Children: Overview of Possible Diagnoses with a Focus on <b><i>SH2B1</i></b> Deletion

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