OBJECTIVE: To investigate the effects of continuous i.v. infusion of hydrocortisone or insulin on leptin secretion in humans. SUBJECTS: Six, nonfasting healthy adults (four women, two men), aged (mean AE s.e.m.) 36.6 AE 1.7 y; body mass index (BMI) 27.6 AE 0.9 kgam 2 . DESIGN: Randomized, placebo-controlled, cross-over study, with a 2-week`wash-out' period. INTERVENTIONS: Intravenous infusion of hydrocortisone (3.3 m mga(kg min)), insulin (1 mUa(kg min)) or normal saline (placebo) for 24 h. MEASUREMENTS: Blood sampling every 1 ± 2 h for measurement of glucose, insulin, cortisol and leptin; subcutaneous abdominal fat biopsy for determination of leptin mRNA expression. RESULTS: Plasma cortisol increased to 50.0 AE 0.4 m mgadl during hydrocortisone infusion, but was unaltered during saline or insulin infusion. The plasma insulin levels were: 28.5 AE 4.7 m mUaml (placebo), 40.8 AE 9.2 m mUaml (hydrocortisone, P 0.214), and 243 AE 23.0 m mUaml (insulin, P 0.0002). Peak hyperleptinemia occurred after 16 h of insulin and 20 h of hydrocortisone infusion; peakabaseline plasma leptin levels (ngaml) were 18.2 AE 4.2a15.1 AE 3.3 (placebo, P 0.056), 42.1 AE 7.0a16.0 AE 3.8 (hydrocortisone, 163%, P 0.008) and 30.2 AE 4.3a16.6 AE 2.7 (insulin, 83%, P 0.024). Adipocyte leptin mRNA increased by 350% after the hydrocortisone infusion. CONCLUSION: Hydrocortisone, a natural glucocorticoid, induces hyperleptinemia in vivo, with a potency greater than that of insulin. The interaction between glucocorticoids and leptin may be of metabolic signi®cance in humans.