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Effects of Exogenous Leptin on Satiety and Satiation in Patients with Lipodystrophy and Leptin Insufficiency
Open accessAbstract
To examine leptin’s role in human appetite regulation, we studied recombinant methionyl human leptin’s effects on satiation and satiety in a model of leptin insufficiency, lipodystrophy. Eight females with hypoleptinemia and lipodystrophy were given sc injections of A-100 (maximal dose, 200% of that predicted to normalize serum leptin) for 4 months. Satiation and satiety were determined before and again during leptin treatment. Satiation was measured as the time to voluntary cessation of eating from a standardized food array after a 12-h fast. Satiety was determined as the time to hunger sufficient to consume a full meal after consumption of a standardized preload. During leptin treatment, satiation time decreased (41.2 ± 18.2 to 19.5 ± 10.6 min; P = 0.01), satiety time increased (62.9 ± 64.8 to 137.8 ± 91.6 min; P = 0.04), energy consumed to produce satiation decreased (2034 ± 405 to 1135 ± 432 kcal or 8.5 ± 1.7 to 4.7 ± 1.8 MJ; P < 0.01), and the amount of food desired in the postabsorptive state decreased (P < 0.02). Ghrelin concentrations also decreased during leptin administration (284.3 ± 127.9 to 140.6 ± 104.5 pmol/liter; P < 0.002). We conclude that increased leptin in patients with lipodystrophy results in less caloric, shorter, more satiating meals and longer-lived satiety. These data support the hypothesis that leptin plays an important, permissive role in human appetite regulation.
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“When patients with lipodystrophy and reduced leptin were placed on r-metHuLeptin, they reported improved satiety and satiation, resulting in ϳ40% reduction of caloric intake (22).”
From Long-Term Efficacy of Leptin Replacement in Patients With Generalized Lipodystrophy (2005) · cites this paper as [22]
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“[40] observed significant improvement in measures of satiety and decrease in food intake under test conditions after leptin therapy.”
BackgroundGLP-1 receptor agonist improves metabolic disease in a pre-clinical model of lipodystrophy
Roumane, A., Mcilroy, G. D., Sommer, N., Han, W., Heisler, L. K., & Rochford, J. J. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1379228 · Cited by 14
Sarmento, A. S. C., Lima, J. G., Timóteo, A. R. D. S., Ururahy, M. A. G., de Araújo, A. A., Vasconcelos, R. C., Dantas, V. K. C., Agnez‐Lima, L. F., & Campos, J. T. A. D. M. (2020) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2020.158610 · Cited by 13
Adamski, K., Cook, K., Gupta, D., Morris, E., Tuttle, E., Carr, E., Cremasco, F., Cochran, E., & Brown, R. J. (2021) · Current Medical Research and Opinion · doi:10.1080/03007995.2021.1976125 · Cited by 11
Lightbourne, M., Wolska, A. T., Abel, B. S., Rother, K. I., Walter, M. F., Kushchayeva, Y. S., Auh, S., Shamburek, R. D., Remaley, A. T., Muniyappa, R., et al. (2020) · Journal of the Endocrine Society · doi:10.1210/jendso/bvaa191 · Cited by 11
“Other mechanisms that may be responsible for metreleptin-mediated reductions in triglycerides include decreased food intake [4, 5], decreased adipose tissue lipolysis [14, 25], increased fatty acid oxidation [26], and decreased de novo lipogenesis [27-29].”
BackgroundCasey, S., Lokan, J., Testro, A., Farquharson, S., Connelly, A., Proietto, J., & Angus, P. (2013) · American Journal of Transplantation · doi:10.1111/ajt.12436 · Cited by 10
“Numerous studies have shown that it decreases episodes of hyperphagia, increases satiety and with that reduces caloric intake (2,8,11,18).”
BackgroundTreatment Options for Lipodystrophy in Children
Mainieri, F., Tagi, V. M., & Chiarelli, F. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.879979 · Cited by 10
“Ultimately, the consequences of leptin deficiency have repercussions on insulin actions as well as on the appetite, determining hyperphagia (41).”
BackgroundTsoukas, M. A., & Mantzoros, C. S. (2015) · Elsevier eBooks · doi:10.1016/b978-0-323-18907-1.00037-8 · Cited by 10
Leptin and Appetite Control in Lipodystrophy
Ahima, R. S., & Osei, S. Y. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1232 · Cited by 10
Metabolic Improvements With Tirzepatide in Lipodystrophy: A Novel Option?
Meral, R., Güler, M. Ç., Kaba, D., Prativadi, J., Frontera, E. D., Foss‐Freitas, M. C., Nachawi, N., Broome, D. T., Lightbourne, M., Brown, R. J., et al. (2025) · Diabetes Care · doi:10.2337/dc24-2408 · Cited by 9
Self-citationAdipokines and etiopathology of metabolic disorders
AL-Dokhi, L. M. (2009) · Saudi Medical Journal · doi:10.15537/1658-3175.4817 · Cited by 9
Clinical Guidance for Lipodystrophy Syndromes: From Diagnosis and Work-Up to Treatment
Gilio, D., Foss‐Freitas, M. C., & Oral, E. A. (2025) · Current Diabetes Reports · doi:10.1007/s11892-025-01603-4 · Cited by 13
“This can lead to weight loss, although the weight typically stabilizes after several months [ 91–93].”
Self-citationTranslational Research of Leptin in Lipodystrophy and Its Related Diseases
Ebihara, K., & Nakao, K. (2015) · Springer eBooks · doi:10.1007/978-4-431-55651-0_14 · Cited by 8
Zhang, Y., & Ren, J. T. (2015) · Springer eBooks · doi:10.1007/978-3-319-19821-7_4 · Cited by 8
Leptin acutely increases hepatic triglyceride secretion in patients with lipodystrophy
Beghini, M., Metz, M., Baumgartner, C., Wolf, P. S., Bastian, M., Hackl, M. T., Baumgartner-Parzer, S. M., Marculescu, R., Krebs, M., Harreiter, J., et al. (2025) · Metabolism · doi:10.1016/j.metabol.2025.156261 · Cited by 7
Metreleptin treatment of non-HIV lipodystrophy syndromes
Chevalier, B., Lemaître, M., Leguier, L., Mapihan, K. L., Douillard, C., Jannin, A., Espiard, S., & Vantyghem, M. (2021) · La Presse Médicale · doi:10.1016/j.lpm.2021.104070 · Cited by 8
Martin, S. A., Sanchez, R. J., Olayinka-Amao, O., Harris, C. A., & Fehnel, S. E. (2022) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-022-00486-3 · Cited by 7
Ambivalent Food Craving and Psychobiological Characteristics in Individuals With Weight Suppression
Lee, M., & Lee, J.-H. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.619025 · Cited by 6
Iwanishi, M., Ebihara, K., Kusakabe, T., Washiyama, M., Ito‐Kobayashi, J., Nakamura, F., Togawa, T., Ozamoto, Y., Hagiwara, A., & Nakao, K. (2014) · Internal Medicine · doi:10.2169/internalmedicine.53.1713 · Cited by 6
“Low levels of serum leptin in patients with FPL may decrease satiety, thereby causing overeating (15, 16).”
BackgroundMetreleptin in lipodystrophy: a profile of its use
Deeks, E. D. (2019) · Drugs & Therapy Perspectives · doi:10.1007/s40267-019-00622-y · Cited by 6
“One such factor is regulation of appetite/eating behaviour, with metreleptin reducing hunger [10, 11], eating importance/ frequency [10], caloric intake [12] and time to satiety [12], as well as increasing satiety [11, 12]; however, some effects of metreleptin (including insulin sensitivity improvements) may be indepe…”
BackgroundConroy, R., Febres, G., McMahon, D. J., Thorner, M. O., Gaylinn, B. D., Conwell, I. M., Aronne, L. J., & Körner, J. (2014) · International Journal of Endocrinology · doi:10.1155/2014/120286 · Cited by 6
Miehle, K., von Schnurbein, J., Faßhauer, M., Stümvoll, M., Borck, G., & Wabitsch, M. (2017) · Medizinische Genetik · doi:10.1007/s11825-017-0162-2 · Cited by 3
Adamowski, M., Sharma, Y., Molcan, T., Wołodko, K., Kelsey, G., & Galvão, A. M. (2024) · Scientific Reports · doi:10.1038/s41598-024-58181-w · Cited by 7
“Leptin is mostly known for its regulatory role on food intake and satiety 12,13 .”
Palazzo, R. P., Torres, I. L. D. S., Grefenhagen, Á. I. D. S., da Silva, B. B., de Meireles, L. C. F., de Vargas, K. C., Alves, Z. D. S., Pereira, L. O., & Siqueira, I. R. (2020) · International Journal of Developmental Neuroscience · doi:10.1002/jdn.10063 · Cited by 5
“We also evaluated the number of bouts, defined as a period of continuous eating (South et al., 2014), length of the first inter-bouts interval, and time point of last bout (McDuffie et al., 2004).”
BackgroundSchlögl, H., Villringer, A., Miehle, K., Faßhauer, M., Stümvoll, M., & Mueller, K. (2023) · Journal of the Endocrine Society · doi:10.1210/jendso/bvad072 · Cited by 4
“In that work, we also obtained a significant decrease of hunger feelings during metreleptin treatment that is in line with the observations of others [34].”
ResultGao, C., & Mantzoros, C. S. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-5583-9.00038-1 · Cited by 4
Brown, R. J., Akıncı, B., Al-Yaarubi, S., Bismuth, É., Cappa, M., Deeb, A., Kamrath, C., Musso, C., Patni, N., Prodam, F., et al. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1597053 · Cited by 4
Altered acylated ghrelin response to food intake in congenital generalized lipodystrophy
de Araújo, C. O. D., Montenegro, R. M., Pedroso, A. P., Fernandes, V. O., Montenegro, A. P. D. R., de Carvalho, A. B., Oyama, L. M., Maia, C. S. C., & Ribeiro, E. B. (2021) · PLoS ONE · doi:10.1371/journal.pone.0244667 · Cited by 3
“The satiety time was considered as the period elapsed between the leaving of the meal room and their reporting of desire to eat another meal [24].”
BackgroundInfluentialBesci, Ö., Güler, M. Ç., Foss‐Freitas, M. C., & Oral, E. A. (2025) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2025.2574318 · Cited by 2
“Metreleptin treatment is associated with weight loss, reductions in BMI, decreased appetite, and decreased energy expenditure [37,40,42,45,56,71].”
InfluentialSelf-citation
Metadata
- Authors
- McDuffie, J. R., Riggs, P. A., Calis, K. A., Freedman, R. J., Oral, E. A., DePaoli, A. M., & Yanovski, J. A.
- Affiliations
- National Institutes of Health (US)
- Nutrition Department (P.A.R.), Maryland 20892
- Drug Information Service, Pharmacy Department (K.A.C.), Warren Grant Magnuson Clinical Center
- Unit on Growth and Obesity, National Institute of Child Health and Human Development (J.R.M., R.J.F., J.A.Y.), Maryland 20892
- Amgen (United States) (US)
- Corresponding author
- Yanovski, Jack A.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2004-09-01
- Volume
- 89
- Issue
- 9
- Pages
- 4258-4263
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2266890
- OpenAlex
- W2150678858
- Cited by
- 129
- References
- 31
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 9 · 2020: 12 · 2019: 6 · 2018: 7 · 2017: 3 · 2016: 4 · 2015: 10 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- Amgen
- National Institutes of Health (Z99HD999999)
- U.S. Public Health Service
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK-54387, R01DK054387)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (ZO1 HD00641, Z01HD000641)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- leptin, lipodystrophy, hypoleptinemia, satiety, satiation, appetite regulation, ghrelin, recombinant human leptin, meal duration, energy intake
- MeSH terms
- Adolescent, Adult, Energy Metabolism, Female, Humans, Lipodystrophy, Satiation, Leptin
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