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Severe lipodystrophy is associated with the hormone leptin deficiency, insulin resistance, hypertriglyceridemia,and hepatic steatosis.It has been found that replacement of Leptin improve these conditions
Nine female patients aged 15 to 42 years; 8 with diabetes mellitus, who had lipodystrophy and Leptin levels of less than 4 ng per millimeter, received recombinant methionyl Human Leptin ( recombinant leptin), subcutaneously twice a day for four months
During treatment with recombinant leptin the serum level of leptin increased from a mean of(±SE) of 1.3±0.3 ng per milliliter to 11.1±2.5 ng per milliliter. The absolute decrease in the glycosylated hemoglobin value was 1.9 percent in the eight patients with diabetes . Four months of therapy decreased average triglyceride levels by 60 percent, and liver volume by an average of 28 percent in all nine patients and led to the discontinuation of or a large reduction in antidiabetes therapy . Self-reported daily caloric intake and the measured resting metabolic rate also decreased significantly with therapy. Overall, recombinant leptin therapy was well tolerated.
Therefore Leptin-replacement therapy improved glycemic control and decreased triglyceride levels in patients with lipodystrophy and leptin deficiency. Leptin deficiency contributes to the insulin resistance and other metabolic abnormalities associated with severe lipodystrophy.