Adipokine profile in glucocorticoid‐treated patients: baseline plasma leptin level predicts occurrence of lipodystrophy. (11th December 2012)

• Record Type: Journal Article
• Authors: Fardet, Laurence; Antuna‐Puente, Barbara; Vatier, Camille; Cervera, Pascale; Touati, Amel; Simon, Tabassome; Capeau, Jacqueline; Fève, Bruno; Bastard, Jean‐Philippe
• Is Part Of: Clinical endocrinology. Volume 78:Number 1(2013:Jan.)
• Page Start: 43
• Page End: 51
• Publication Date: 2012-12-11
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/j.1365-2265.2012.04348.x
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" xml:lang="en" id="cen4348-abs-0001"> <title>Summary</title> <sec id="cen4348-sec-0001" sec-type="section"> <title>Context</title> <p>Glucocorticoid therapy may result in adipose tissue redistribution of unknown pathophysiology.</p> </sec> <sec id="cen4348-sec-0002" sec-type="section"> <title>Objectives</title> <p>To evaluate the effects of glucocorticoids on adipokine levels and adipose tissue inflammation. To compare the results in patients with or without glucocorticoid‐induced lipodystrophy (GIL) after 3 months of therapy.</p> </sec> <sec id="cen4348-sec-0003" sec-type="section"> <title>Design and setting</title> <p>Prospective monocentric study.</p> </sec> <sec id="cen4348-sec-0004" sec-type="section"> <title>Patients</title> <p>Adult patients <italic>initiating</italic> systemic, high‐dose prednisone therapy for at least 3 months. Blood samples and subcutaneous abdominal adipose tissue biopsies were collected at baseline and month 3. The presence of GIL after 3 months of therapy was assessed using standardized photography.</p> </sec> <sec id="cen4348-sec-0005" sec-type="section"> <title>Results</title> <p>Thirty‐two patients were enrolled. Blood samples and subcutaneous abdominal adipose tissue were available at baseline and month 3 for 30 patients [median age: 61 (38–79) years, 77% women]. Among those 30 patients, 15 were classified as GIL+ and 15 were GIL− at month 3. Between baseline and month 3, adiponectin and leptin levels increased in the overall population while the level of resistin remained unchanged. At baseline, leptin level was higher [19·3 (8·3–31·1) <italic>vs</italic> 4·5 (2·4–11·3) μg/l, <italic>P</italic> = 0·006] and resistin level lower [7·1 (6·3–12·4) <italic>vs</italic> 10·4 (8·0–21·7) μg/l, <italic>P</italic> = 0·05] in GIL+ than in GIL− patients. Baseline leptin level was predictive of GIL occurrence. Receiver operating characteristic curve analysis demonstrated that the best diagnostic accuracy was obtained with a baseline leptin cut‐off of 5·9 μg/l (sensitivity: 93%, specificity: 60%). At month 3, leptin and adiponectin levels increased more in the GIL+ than in the GIL− group, as did the number of anti‐inflammatory M2 macrophages in subcutaneous abdominal fat.</p> </sec> <sec id="cen4348-sec-0006" sec-type="section"> <title>Conclusion</title> <p>Glucocorticoid‐induced lipodystrophy is associated with a different adipokine profile both before and after glucocorticoid therapy. Serum leptin level prior to glucocorticoid therapy is highly predictive of GIL occurrence.</p> </sec> </abstract>