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Adipokine profile in glucocorticoid-treated patients: baseline plasma leptin level predicts occurrence of lipodystrophy.
MedLine Citation:
PMID:  22268638     Owner:  NLM     Status:  Publisher    
CONTEXT: Glucocorticoid therapy may result in adipose tissue redistribution of unknown pathophysiology OBJECTIVES: 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 three months of therapy. DESIGN AND SETTING: Prospective monocentric study PATIENTS: Adult patients initiating systemic, high-dose prednisone therapy for at least three months. Blood samples and subcutaneous abdominal adipose tissue biopsies were collected at baseline and month 3. The presence of GIL after three months of therapy was assessed using standardized photography. RESULTS: 32 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. In the overall population, glucocorticoid exposure was associated with adiponectin and leptin level increases between baseline and month 3 while resistin levels remained unchanged. At baseline, leptin level was higher (19.3 [8.3-31.1] vs 4.5 [2.4-11.3] μg/l, p=0.006) and resistin level lower (7.1 [6.3-12.4] vs 10.4 [8.0-21.7] μg/l, p=0.05) in GIL+ than in GIL- patients. Baseline leptin level was predictive of GIL occurrence. ROC 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. CONCLUSION: GIL 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. © 2012 Blackwell Publishing Ltd.
Laurence Fardet; Barbara Antuna-Puente; Camille Vatier; Pascale Cervera; Amel Touati; Tabassome Simon; Jacqueline Capeau; Bruno Fève; Jean-Philippe Bastard
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-24
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne, Paris, 75012, France; Université Pierre et Marie Curie, UPMC Paris 6, Faculté de médecine, Paris, 75012, France; INSERM, UMR-S938, Paris, 75012, France.
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