title: Severe hypoleptinaemia associated with insulin resistance in patients with common variable immunodeficiency.
abstract: OBJECTIVE
  Common variable immunodeficiency (CVI) is a primary immunodeficiency syndrome characterized by impaired production of antibodies and recurrent infections. Delay in diagnosis leads to metabolic wastage and low body weight. Leptin, a hormone produced by white adipose tissue, modulates insulin action by signal transduction cross-talk and by direct action on pancreatic beta-cells. We hypothesized that patients with CVI might present a defective regulation of leptin production and insulin resistance.
  
  
  METHODS
  Thirteen CVI patients (39 +/- 11 years) under gammaglobulin replacement were evaluated in parallel with 13 gender-, age-, body weight- and body mass index (BMI)-matched healthy voluntaries, and with data from two large population series, the Bruneck and the Hoorn Studies.
  
  
  METHODS
  Serum leptin and insulin levels, homeostasis model assessment - insulin resistance (HOMA-IR), body composition, haematological, biochemical and immunoglobulin measurements were obtained. Data were analysed by a one-way analysis of variance (anova) and by Pearson's rank analysis. The institutional ethics committee approved the study, and informed consent was obtained from patients and controls.
  
  
  RESULTS
  No differences were found between CVI and the control group when comparing gender distribution, age, body weight, BMI, waist/hip ratio, relative body fat and fasting glucose levels. Leptin levels were lower (P < 0.05) in CVI patients than in controls and lower than fasting leptin levels detected in a large population study. CVI patients' serum leptin levels did not correlate with BMI (r = 0.074, P = 0.8) and their high HOMA-IR indicated insulin resistance.
  
  
  CONCLUSIONS
  CVI patients are relatively hypoleptinaemic and insulin resistant, and their serum leptin levels are not correlated to their BMI.
authors.affiliation: Department of Internal Medicine, State University of Campinas, SP, Brazil.
authors.forename: Natasha Rebouças
authors.initials: NR
authors.lastname: Ferraroni
authors.forename: Bruno
authors.initials: B
authors.lastname: Geloneze
authors.forename: Eli
authors.initials: E
authors.lastname: Mansour
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Perroud
authors.forename: Elza O
authors.initials: EO
authors.lastname: Muscelli
authors.forename: Marcos
authors.initials: M
authors.lastname: Tambascia
authors.forename: Ricardo
authors.initials: R
authors.lastname: de Lima Zollner
authors.forename: Licio Augusto
authors.initials: LA
authors.lastname: Velloso
mesh_terms: D000328:Adult; D015992:Body Mass Index; D017074:Common Variable Immunodeficiency / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005947:Glucose / Q000378:metabolism; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D007328:Insulin; D020738:Leptin; D005947:Glucose