Role of leptin in energy-deprivation states: normal human physiology and clinical implications for hypothalamic amenorrhoea and anorexia nervosa.
Leptin is an adipocyte-secreted hormone that plays a key part in energy homoeostasis. Advances in leptin physiology have established that the main role of this hormone is to signal energy availability in energy-deficient states. Studies in animals and human beings have shown that low concentrations of leptin are fully or partly responsible for starvation-induced changes in neuroendocrine axes, including low reproductive, thyroid, and insulin-like growth factor (IGF) hormones. Disease states such as exercise-induced hypothalamic amenorrhoea and anorexia nervosa are also associated with low concentrations of leptin and a similar spectrum of neuroendocrine abnormalities. We have recently shown in an interventional, proof-of-concept study that leptin can restore ovulatory menstrual cycles and improve reproductive, thyroid, and IGF hormones and bone markers in hypothalamic amenorrhoea. Further studies are warranted to establish the safety and effectiveness of leptin for the infertility and osteoporosis associated with hypothalamic amenorrhoea, and to clarify its role in anorexia nervosa.
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Stoneman 816, Boston, MA 02215, USA.
Jean L
JL
Chan
Christos S
CS
Mantzoros
D000568:Amenorrhea / Q000209:etiology / Q000503:physiopathology*; D000818:Animals; D000856:Anorexia Nervosa / Q000503:physiopathology*; D002149:Energy Intake; D005260:Female; D006066:Gonads / Q000503:physiopathology; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D020738:Leptin / Q000502:physiology*; D009765:Obesity / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D013217:Starvation / Q000503:physiopathology
D020738:Leptin