title: Cerebrospinal fluid hypocretin 1 deficiency, overweight, and metabolic dysregulation in patients with narcolepsy.
abstract: OBJECTIVE
  The possible relationship between cerebrospinal fluid (CSF) hypocretin and leptin levels, overweight, and association to risk factors for diabetes 2 in narcolepsy with cataplexy were compared to patients with idiopathic hypersomnia and controls.
  
  
  METHODS
  26 patients with narcolepsy, cataplexy, and hypocretin deficiency; 23 patients with narcolepsy, cataplexy, and normal hypocretin values; 11 patients with idiopathic hypersomnia; and 43 controls.
  
  
  RESULTS
  Body mass index (BMI), serum leptin, and HbA1C were measured in patients and controls; and CSF hypocretin 1 and leptin measured in all patients. Female and male patients with narcolepsy and hypocretin deficiency had the highest mean BMI (27.8 and 26.2, respectively), not statistically different from patients with narcolepsy and normal hypocretin or controls, but statistically higher than the patients with idiopathic hypersomnia (p < 0.001 and 0.011, respectively). The number of obese patients (BMI > 30) was increased in both narcolepsy groups. Serum and CSF leptin levels correlated positively to BMI in patients and controls, but not to CSF hypocretin concentrations. HbA1C was within normal levels and similar in all groups.
  
  
  CONCLUSIONS
  The study confirms a moderate tendency to obesity (BMI > 30) and overweight in patients with narcolepsy and cataplexy. Obesity was not correlated to hypocretin deficiency or reduced serum or CSF leptin concentrations. We suggest that overweight and possible metabolic changes previously reported in narcolepsy, may be caused by other mechanisms.
authors.affiliation: Department of Clinical Neurophysiology, Oslo University Hospital, Ullevål, Oslo, Norway. msheier@online.no
authors.forename: Mona S
authors.initials: MS
authors.lastname: Heier
authors.forename: Tine S
authors.initials: TS
authors.lastname: Jansson
authors.forename: Kaare M
authors.initials: KM
authors.lastname: Gautvik
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002385:Cataplexy / Q000175:diagnosis* / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D020177:Idiopathic Hypersomnia / Q000175:diagnosis* / Q000453:epidemiology; D047908:Intracellular Signaling Peptides and Proteins / Q000134:cerebrospinal fluid* / Q000172:deficiency* / Q000378:metabolism; D020738:Leptin / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D009290:Narcolepsy / Q000175:diagnosis* / Q000453:epidemiology; D009479:Neuropeptides / Q000134:cerebrospinal fluid* / Q000172:deficiency* / Q000378:metabolism; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D000068797:Orexins; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: C000596229:HCRT protein, human; D047908:Intracellular Signaling Peptides and Proteins; D020738:Leptin; D009479:Neuropeptides; D000068797:Orexins