ESPE2022 Poster Category 1 Fat, Metabolism and Obesity (73 abstracts)
1Ulm University Hospital, Ulm, Germany; 2University Hospital Essen, Essen, Germany; 3The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan; 4University of Health Science, Lahore, Pakistan
Purpose: States of starvation are characterized by reduced physical activity and social withdrawal. The reduction of leptin levels during starvation has been proposed to be a mediator of these changes, therefore we aimed to ascertain if leptin substitution in patients with congenital leptin deficiency (CLD) can increase physical activity and improve mood.
Methods: Seven CLD patients were filmed prior to and after short term (2-21 days, n=6) and long term (3-4 months, n=4) metreleptin substitution in a play situation. Each video was ranked by six independent and blinded investigators concerning the scales motor activity, social interaction, emotionality, and mood; ranking for all scales was such that high scores represent increments/improvements. Scale scores and a total score were calculated.
Results: Short term metreleptin substitution significantly increased the mean total score from 17.7 ± 4.1 to 22.6 ± 6.6 (P=0.039). In 5 out of 6 patients, all four scales were ranked higher than at baseline. The mean scores for motor activity (4.1 ± 1.1 to 5.1 ± 1.5, P=0.023) and social interaction (4.6 ± 1.1 to 6.2 ± 1.7, P=0.016) also increased significantly. After long term substitution the means of all four scales and of the total score were even higher than at short-term follow-up.
Conclusions: Metreleptin substitution improved indices of physical activity and indices of psychological wellbeing in patients with CLD. These data suggest that reduced leptin levels in starvation might be in part responsible for emotional and behavioural changes seen during starvation.