Leptin therapy in insulin-deficient type I diabetes

• Published in: Proceedings of the National Academy of Sciences - PNAS Vol. 107; no. 11; pp. 4813 - 4819
• Main Authors: Wang, May-yun, Chen, Lijun, Clark, Gregory O, Lee, Young, Stevens, Robert D, Ilkayeva, Olga R, Wenner, Brett R, Bain, James R, Charron, Maureen J, Newgard, Christopher B, Unger, Roger H
• Format: Journal Article
• Language: English
• Published: United States National Academy of Sciences 16-03-2010; National Acad Sciences
• Series: Feature Article
• Subjects: Adenylate Kinase - metabolism; Amino acid metabolism; Animals; Biological Sciences; Blood Glucose - metabolism; Blood plasma; Diabetes; Diabetes complications; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Drug Implants; Gene Expression Regulation; Glucagon - blood; Glucose; Hemoglobin; Hormone replacement therapy; Insulin; Insulin - administration & dosage; Insulin - deficiency; Insulin - therapeutic use; Insulin resistance; Leptin - administration & dosage; Leptin - therapeutic use; Lipid metabolism; Liver; Liver - enzymology; Metabolome; Mice; Mice, Inbred NOD; Phosphorylation; Recombinant Proteins - therapeutic use; RNA, Messenger - genetics; RNA, Messenger - metabolism; Rodents; Triglycerides - blood; Type 1 diabetes mellitus; Type 2 diabetes mellitus
• ISSN: 0027-8424; 1091-6490
• DOI: 10.1073/pnas.0909422107

In nonobese diabetic mice with uncontrolled type 1 diabetes, leptin therapy alone or combined with low-dose insulin reverses the catabolic state through suppression of hyperglucagonemia. Additionally, it mimics the anabolic actions of insulin monotherapy and normalizes hemoglobin A1c with far less glucose variability. We show that leptin therapy, like insulin, normalizes the levels of a wide array of hepatic intermediary metabolites in multiple chemical classes, including acylcarnitines, organic acids (tricarboxylic acid cycle intermediates), amino acids, and acyl CoAs. In contrast to insulin monotherapy, however, leptin lowers both lipogenic and cholesterologenic transcription factors and enzymes and reduces plasma and tissue lipids. The results imply that leptin administration may have multiple short- and long-term advantages over insulin monotherapy for type 1 diabetes.