Simha Vinaya
a Mayo Clinic , 200 First St SW, Rochester, MN 55905, USA.
Expert Rev Endocrinol Metab. 2014 May;9(3):205-212. doi: 10.1586/17446651.2014.894877. Epub 2014 Mar 7.
Lipodystrophy is a group of acquired and inherited disorders characterized by selective loss of adipose tissue. Despite wide genotypic and phenotypic variety, many patients with lipodystrophy have similar metabolic complications including insulin resistance, diabetes mellitus, hypertriglyceridemia and hepatic steatosis. Often, these metabolic abnormalities are severe and difficult to treat with conventional glucose and lipid-lowering therapies. Lack of adipose tissue also results in marked hypoleptinemia, and there has recently been much interest in using leptin-replacement therapy to treat the metabolic complications of lipodystrophy. Administration of metreleptin, the human recombinant leptin analogue, has been shown in prospective, open-label studies to improve glucose control, dyslipidemia and steatohepatitis. This article summarizes the current evidence for the safety and efficacy of leptin-replacement therapy in patients with lipodystrophy.
脂肪营养不良是一组获得性和遗传性疾病，其特征是脂肪组织选择性缺失。尽管存在广泛的基因型和表型差异，但许多脂肪营养不良患者有相似的代谢并发症，包括胰岛素抵抗、糖尿病、高甘油三酯血症和肝脂肪变性。通常，这些代谢异常很严重，难以用传统的降糖和降脂疗法治疗。脂肪组织的缺乏还会导致明显的低瘦素血症，最近人们对使用瘦素替代疗法治疗脂肪营养不良的代谢并发症产生了浓厚兴趣。在一项前瞻性开放标签研究中，已证实给予人重组瘦素类似物米泊美生可改善血糖控制、血脂异常和脂肪性肝炎。本文总结了瘦素替代疗法治疗脂肪营养不良患者安全性和有效性的现有证据。
