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Effect of small doses of dexamethasone on plasma leptin levels in normal and obese subjects: A dose-response study

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Abstract

To further elucidate the role of glucocorticoids in the regulation of leptin secretion, we studied the effects of overnight small doses of dexamethasone on plasma leptin levels in normal weight controls and in obese patients and correlated the results with indexes of insulin sensitivity and body fat distribution. In 114 subjects (81 obese patients, 49 women and 32 men, BMI 37.4±0.77 kg/m2 and 33 normal-weight subjects, 17 women and 16 men, BMI 22.1±0.41 kg/m2) plasma F and leptin levels were measured at 08:00 h basally and after the administration of different doses of dexamethasone (a fixed dose of 1-mg and 0.0035, 0.007, 0.015-mg/kg bw, given po at 23:00 h the night before). Tests were performed one week apart with bw remaining stable over the study period. Basal leptin levels were significantly higher in obese than in normal subjects (31.9±2.41 vs 7.7±0.93 ng/ml, p<0.0001). In obese patients, leptin levels increased significantly by 1-mg (from 31.9±2.41 to 35.0±2.59 ng/ml, p<0.005) and the 0.015-mg/kg bw dose (from 31.5±2.34 to 33.7±2.44 ng/ml, p<0.05), while they were unaffected by each dose of dexamethasone in normal subjects. However, after splitting subjects by gender, mean leptin levels rose from 39.3±2.97 to 43.3±3.12 ng/ml after the 1-mg dose, p<0.005, from 39.1±2.87 to 43.6±2.91 ng/ml after the 0.015-mg/kg bw dose, p<0.005, from 39.3±2.90 to 42.2±2.90 ng/ml after the 0.007-mg/kg bw dose, p<0.05 and from 38.8±2.66 to 41.1±2.87 ng/ml after the 0.0035-mg/kg bw dose, p=0.055, only in obese women. Conversely, no leptin changes were seen in the other groups and no differences were observed in the leptin response between groups. After the 1-mg dose, in the whole group, the absolute leptin variation was weakly but significantly related to BMI values (r=0.231, p<0.02) while in all sessions the percent leptin changes over baseline were not significantly correlated with age, BMI, waist, WHR, insulin, HOMA index, a marker of insulin sensitivity, plasma dexamethasone concentrations and to the percent cortisol variation following dexamethasone. In conclusion, in obese women but not in obese men and in normal weight subjects, small overnight increases in plasma glucocorticoid concentrations induced gender-related plasma leptin elevations that were unrelated to body fat distribution and insulin sensitivity. A greater sensitivity of female adipose tissue to glucocorticoids probably underlies this sexually dimorphic pattern of leptin response. These findings provide an additional piece of information on the regulation of leptin secretion exerted by glucocorticoids.

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Authors and Affiliations

  1. Ospedale San Luca IRCCS, University of Milan, Via Spagnoletto 3, 20149, Milan, Italy

    P. Putignano (Chair of Endocrinology), A. Dubini (Chair of Endocrinology), M. Bertolini (Chair of Endocrinology) &  Francesco Cavagnini (Chair of Endocrinology)

  2. Ospedale San Giuseppe IRCCS, Verbania, Istituto Auxologico Italiano, Italy

    A. Brunani

  3. Endocrinology Unit, Department of Internal Medicine, University of Bologna, Bologna, Italy

    R. Pasquali

Authors
  1. P. Putignano
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  2. A. Brunani
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  3. A. Dubini
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  4. M. Bertolini
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  5. R. Pasquali
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  6. Francesco Cavagnini
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“Study Group on Obesity” of the Italian Society of Endocrinology

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Correspondence to Francesco Cavagnini.

Additional information

Additional Authors, who are members of the Study Group on Obesity of the Italian Society of Endocrinology and have participated in the study, are: B. Ambrosi (Institute of Endocrine Sciences, University of Milan), D. Armanini (Endocrinology, Department of Medical and Surgica Sciences, University of Padua), E. Degli Uberti (Endocrinology Section, University of Ferrara), G. Del Rio (Endocrinology Service, University of Modena), G. De Pergola (DETO, University of Bari), M. Maccario (Division of Endocrinology, University of Turin), F. Mantero (Endocrinology, Department of Medical and Surgical Sciences, University of Padua), M. Marugo (Galliera Hospital, Genoa), C.M. Rotella (Endocrinology Section, Department of Clinical Physiopathology, University of Florence), R. Vettor (Institute of Medical Semeiotic, University of Padua), Italy.

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Putignano, P., Brunani, A., Dubini, A. et al. Effect of small doses of dexamethasone on plasma leptin levels in normal and obese subjects: A dose-response study. J Endocrinol Invest 26, 111–116 (2003). https://doi.org/10.1007/BF03345137

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