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Mosbah H, Vantyghem M, Nobécourt E, Andreelli F, Archambeaud F, Bismuth E, Briet C, Cartigny M, Chevalier B, Donadille B, Daguenel A, Fichet M, Gautier J, Janmaat S, Jéru I, Legagneur C, Leguier L, Maitre J, Mongeois E, Poitou C, Renard E, Reznik Y, Spiteri A, Travert F, Vergès B, Zammouri J, Vigouroux C, Vatier C. Therapeutic indications and metabolic effects of metreleptin in patients with lipodystrophy syndromes: Real-life experience from a national reference network. Diabetes Obes Metab 2022; 24:1565-1577. [PMID: 35445532 PMCID: PMC9541305 DOI: 10.1111/dom.14726] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/05/2022] [Accepted: 04/18/2022] [Indexed: 12/01/2022]
Abstract
AIM To describe baseline characteristics and follow-up data in patients with lipodystrophy syndromes treated with metreleptin in a national reference network, in a real-life setting. PATIENTS AND METHODS Clinical and metabolic data from patients receiving metreleptin in France were retrospectively collected, at baseline, at 1 year and at the latest follow-up during treatment. RESULTS Forty-seven patients with lipodystrophy including generalized lipodystrophy (GLD; n = 28) and partial lipodystrophy (PLD; n = 19) received metreleptin over the last decade. At baseline, the median (interquartile range [IQR]) patient age was 29.3 (16.6-47.6) years, body mass index was 23.8 (21.2-25.7) kg/m2 and serum leptin was 3.2 (1.0-4.9) ng/mL, 94% of patients had diabetes (66% insulin-treated), 53% had hypertension and 87% had dyslipidaemia. Metreleptin therapy, administered for a median (IQR) of 31.7 (14.2-76.0) months, was ongoing in 77% of patients at the latest follow-up. In patients with GLD, glycated haemoglobin (HbA1c) and fasting triglyceride levels significantly decreased from baseline to 1 year of metreleptin treatment, from 8.4 (6.5-9.9)% [68 (48-85) mmol/mol] to 6.8 (5.6-7.4)% [51(38-57) mmol/mol], and 3.6 (1.7-8.5) mmol/L to 2.2 (1.1-3.7) mmol/L, respectively (P < 0.001), with sustained efficacy thereafter. In patients with PLD, HbA1c was not significantly modified (7.7 [7.1-9.1]% [61 (54-76) mmol/mol] at baseline vs. 7.7 [7.4-9.5]% [61(57-80) mmol/mol] at 1 year), and the decrease in fasting triglycerides (from 3.3 [1.9-9.9] mmol/L to 2.5 [1.6-5.3] mmol/L; P < 0.01) was not confirmed at the latest assessment (5.2 [2.2-11.3] mmol/L). However, among PLD patients, at 1 year, 61% were responders regarding glucose homeostasis, with lower baseline leptin levels compared to nonresponders, and 61% were responders regarding triglyceridaemia. Liver enzymes significantly decreased only in the GLD group. CONCLUSIONS In this real-life setting study, metabolic outcomes are improved by metreleptin therapy in patients with GLD. The therapeutic indication for metreleptin needs to be clarified in patients with PLD.
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Affiliation(s)
- Héléna Mosbah
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Marie‐Christine Vantyghem
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital; University of Lille, INSERM U1190European Genomic Institute for DiabetesLilleFrance
| | - Estelle Nobécourt
- Department of Endocrinology, Diabetology and MetabolismLa Réunion University HospitalSaint Pierre de la RéunionFrance
| | - Fabrizio Andreelli
- AP‐HP, Pitié‐Salpêtrière University Hospital, Department of Diabetology; Sorbonne University, INSERMNutrition and Obesity: systemic approaches « NutriOmics »ParisFrance
| | - Francoise Archambeaud
- Department of Endocrinology, Diabetology and MetabolismDupuytren University HospitalLimogesFrance
| | - Elise Bismuth
- AP‐HP, Robert‐Debré University Hospital, Department of Paediatric Endocrinology, Diabetology and MetabolismUniversity of ParisParisFrance
| | - Claire Briet
- Department of EndocrinologyDiabetology and Metabolism, Angers University Hospital, Laboratory MITOVASC, UMR CNRS 6015, INSERM 1083AngersFrance
| | - Maryse Cartigny
- Reference Centre for Rare Diseases of Genital Development DEVGEN, Endocrinology Unit, Diabetology and Paediatric Gynecology DepartmentLille University HospitalLilleFrance
| | - Benjamin Chevalier
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital; University of Lille, INSERM U1190European Genomic Institute for DiabetesLilleFrance
| | - Bruno Donadille
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Anne Daguenel
- Department of PharmacyAP‐HP, Saint–Antoine University HospitalParisFrance
| | - Mathilde Fichet
- Department of Endocrinology, Diabetology and MetabolismRennes University HospitalRennesFrance
| | - Jean‐François Gautier
- Department of Endocrinology, Diabetology and MetabolismAP‐HP, Lariboisière University HospitalParisFrance
| | - Sonja Janmaat
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Isabelle Jéru
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Carole Legagneur
- Department of Paediatric Endocrinology, Diabetology and MetabolismUniversity Hospital Brabois‐Vandoeuvre lès NancyVandoeuvre lès NancyFrance
| | - Lysiane Leguier
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital; University of Lille, INSERM U1190European Genomic Institute for DiabetesLilleFrance
| | - Julie Maitre
- Department of Paediatrics and Endocrinology, Diabetology and MetabolismOrléans HospitalOrléansFrance
| | - Elise Mongeois
- Department of Paediatrics and Endocrinology, Diabetology and MetabolismOrléans HospitalOrléansFrance
| | - Christine Poitou
- Nutrition Department, Sorbonne University/INSERM, Research Unit: Nutrition and Obesity; Systemic Approaches (NutriOmics)AP‐HP, Pitié‐Salpêtrière University Hospital, Reference Centre for Rare Diseases PRADORT (PRADer‐Willi Syndrome and other Rare Obesities with Eating Disorders)ParisFrance
| | - Eric Renard
- Department of Endocrinology, Diabetes and Nutrition, Montpellier University Hospital; Clinical Investigation Centre INSERM1411; Institute of Functional Genomics, CNRS, INSERMUniversity of MontpellierMontpellierFrance
| | - Yves Reznik
- Department of Endocrinology, Diabetology and MetabolismCôte de Nacre University HospitalCaenFrance
| | - Anne Spiteri
- Department of Endocrinology, Diabetology and MetabolismGrenoble University HospitalGrenobleFrance
| | - Florence Travert
- Department of Diabetology and MetabolismAP‐HP, Bichat University HospitalParisFrance
| | - Bruno Vergès
- Department of Endocrinology, Diabetology and MetabolismBocage University HospitalDijonFrance
| | - Jamila Zammouri
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
- AP‐HP, Robert‐Debré University Hospital, Department of Paediatric Endocrinology, Diabetology and MetabolismUniversity of ParisParisFrance
| | - Corinne Vigouroux
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Camille Vatier
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
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Lefeuvre S, Bois-Maublanc J, Mongeois E, Policarpo V, Formaux L, Francia T, Billaud EM, Got L. Quantitation using HRMS: A new tool for rapid, specific and sensitive determination of catecholamines and deconjugated methanephrines metanephrines in urine. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1166:122391. [PMID: 33246878 DOI: 10.1016/j.jchromb.2020.122391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 12/27/2022]
Abstract
Urinary catecholamines and their methylated metabolites are biochemical indicators of pheochromocytoma, paraganglioma and neuroblastoma. A rapid and precise analytical method based on solid-phase extraction (SPE) and liquid chromatography separation coupled to high-resolution mass spectrometry (LC-HRMS) was developed and validated to measure urinary catecholamines (epinephrine (E), norepinephrine (NorE), dopamine (D)) and total methylated metabolites (normetanephrine (NorMN), metanephrine(MN) and 3-methoxytyramine (3-MT)) in a clinical setting. Results of 51 urine specimens measured using this LC-HRMS method were compared with a liquid chromatography assay with electrochemical detection (LC-EC). Urine samples (200 μL) were spiked with an internal standard solution followed by SPE purification. In the case of total methylated metabolites, urine was hydrolyzed before SPE purification. Separation was achieved on an Acclaim Mixed Mode WCX column, with an 8.5 min runtime. All compounds were detected in electrospray positive ionization mode with a parallel reaction monitoring acquisition and quantified with a linear regression (r2 > 0.998) between 2 and 200 µg/L (10.9-1090; 11.8-1182 nmol/L) for E and NorE respectively and between 10 and 1000 µg/L for others (65.2-6520; 50.7-5070; 54.5-5450 ; 59.8-5980 nmol/L for D, M, NorMN and 3-MT, respectively). Overall imprecision and bias did not exceed 15%. No significant matrix effect was observed. Correlation between the two assays was good except for epinephrine. Epinephrine concentrations measured by LC-EC method were slightly higher than values obtained with LC-HRMS method but without impact on clinical decision. This LC-HRMS assay provides a new tool for simultaneous quantitative catecholamine determination and was successfully applied in routine for the screening or follow up of pheochromocytoma, paraganglioma and neuroblastoma. LC-HRMS method offers significant advantages compared to LC-EC with good sensitivity, an unambiguous analyte determination and high sample throughput.
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Affiliation(s)
- S Lefeuvre
- Laboratory of Biochemistry, CHR Orléans, France.
| | | | - E Mongeois
- Diabetology - Endocrinology - Nutrition Department, CHR Orléans, France
| | - V Policarpo
- Laboratory of Biochemistry, CHR Orléans, France
| | - L Formaux
- Laboratory of Biochemistry, CHR Orléans, France
| | - T Francia
- Laboratory of Biochemistry, CHR Orléans, France
| | - E M Billaud
- Pharmacology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France
| | - L Got
- Laboratory of Biochemistry, CHR Orléans, France
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Vatier C, Fetita S, Boudou P, Tchankou C, Deville L, Riveline J, Young J, Mathivon L, Travert F, Morin D, Cahen J, Lascols O, Andreelli F, Reznik Y, Mongeois E, Madelaine I, Vantyghem M, Gautier J, Vigouroux C. One-year metreleptin improves insulin secretion in patients with diabetes linked to genetic lipodystrophic syndromes. Diabetes Obes Metab 2016; 18:693-7. [PMID: 26584826 DOI: 10.1111/dom.12606] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 11/16/2015] [Accepted: 11/16/2015] [Indexed: 12/21/2022]
Abstract
Recombinant methionyl human leptin (metreleptin) therapy was shown to improve hyperglycaemia, dyslipidaemia and insulin sensitivity in patients with lipodystrophic syndromes, but its effects on insulin secretion remain controversial. We used dynamic intravenous (i.v.) clamp procedures to measure insulin secretion, adjusted to insulin sensitivity, at baseline and after 1 year of metreleptin therapy, in 16 consecutive patients with lipodystrophy, diabetes and leptin deficiency. Patients, with a mean [± standard error of the mean (s.e.m.)] age of 39.2 (±4) years, presented with familial partial lipodystrophy (n = 11, 10 women) or congenital generalized lipodystrophy (n = 5, four women). Their mean (± s.e.m.) BMI (23.9 ± 0.7 kg/m(2) ), glycated haemoglobin levels (8.5 ± 0.4%) and serum triglycerides levels (4.6 ± 0.9 mmol/l) significantly decreased within 1 month of metreleptin therapy, then remained stable. Insulin sensitivity (from hyperglycaemic or euglycaemic-hyperinsulinaemic clamps, n = 4 and n = 12, respectively), insulin secretion during graded glucose infusion (n = 12), and acute insulin response to i.v. glucose adjusted to insulin sensitivity (disposition index, n = 12), significantly increased after 1 year of metreleptin therapy. The increase in disposition index was related to a decrease in percentage of total and trunk body fat. Metreleptin therapy improves not only insulin sensitivity, but also insulin secretion in patients with diabetes attributable to genetic lipodystrophies.
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Affiliation(s)
- C Vatier
- Sorbonne Universités, UPMC, Univ Paris 06, Paris, France
- Centre de Recherche Saint-Antoine, INSERM, UMR_S938, Paris, France
- ICAN, Institute of Cardiometabolism and Nutrition, Paris, France
| | - S Fetita
- Service de Diabétologie et Endocrinologie, AP-HP, Groupe Hospitalier Lariboisière-Saint-Louis, Paris, France
| | - P Boudou
- Service de Biochimie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - C Tchankou
- Service de Diabétologie et Endocrinologie, AP-HP, Groupe Hospitalier Lariboisière-Saint-Louis, Paris, France
| | - L Deville
- Département de Pharmacie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Jp Riveline
- Service de Diabétologie et Endocrinologie, AP-HP, Groupe Hospitalier Lariboisière-Saint-Louis, Paris, France
- Centre de Recherche des Cordeliers, INSERM, UMR_S1138, Paris, France
| | - J Young
- Service d'Endocrinologie et des Maladies de la Reproduction, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - L Mathivon
- Service de Pédiatrie, Centre Hospitalier de Meaux, Meaux, France
| | - F Travert
- Service d'Endocrinologie, Diabétologie, Nutrition, AP-HP, Hôpital Bichat, Paris, France
| | - D Morin
- Service de Pédiatrie, CHRU Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - J Cahen
- Service d'Endocrinologie et Métabolismes, Centre Hospitalier, Argenteuil, France
| | - O Lascols
- Sorbonne Universités, UPMC, Univ Paris 06, Paris, France
- Centre de Recherche Saint-Antoine, INSERM, UMR_S938, Paris, France
- ICAN, Institute of Cardiometabolism and Nutrition, Paris, France
- Laboratoire Commun de Biologie et Génétique Moléculaires, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - F Andreelli
- ICAN, Institute of Cardiometabolism and Nutrition, Paris, France
- Service de Diabétologie, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Y Reznik
- Service d'Endocrinologie, Centre Hospitalier Universitaire Côte-de-Nacre, Caen, France
| | - E Mongeois
- Service d'Endocrinologie, Centre Hospitalier Régional d'Orléans, Orléans, France
| | - I Madelaine
- Département de Pharmacie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Mc Vantyghem
- Service d'Endocrinologie et Métabolisme, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Jf Gautier
- Service de Diabétologie et Endocrinologie, AP-HP, Groupe Hospitalier Lariboisière-Saint-Louis, Paris, France
- Centre de Recherche des Cordeliers, INSERM, UMR_S1138, Paris, France
- University Paris-Diderot Paris-7, Paris, France
| | - C Vigouroux
- Sorbonne Universités, UPMC, Univ Paris 06, Paris, France
- Centre de Recherche Saint-Antoine, INSERM, UMR_S938, Paris, France
- ICAN, Institute of Cardiometabolism and Nutrition, Paris, France
- Laboratoire Commun de Biologie et Génétique Moléculaires, AP-HP, Hôpital Saint-Antoine, Paris, France
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Guimard A, Vibarel-Rebot N, Prieur F, Baillot A, Mongeois E, Barrande MG, Lasne F, Collomp K. Effect of obesity on diurnal patterns of testosterone and dehydroepiandrosterone in male subjects. Sci Sports 2013. [DOI: 10.1016/j.scispo.2013.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Duprez R, Lebas P, Marc OS, Mongeois E, Emy P, Michenet P. Preoperative US-guided hook-needle insertion in recurrent lymph nodes of papillary thyroid cancer: A help for the surgeon. Eur J Radiol 2010; 73:40-2. [DOI: 10.1016/j.ejrad.2008.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 10/03/2008] [Indexed: 11/29/2022]
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Muresan M, Chatelin J, Bardou-Jacquet E, Mongeois E, Civit T, Moret C, Klein M, Weryha G. Diabète insipide et histiocytose langerhansienne:à propos de trois observations. Rev Med Interne 2003. [DOI: 10.1016/s0248-8663(03)80505-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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