Objective: To examine the spontaneous leptin secretion in patients with myelomeningocele (MMC) and growth hormone deficiency (GHD). Methods: Serum leptin levels were studied in 10 prepubertal MMC patients with GHD (CA 6.2 ± 0.5 years), 10 patients with idiopathic GHD (IGHD; CA 7.6 ± 0.7 years) and 12 children with normal variant short stature (NVSS; CA 7.6 ± 0.5 years). Mean BMI (kg/m2) values of the groups did not differ significantly. Nocturnal leptin levels were analyzed over 10 h (blood samples every 20 min) and measured by specific radioimmunoassay. Results: Mean leptin concentrations did not correlate with BMI in MMC patients. Nocturnal leptin secretion of MMC patients was significantly different to those of children with IGHD and NVSS. Morning leptin levels did not decline as observed in both other groups. Conclusion: Since all groups were matched for BMI values, we suggest a hypothalamic dysregulation of leptin secretion in MMC patients.

1.
Kjaer I, Fischer-Hansen B, Keeling JW: Axial skeleton and pituitary gland in human fetuses with spina bifida and cranial encephalocele. Pediatr Pathol 1996;16:909–926.
2.
Fiore P, Picco P, Castagnola E, Palmieri A, Levato L, Gremmo M, Tramalloni R, Cama A: Nutritional survey of children and adolescents with myelomeningocele (MMC): Overweight associated with reduced energy intake. Eur J Pediatr Surg 1998;8(suppl 1):34–36.
3.
Greene SA, Frank M, Zachmann M, Prader A: Growth and sexual development in children with meningomyelocele. Eur J Pediatr 1985;144:146–148.
4.
Perrone L, Del Gaizo D, D’Angelo E, Rea L, Di Manso G, Del Gado R: Endocrine studies in children with myelomeningocele. J Pediatr Endocrinol 1994;7:219–223.
5.
Elias RE: Precocious puberty in girls with myelodysplasia. Pediatrics 1994;3:521–522.
6.
Rotenstein D, Reigel DH: Growth hormone treatment of children with neural tube defects: Results from 6 months to 6 years. J Pediatr 1996;128:184–187.
7.
Satin-Smith MS, Katz LL, Thornton P, Gruccio D, Moshang T: Arm span as measurement of response to growth hormone (GH) treatment in a group of children with meningomyelocele and GH deficiency. J Clin Endocrin Metab 1996;81:1654–1656.
8.
Trollmann R, Strehl E, Dörr HG: Precocious puberty in children with myelomeningocele: Treatment with GnRH analogues. Dev Med Child Neurol 1998;40:38–43.
9.
Trollmann R, Strehl E, Wenzel D, Dörr HG: Does growth hormone (GH) enhance growth in GH-deficient children with myelomeningocele? J Clin Endocrinol Metab 2000;85:2740–2743.
10.
Blum WF, Englaro P, Hanitsch S, Juul A, Hertel NT, Müller J, Skakkebaek NE, Heiman ML, Birkett M, Attanasio AM, Kiess W, Rascher W: Plasma leptin levels in healthy children and adolescents: Dependence on body mass index, body fat mass, gender, pubertal stage, and testosterone. J Clin Endocrinol Metab 1997;82:2904–2910.
11.
Campfield LA, Smith FJ: Overview: Neurobiology of OB protein (leptin). Proc Nutr Soc 1998;57:429–440.
12.
Kastin AJ, Pan W, Maness LM, Koletsky RJ, Ernsberger P: Decreased transport of leptin across the blood-brain barrier in rats lacking the short form of the leptin receptor. Peptides 1999;20:1449–1453.
13.
Zlokovic BV, Jovanovic S, Miao W, Samara S, Verma S, Farrell CL: Differential regulation of leptin transport by the choroid plexus and blood-brain barrier and high affinity transport systems for entry into hypothalamus and across the blood-cerebrospinal fluid barrier. Endocrinology 2000;141:1434–1441.
14.
Banks WA, Kastin AJ, Huang W, Jaspan JB, Maness LM: Leptin enters the brain by a saturable system independent of insulin. Peptides 1996;17:305–311.
15.
Dötsch J, Adelmann M, Englaro P, Dötsch A, Hänze J, Blum WF, Kiess W, Rascher W: Relation of leptin and neuropeptide Y in human blood and cerebrospinal fluid. J Neurol Sci 1997;151:185–188.
16.
Schwartz MW, Peskind E, Raskind M, Boyko EJ, Porte D: Cerebrospinal fluid leptin levels: Relationship to plasma levels and adiposity in humans. Nat Med 1996;2:589–593.
17.
Rolland-Cachera MF, Cole TJ, Sempe M, Tichet J, Rossignol C, Charraud A: Body Mass Index variations: Centiles from birth to 87 years. Eur J Clin Nutr 1991;45:13–21.
18.
Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM: Positional cloning of the mouse obese gene and its human homologue. Nature 1994;372:425–432.
19.
Schwartz MW, Seeley RJ, Campfield LA, Burn P, Baskin DG: Identification of targets of leptin action in rat hypothalamus. J Clin Invest 1996;98:1101–1106.
20.
Kiess W, Englaro P, Hanitsch S, Rascher W, Attanasio A, Blum WF: High leptin concentrations in serum of very obese children are further stimulated by dexamethasone. Horm Metab Res 1996;28:708–710.
21.
Wabitsch M, Jensen PB, Blum WF, Christoffersen CT, Englaro P, Heinze E, Rascher W, Teller W, Tornqvist H, Hauner H: Insulin and cortisol promote leptin production in cultured human fat cells. Diabetes 1996;45:1435–1438.
22.
Rauch F, Westermann F, Englaro P, Blum WF, Schönau E: Serum leptin during growth hormone therapy in growth hormone deficient children. Horm Res 1996;48(suppl 2):55.
23.
Wolthers OD, Heuck C, Skjaerbaek C: Diurnal rhythm in serum leptin. J Pediatr Endocrinol Metab 1999;12:863–866.
24.
Van Aggel Leijssen DP, van Baak MA, Tenenbaum R, Campfield LA, Saris WH: Regulation of average 24 h human plasma leptin level: The influence of exercise and physiological changes in energy balance. Int J Obes Relat Metab Disord 1999;23:151–158.
25.
Brennan BMD, Rahim A, Blum WF, Adams JA, Eden OB, Shalet SM: Hyperleptinaemia in young adults following cranial irradiation in childhood: Growth hormone deficiency or leptin insensitivity? Clin Endocrinol 1999;50:163–169.
26.
Caro E, Senaris R, Considine RV, Casanueva FF, Dieguez C: Regulation of in vivo growth hormone secretion by leptin. Endocrinology 1997;138:2203–2206.
27.
Fisker S, Vahl N, Hansen TB, Jorgensen JO, Hagen C, Orskov H, Christiansen JS: Serum leptin is increased in growth hormone deficient adults: Relationship to body composition and effects of placebo-controlled growth hormone therapy for 1 year. Metabolism 1997;46:812–817.
28.
Brabant G, Horn R, Mayr B, von zur Muhlen A, Honegger J, Buchfelder M: Serum leptin levels following hypothalamic surgery. Horm Metab Res 1996;28:728–731.
29.
Roth C, Wilken B, Hanefeld F, Schroter W, Leonhardt U: Hyperphagia in children with craniopharyngioma is associated with hyperleptinaemia and a failure in the downregulation of appetite. Eur J Endocrinol 1998;138:89–91.
30.
Campfield LA, Smith FJ, Guisez Y, Devos R, Burn P: Recombinant mouse OB protein: Evidence for a peripheral signal linking adiposity and central neuronal networks. Science 1995;269:546–549.
31.
Caro JF, Kolaczynski JW, Nyce MR, Ohannesian JP, Opentanova I, Goldman WH, Lynn RB, Zhang PL, Sinha MK, Considine RV: Decreased cerebrospinal-fluid-/serum leptin ratio in obesity: A possible mechanism for leptin resistance. Lancet 1996;348:159–161.
32.
Huang Q, Rivest R, Richard D: Effects of leptin on corticotropin-releasing factor (CRF) synthesis and CRF neuron activation in the paraventricular hypothalamic nucleus of obese (ob/ob) mice. Endocrinology 1998;139:1524–1532.
33.
Ahima RS, Dushay J, Flier S, Prabakaran D, Flier JS: Leptin accelerates the onset of puberty in normal female mice. J Clin Invest 1997;99:391–395.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.