The circadian rhythm of leptin is preserved in growth hormone deficient hypopituitary adults

OBJECTIVE Leptin acts as a satiety factor in regulating food intake and body homeostasis, but its regulation is not well defined. Specific leptin receptors have been found in the brain and it has been hypothesized that leptin production by adipose tissue is under neuroendocrine control. A circadian rhythm has been demonstrated with highest leptin levels between midnight and early morning hours. The possibility that hypopituitarism (or pituitary surgery ± radiotherapy) abolishes this leptin rhythm was investigated by measuring serum leptin levels during a 24‐h period in patients with impaired pituitary function. PATIENTS AND DESIGN Circulating leptin levels were measured hourly over 24‐h in 14 hypopituitary patients (8 women and 6 men) using a sensitive and specific radioimmunoassay. Hypopituitarism was the consequence of pituitary tumors treated surgically and/or with radiotherapy. All patients were GH deficient and were receiving conventional replacement with cortisol (n = 13), thyroxine (n = 12) and desmopressin (n = 4) but not with GH. RESULTS A significant diurnal variation in circulating leptin concen_trations was observed in 13 of the 14 patients. The mean (±SEM) leptin levels for 8 women were 51.9 (±10.7) ng/ml and for 6 men 11.0 (±2.0) μg/l. The overall lowest leptin levels (29.3 ± 7.9 ng/ml) were observed at 0830 h after overnight fasting, rising gradually to maximum levels (43.0 ± 9.8 ng/ml) at 0200 h declining thereafter towards fasting values. The mean (±SEM) magnitude of circadian variation in absolute leptin levels from the calculated mean level for each patient was 5.6 (±1.2) ng/ml (8.4 ± 1.4 for women and 1.9 ± 0.3 for men). The mean (±SEM) of the ratio of the amplitude versus mean leptin levels over 24 h for each individual patient was 0.18 (±0.02) (0.19 ± 0.03 for women and 0.18 ± 0.02 for men). CONCLUSIONS A circadian rhythm for leptin is generally present in hypopituitary patients who had undergone pituitary surgery and/or radiotherapy, with the highest serum leptin levels being obtained between midnight and early morning hours. Although some patients had some residual pituitary activity, intact hypothalamic‐pituitary function is not essential for leptin's circadian rhythm.