European Association for the Study of Diabetes (EASD) 2001 meeting.

Abstract

This report is on the 37th Annual Meeting of the European Association for the Study of Diabetes (EASD), held in Glasgow, U.K., from 9 to 13 September 2001. It covers such topics as the primary prevention of type 2 diabetes and potential therapeutic strategies for diabetic neuropathy. At the Robert Turner Memorial Lecture opening the 37th Annual Meeting of the European Association for the Study of Diabetes (EASD), Stephen O’Rahilly (Cambridge, U.K.) discussed the relationship between peroxisome proliferator-activated receptor (PPAR)-γ and human metabolic disease. He tried to “get some of the flavor of Robert [Turner]” in his analysis of “extreme human phenotypes” having abnormality of the PPAR-γ gene, pointing out that “experiments of nature” are serious diseases with high morbidity and mortality that can illuminate normal biology and act as models for common diseases. He noted that similar studies of individuals who lack estrogen receptor or IGF-1 have illuminated other more common clinical syndromes. His Genetics of Obesity program has enrolled children with prepubertal onset and weight >3 SDs. Studies of two related children with severe obesity lacking functional leptin have shown that deficiency of this hormone in humans causes pathology similar to that described in mice. Two other pedigrees with the same mutation were subsequently discovered. Treatment of four leptin-deficient patients with recombinant human leptin markedly decreased energy intake and lowered fat mass. These children had decreased interferon (IFN)-γ production by T-cells that was reversed by leptin treatment. Individuals without leptin fail to enter puberty. Normal age-appropriate gonadotropin response is seen with replacement treatment. O’Rahilly speculated that the physiologic role of leptin may be particularly important when levels are very low and that the main function of leptin may be to signal the transition between the fed and starved states. Heterozygotes from these families may have an abnormal relationship …