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Congenital leptin deficiency is associated with severe early-onset obesity in humans

Abstract

The extreme obesity of the obese (ob/ob) mouse is attributable to mutations in the gene encoding leptin1, an adipocyte-specific secreted protein which has profound effects on appetite and energy expenditure. We know of no equivalent evidence regarding leptin's role in the control of fat mass in humans. We have examined two severely obese children who are members of the same highly consanguineous pedigree. Their serum leptin levels were very low despite their markedly elevated fat mass and, in both, a homozygous frame-shift mutation involving the deletion of a single guanine nucleotide in codon 133 of the gene for leptin was found. The severe obesity found in these congenitally leptin-deficient subjects provides the first genetic evidence that leptin is an important regulator of energy balance in humans.

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Figure 1: Detection of a homozygous frame-shift mutation in the leptin genes of probands Ob1 and Ob2.
Figure 2: Serum leptin concentrations in Ob1 and Ob2 deviate markedly from the normal relationship between percentage body fat and serum leptin.
Figure 3: Ob1 and Ob2 had normal birthweights but rapidly developed severe postnatal obesity.

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Acknowledgements

We thank S. Jebb for help with analysis of body composition; C. N. Hales, S. Kumar, A. Kelly and P. Raggett for access to control samples; A. Roberts for help with clinical studies; M.McCaleb, F. Martin, N. Hernday, C. N. Hales, A. Krook, S. Jebb, A. Prentice and N. Finer for discussions; T. M. Cox, V. K. K. Chatterjee and P. Luzio for reading the manuscript; and M. Flint for secretarial assistance. This research was supported by grants from the Wellcome Trust, the British Diabetic Association and a Medical Research Council (UK) studentship to C.T.M. H.R. is supported by the TMR programme of the EC.

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Correspondence to Stephen O'Rahilly.

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Correspondence and requests for materials should be addressed to S.O.R. (e-mail: sorahill@hgmp.mrc.ac.uk)

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Montague, C., Farooqi, I., Whitehead, J. et al. Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature 387, 903–908 (1997). https://doi.org/10.1038/43185

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