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Postprandial leptin responses after an oral fat tolerance test: differences in type 2 diabetes.

The finding that circulating leptin concentrations exhibit a diurnal pattern (1,2), with peak nocturnal concentrations up to two times higher than nadir levels, raised the hypothesis that the evaluation of fasting leptin levels might have underestimated the effect of food secretagouges on postpradial leptin regulation and action. This variation in diurnal leptinemia is related to insulin excursions in response to meals (2), and shifting mealtime by 6.5 h without changing the light and sleep cycles will shift plasma-leptin rhythm by 5–7 h (3). In a recent study (4), it was reported that meals with high fat content result in the production of lower 24-h leptin concentrations compared with meals high in carbohydrates, a phenomenon attributed to lower insulin excursions after fatty meals. However, the impact of reduced insulin sensitivity on short-term leptin production in response to meals has not been investigated in subjects with similar degrees of obesity. We hypothesize that patients with type 2 diabetes (a well-established insulin-resitant state) show …