Figure 3.

Effects of metreleptin initiation or withdrawal on change in energy expenditure and skeletal muscle work efficiency in patients with lipodystrophy. Resting energy expenditure (A) decreased 2 weeks (2w; gray circles) after metreleptin initiation, but did not change from baseline to 6 months (6mo; blue circles) after metreleptin initiation or 2 weeks after metreleptin withdrawal (gray squares). Twenty-four-hour energy expenditure (B) decreased from baseline to 2 weeks and 6 months after metreleptin initiation but did not change after 2 weeks of metreleptin withdrawal. There were no changes in nonresting energy expenditure (C) or skeletal muscle work efficiency at 10 Watts (D), 25 Watts (E), and 50 Watts (F) from baseline to 2 weeks or 6 months following metreleptin initiation, or 2 weeks after metreleptin withdrawal (kcal/24 h). Patients with generalized lipodystrophy are shown as circles or squares without borders and those with partial lipodystrophy as circles with black borders. Comparisons were made using Wilcoxon rank-signed test and paired t-test for nonnormally and normally distributed data, respectively. Linear mixed effects models applying a Dunnett correction for multiple comparisons were used for outcomes measured at >2 time points. P < 0.05 represented statistical significance. P-values are 2-sided.