{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:50:45Z","timestamp":1787025045245,"version":"build-2736575974"},"reference-count":11,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Anti\u2013programmed cell death-1 (anti-PD-1) antibodies have revolutionized advanced cancer therapy. Anti-PD-1 therapy is responsible for immune-related adverse events, with frequent endocrine manifestations, including acute-onset type 1 diabetes. Acquired generalized lipodystrophy (AGL) is a rare disease, believed to be immune mediated, characterized by loss of adipose tissue and insulin resistance\u2013associated complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>We describe the first reported case of AGL induced by immune checkpoint therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A 62-year-old woman with metastatic melanoma treated with nivolumab was referred for major hyperglycemia, hypertriglyceridemia, and nonalcoholic steatohepatitis. She had presented with a rapidly progressive generalized loss of subcutaneous adipose tissue. Diabetes was associated with severe insulin resistance and undetectable plasma leptin. Subcutaneous biopsy revealed atrophic adipose tissue infiltrated with cytotoxic CD8+ T lymphocytes and fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>AGL is an additional immune-related adverse event of anti-PD-1 therapy that leads to severe insulin resistance\u2013associated complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc18-2535","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T18:35:26Z","timestamp":1566412526000},"page":"2008-2010","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":54,"title":["Acquired Generalized Lipodystrophy: A New Cause of Anti-PD-1 Immune-Related Diabetes"],"prefix":"10.2337","volume":"42","author":[{"given":"Alexandre","family":"Jehl","sequence":"first","affiliation":[{"name":"French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France"},{"name":"Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-B\u00e9nite, France"},{"name":"Lyon University, Universit\u00e9 Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rh\u00f4ne-Alpes, CarMeN Laboratory, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Cugnet-Anceau","sequence":"additional","affiliation":[{"name":"French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France"},{"name":"Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-B\u00e9nite, France"},{"name":"Lyon University, Universit\u00e9 Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine 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