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Heroin Addiction and Related Clinical Problems: 2021, 23, N6 (pages: 25 - 32)

Levels of leptin and adiponectin after initiation of methadone maintenance treatment: A systematic review and meta-analysis

Jangipour Afshar P., Salehinejad S., and Shahesmaeili A.

Summary: Background: The current evidence suggests that methadone maintenance treatment (MMT) may correct opioid-induced endocrinopathy. Aim: In this systematic review and meta-analysis we have investigated changes in serum leptin and adiponectin after the initiation of MMT among chronic opioid users. Methods: We searched the Cochrane Library, PubMed, Embase, Web of Science and Scopus up to 4th November 2020. Two independent reviewers extracted the related data from appropriate articles. The pooled standardized mean difference (SMD) and their 95% confidence interval (95% CI) were calculated using ‘metan' commands in Stata 15 software. In cases where I2 statistics were >50%, the random effect model was used. Results: Out of 42 pertinent studies, 4 articles were considered suitable and were therefore included in the qualitative synthesis, while 3 of those 4 were included in the quantitative analysis. Compared with healthy individuals, the serum level of leptin fell among opioid-dependent individuals. The pooled mean difference (CI 95%) of changes in leptin before and after MMT was 3.72 (2.50, 4.93), so proving to be significant. Comparing the serum level of leptin in patients receiving MMT with healthy controls, the pooled standardized mean difference of leptin was -0.55(-2.66, 1.55) which failed to reach the threshold of significance. The serum level of adiponectin after MMT was unchanged with respect to baseline. Conclusions: Our findings indicate lower serum levels of leptin and adiponectin among chronic opioid users, and highlight the beneficial role of MMT in regulating leptin but not adiponect in these patients.