Leptin is a powerful inhibitor of bone formation in vivo. This antiosteogenic function involves leptin binding to its receptors on ventromedial hypothalamic neurons, the autonomous nervous system and â€-adrenergic receptors on osteoblasts. However, the mechanisms whereby leptin controls the function of ventromedial hypothalamic antiosteogenic neurons remain unclear. In this study, we compared the ability of leptin to regulate body weight and bone mass and show that leptin antiosteogenic and anorexigenic functions are affected by similar amounts of leptin. Using a knock-in of LacZ in the leptin locus, we failed to detect any leptin synthesis in the central nervous system. However, increasing serum leptin level, even dramatically, reduced bone mass. Conversely, reducing serum-free leptin level by overexpressing a soluble receptor for leptin increased bone mass. Congruent with these results, the high bone mass of lipodystrophic mice could be corrected by restoring serum leptin level, suggesting that leptin is an adipocyte product both necessary and sufficient to control bone mass. Consistent with the high bone mass phenotype of lipodystrophic mice, we observed an advanced bone age, an indirect reflection of premature bone formation, in lipodystrophic patients. Taken together, these results indicate that adipocyte-derived circulating leptin is a determinant of bone formation and suggests that leptin antiosteogenic function is conserved in vertebrates.A growing body of work has established the central role of the hypothalamus in the regulation of bone formation by osteoblasts (1-4). The thrust of this influence is exerted by neurons located in the ventromedial hypothalamus. These neurons are themselves the target of leptin, which was demonstrated to be a powerful antiosteogenic hormone (1). Based on chemical lesioning, genetic manipulations, and pharmacological experiments, hypothalamic neurons mediating leptin antiosteogenic and anorexigenic functions could be distinguished. Moreover, genetic evidence indicates that, peripherally, the sympathetic nervous system mediates preferentially leptin antiosteogenic function (2). Thus leptin uses distinct pathways to regulate bone mass and body weight.The discovery of leptin antiosteogenic function was a surprise for at least two reasons. First, it was not the function for which leptin was molecularly cloned, and this implied a more pleiotropic role for this hormone than originally anticipated. Second, and more important physiologically, the high bone mass of leptin signaling-deficient mice existed despite the presence of an increase in bone resorption caused by the hypogonadism of these mice. This coexistence of hypogonadism and high bone mass is pivotal to appreciate the physiological importance of leptin antiosteogenic function. Indeed, it established genetically that leptin signaling plays a dominant role over gonadal function in the regulation of bone mass and thereby implied that this is a major function of leptin.In the present study we addressed several questions raise...