Patient description: A 35-year-old woman presents with history of acne and mild hirsutism. The primary evaluation revealed elevated testosterone levels. She recently noticed gradual enlargement of her hands and feet and recognized that her ring is getting small for her finger. There is some irregularity in her menstrual cycle as well as some nipple discharge. She also has positive history for snoring and headache. The physical examination revealed subtle facial features of acromegaly and prognathism. Visual fields are normal by confrontation. Hirsutism, soft tissue thickening and diaphoresis of the hands and feet are noted. Laboratory evaluation in the fasting state reveals IGF-1 of 968 ng/mL and random GH of 19.7 ng/mL. MRI reveals a macroadenoma with no invasion. She is on stable doses of octreotide LAR since her diagnosis was confirmed. She is married and has 2 children. She is using IUD as her contraceptive method.

Clinical trial eligibility criteria: eligible ages (years): 0.5-999.0,  Lipodystrophy All ethnic groups. Males and females Age greater than or equal to 6 months Clinically significant lipodystrophy, identified by the study physician during the physical examination as an absence of fat outside the range of normal variation and/or identified as a disfiguring factor by the patient. Circulating leptin levels less than 12.0 ng/ml in females and less than 8.0 ng/ml in males as measured by Linco assay on a specimen obtained after an overnight fast. In children ages 6 months 5 years, a circulating leptin level of less than 6 ng/mL will be used. Leptin samples will be run through Millipore Laboratories, who use the Linco Assay, which has been the assay previously used to measure leptin levels throughout this study period. Presence of at least one of the following metabolic abnormalities: 1. Presence of diabetes as defined by the 2007 ADA 1. Fasting plasma glucose greater than or equal to 126 mg/dL, or 2. 2 hour plasma glucose greater than or equal to 200 mg/dL following a 75 gram (1.75gm/kg) oral glucose load, or 3. Diabetic symptoms with a random plasma glucose greater than or equal to 200 mg/dl 2. Fasting insulin greater than 30 micro units/ml. 3. Fasting hypertriglyceridemia greater than 200 mg/dL or postprandially elevated triglycerides greater than 500 mg/dL when fasting is clinically not indicated (e.g. in infants) -Persons with impaired decision-making capacity and who may be unable to provide informed consent may participate in this study per the discretion of the Principal Investigator  Pregnant women, women in their reproductive years who do not use an effective method of birth control, and women currently nursing or lactating within 6 weeks of having completed nursing. Exclusions for underlying diseases likely to increase side effects or hinder objective data collection Known infectious liver disease Known HIV infection Current alcohol or substance abuse Psychiatric disorder impeding competence or compliance Active tuberculosis Use of anorexiogenic drugs Other condition(s) which in the opinion of the clinical investigators would impede completion of the study Subjects who have known hypersensitivity to E. Coli derived proteins Subjects with acquired lipodystrophy and a hematologic abnormality such as neutropenia and/or lymphadenopathy