nih-gov/medlineplus.gov/genetics/gene/lepr/index.html
2025-02-26 13:17:41 -05:00

660 lines
31 KiB
HTML
Raw Blame History

This file contains ambiguous Unicode characters

This file contains Unicode characters that might be confused with other characters. If you think that this is intentional, you can safely ignore this warning. Use the Escape button to reveal them.

<!DOCTYPE html>
<html lang="en" id="gene" class="nojs us" data-root="https://medlineplus.gov/">
<head>
<meta charset="utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1" />
<meta http-equiv="window-target" content="_top" />
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<meta name="viewport" content="width=device-width, initial-scale=1" />
<link rel="canonical" href="https://medlineplus.gov/genetics/gene/lepr/" />
<link href="https://medlineplus.gov/genetics/gene/lepr/" hreflang="x-default" rel="alternate">
<meta name="ac-dictionary" content="medlineplus-ac-dictionary" />
<meta name="description" content="The LEPR gene provides instructions for making a protein called the leptin receptor, which is involved in the regulation of body weight. Learn about this gene and related health conditions." />
<link rel="shortcut icon" href="https://medlineplus.gov/images/favicon.ico" type="image/x-icon" />
<link rel="apple-touch-icon" href="https://medlineplus.gov/images/touch-icon.png" />
<meta property="fb:app_id" content="1042245625821448" />
<meta property="og:title" content="LEPR gene: MedlinePlus Genetics" />
<meta property="og:url" content="https://medlineplus.gov/genetics/gene/lepr/" />
<meta property="og:image" content="https://medlineplus.gov/images/Genetics_Share.jpg" />
<meta property="og:description" content="The LEPR gene provides instructions for making a protein called the leptin receptor, which is involved in the regulation of body weight. Learn about this gene and related health conditions." />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:site" content="@medlineplus" />
<meta name="twitter:creator" content="@medlineplus" />
<meta name="twitter:title" content="LEPR gene: MedlinePlus Genetics" />
<meta name="twitter:description" content="The LEPR gene provides instructions for making a protein called the leptin receptor, which is involved in the regulation of body weight. Learn about this gene and related health conditions." />
<meta name="twitter:image" content="https://medlineplus.gov/images/Genetics_Share.jpg" />
<meta name="twitter:image:alt" content=""/>
<meta property="og:image:alt" content="" />
<title>LEPR gene: MedlinePlus Genetics</title>
<link rel="stylesheet" href="https://medlineplus.gov/css/common_new.css?1738957163961" />
<!--[if IE 8]> <link rel="stylesheet" href="https://medlineplus.gov/css/ie8/common.css"> <![endif]-->
<link rel="stylesheet" href="https://medlineplus.gov/uswds/css/uswds_styles.css" />
<script type="text/javascript">document.getElementsByTagName('html')[0].className = document.getElementsByTagName('html')[0].className.replace( /(?:^|\s)nojs(?!\S)/g , '').trim();</script>
<script src="https://medlineplus.gov/uswds/js/uswds-init.min.js" type="text/javascript"></script>
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
})(window,document,'script','dataLayer','GTM-MMVM77');</script>
</head>
<body>
<noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-MMVM77"
height="0" width="0" style="display:none;visibility:hidden" title="googletagmanager"></iframe></noscript>
<a name="top" id="top"></a>
<a class="hide-offscreen" href="#start">Skip navigation</a>
<section
class="usa-banner"
aria-label="Official website of the United States government"
>
<div class="usa-accordion">
<header class="usa-banner__header">
<div class="usa-banner__inner">
<div class="grid-col-auto">
<img
aria-hidden="true"
class="usa-banner__header-flag"
src="https://medlineplus.gov/uswds/img/us_flag_small.png"
alt=""
/>
</div>
<div class="grid-col-fill tablet:grid-col-auto" aria-hidden="true">
<p class="usa-banner__header-text">
An official website of the United States government
</p>
<p class="usa-banner__header-action">Heres how you know</p>
</div>
<button
type="button"
class="usa-accordion__button usa-banner__button"
aria-expanded="false"
aria-controls="gov-banner-default-default"
>
<span class="usa-banner__button-text">Heres how you know</span>
</button>
</div>
</header>
<div
class="usa-banner__content usa-accordion__content"
id="gov-banner-default-default"
>
<div class="grid-row grid-gap-lg">
<div class="usa-banner__guidance tablet:grid-col-6">
<img
class="usa-banner__icon usa-media-block__img"
src="https://medlineplus.gov/uswds/img/icon-dot-gov.svg"
role="img"
alt=""
aria-hidden="true"
/>
<div class="usa-media-block__body">
<p>
<strong>Official websites use .gov</strong><br />A
<strong>.gov</strong> website belongs to an official government
organization in the United States.
</p>
</div>
</div>
<div class="usa-banner__guidance tablet:grid-col-6">
<img
class="usa-banner__icon usa-media-block__img"
src="https://medlineplus.gov/uswds/img/icon-https.svg"
role="img"
alt=""
aria-hidden="true"
/>
<div class="usa-media-block__body">
<p>
<strong>Secure .gov websites use HTTPS</strong><br />A
<strong>lock</strong> (
<span class="icon-lock"
><svg
xmlns="http://www.w3.org/2000/svg"
width="52"
height="64"
viewBox="0 0 52 64"
class="usa-banner__lock-image"
role="img"
aria-labelledby="banner-lock-description-default"
focusable="false"
>
<title id="banner-lock-title-default">Lock</title>
<desc id="banner-lock-description-default">Locked padlock icon</desc>
<path
fill="#000000"
fill-rule="evenodd"
d="M26 0c10.493 0 19 8.507 19 19v9h3a4 4 0 0 1 4 4v28a4 4 0 0 1-4 4H4a4 4 0 0 1-4-4V32a4 4 0 0 1 4-4h3v-9C7 8.507 15.507 0 26 0zm0 8c-5.979 0-10.843 4.77-10.996 10.712L15 19v9h22v-9c0-6.075-4.925-11-11-11z"
/>
</svg> </span
>) or <strong>https://</strong> means youve safely connected to
the .gov website. Share sensitive information only on official,
secure websites.
</p>
</div>
</div>
</div>
</div>
</div>
</section>
<div id="mplus-wrap">
<header>
<div id="mplus-header">
<div id="mplus-orgs">
<a href="https://www.nih.gov/" class="nih-org" target="_blank" title="National Institutes of Health">
<img class="nihlogo" src="https://medlineplus.gov/images/nihlogo.png" alt="National Institutes of Health"/>
</a><a href="https://www.nlm.nih.gov/" target="_blank"> National Library of Medicine</a>
</div>
<div id="mplus-logo" class="years-25">
<a href="https://medlineplus.gov/">
<img alt="MedlinePlus Trusted Health Information for You" title="MedlinePlus Trusted Health Information for You" src="https://medlineplus.gov/images/m_logo_25.png"/>
</a>
</div>
<div id="mplus-nav">
<div aria-live="polite" class="sm-live-area hide-offscreen"></div>
<button id="sm-menu-btn" class="navmenu-btn" title="Menu" role="button" aria-controls="mplus-menu-list" type="submit">Menu<span class="icon icon-nav-menu"></span></button>
<ul id="mplus-menu-list" class="nav-list">
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li>
<li><a href="https://medlineplus.gov/druginformation.html">Drugs & Supplements</a></li>
<li><a href="https://medlineplus.gov/genetics/">Genetics</a></li>
<li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li>
<li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
</ul><button id="sm-search-btn" class="navmenu-btn" title="Search" role="button" aria-controls="mplus-search" type="submit"><span class="hide-offscreen"></span>Search<span class="icon icon-nav-search"></span></button>
<div class="top-1">
<form id="mplus-search" method="get" action="https://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta" title="Search MedlinePlus" target="_self">
<input type="hidden" name="v:project" value="medlineplus"/>
<input type="hidden" name="v:sources" value="medlineplus-bundle"/>
<div class="form-box text-combo">
<div class="form-area"><label class="hide-offscreen" for="searchtext_primary">Search MedlinePlus</label>
<input id="searchtext_primary" class="form-text" type="text" placeholder="Search MedlinePlus" alt="#Site Search input" title="Site Search input" maxlength="400" size="40" name="query" autocomplete="off" role="textbox" aria-autocomplete="list" aria-haspopup="true"/>
</div>
<div class="button-area">
<button class="form-btn" title="Search MedlinePlus" alt="Search MedlinePlus" type="submit">GO</button>
</div>
</div>
</form>
<div class="secondarynav">
<ul class="nav-list">
<li><a href="https://medlineplus.gov/about/"><span>About MedlinePlus</span></a></li>
<li><a href="https://medlineplus.gov/whatsnew/">What's New</a></li>
<li><a href="https://medlineplus.gov/sitemap.html"><span>Site Map</span></a></li>
<li><a href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&category=medlineplus&from=https%3A//medlineplus.gov/genetics/gene/lepr/" target="_blank"><span>Customer Support</span></a></li>
</ul>
</div>
</div>
<div id="mplus-nav-bar">
<ul class="nav-list">
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li><li><a href="https://medlineplus.gov/druginformation.html">Drugs & Supplements</a></li><li><a href="https://medlineplus.gov/genetics/">Genetics</a></li><li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li><li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
</ul>
</div>
</div>
</div>
</header>
<div id="mplus-content">
<div id="breadcrumbs">
<div itemprop="breadcrumb" itemscope="" itemtype="http://schema.org/BreadcrumbList">
<span class="hide-offscreen">You Are Here:</span>
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
<a href="https://medlineplus.gov/" itemprop="item"><span itemprop="name">Home</span></a>
&rarr;
<meta itemprop="position" content="1"/>
</div>
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
<a href="https://medlineplus.gov/genetics/" itemprop="item"><span itemprop="name">Genetics</span></a>
&rarr;
<meta itemprop="position" content="2"/>
</div>
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
<a href="https://medlineplus.gov/genetics/gene/" itemprop="item"><span itemprop="name">Genes</span></a>
&rarr;
<meta itemprop="position" content="3"/>
</div>
<div>
<span>LEPR gene</span>
</div>
</div>
</div>
<span class="page-url print-only">URL of this page: https://medlineplus.gov/genetics/gene/lepr/</span>
<div >
<article>
<div class="page-info">
<div class="page-title">
<a name="start" id="start"></a>
<h1 class="with-also">LEPR gene</h1>
<span class="alsocalled">leptin receptor</span>
</div>
<div class="page-actions"></div>
<noscript><span class="js-disabled-message">To use the sharing features on this page, please enable JavaScript.</span></noscript>
</div>
<div class="main">
<div class="mp-exp exp-full" data-bookmark="function">
<h2>Normal Function</h2>
<section><div class="mp-content"><p>The <i>LEPR</i> gene provides instructions for making a protein called the leptin receptor, which is involved in the regulation of body weight. The leptin receptor protein is found on the surface of cells in many organs and tissues of the body, including a part of the brain called the hypothalamus. The hypothalamus controls hunger and thirst as well as other functions such as sleep, moods, and body temperature. It also regulates the release of many hormones that have functions throughout the body.</p><p>The leptin receptor is turned on (activated) by a hormone called leptin that attaches (binds) to the receptor, fitting into it like a key into a lock. Normally, the body's fat cells release leptin in proportion to their size. As fat cells become larger, they produce more leptin. This rise in leptin indicates that fat stores are increasing. In the hypothalamus, the binding of leptin to its receptor triggers a series of chemical signals that affect hunger and help produce a feeling of fullness (satiety).</p></div>
</section>
</div>
<div class="mp-exp exp-full" data-bookmark="conditions">
<h2>Health Conditions Related to Genetic Changes</h2>
<section>
<div class="mp-content mp-exp exp-full">
<h3>Leptin receptor deficiency</h3>
<p>At least 18 <i>LEPR</i> gene mutations that cause leptin receptor deficiency have been identified; this disorder is associated with excessive hunger, massive weight gain, and reduced production of hormones that direct sexual development (hypogonadotropic hypogonadism). Some of the mutations result in less receptor protein getting to the cell surface where leptin binding takes place. The receptors that get to the cell surface may bind to leptin, but their signaling function is impaired. The resulting shortage of leptin signaling disrupts normal feelings of hunger and satiety, leading to extreme weight gain.</p><p>Because hypogonadotropic hypogonadism occurs in leptin receptor deficiency, researchers suggest that leptin receptor signaling is also involved in regulating the body's response to hormones that control sexual development, and that this response is affected by <i>LEPR</i> gene mutations. However, the mechanism of this effect is unknown.</p>
<a class="more-info-link" href="https://medlineplus.gov/genetics/condition/leptin-receptor-deficiency/">More About This Health Condition</a>
</div>
</section>
</div>
<div class="mp-exp exp-full" data-bookmark="synonyms">
<h2>Other Names for This Gene</h2>
<section>
<ul class="bulletlist">
<li>LEP-R</li> <li>LEPR_HUMAN</li> <li>OB receptor</li> <li>OB-R</li> <li>OBR</li>
</ul>
</section>
</div>
<div class="mp-exp exp-full" data-bookmark="resources">
<h2>Additional Information & Resources</h2>
<section>
<div class="mp-content">
<h2>Tests Listed in the Genetic Testing Registry</h2>
<ul>
<li><a href="https://www.ncbi.nlm.nih.gov/gtr/all/tests/?term=3953[geneid]" target="TheNewWin">Tests of LEPR</a> <span class="desc-text"><img alt="From the National Institutes of Health" title="From the National Institutes of Health" src="https://medlineplus.gov/images/nih.png" class="imgdesc" width="25" height="16"></span></li>
</ul>
</div>
</section>
<section>
<div class="mp-content">
<h2>Scientific Articles on PubMed</h2>
<ul>
<li><a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28LEPR%5BTI%5D%29+OR+%28leptin+receptor%5BTI%5D%29%29+AND+%28%28Genes%5BMH%5D%29+OR+%28Genetic+Phenomena%5BMH%5D%29%29+AND+english%5Bla%5D+AND+human%5Bmh%5D+AND+%22last+720+days%22%5Bdp%5D" target="TheNewWin">PubMed</a> <span class="desc-text"><img alt="From the National Institutes of Health" title="From the National Institutes of Health" src="https://medlineplus.gov/images/nih.png" class="imgdesc" width="25" height="16"></span></li>
</ul>
</div>
</section>
<section>
<div class="mp-content">
<h2>Catalog of Genes and Diseases from OMIM</h2>
<ul>
<li><a href="https://omim.org/entry/601007" target="TheNewWin">LEPTIN RECEPTOR; LEPR</a></li>
</ul>
</div>
</section>
<section>
<div class="mp-content">
<h2>Gene and Variant Databases</h2>
<ul>
<li><a href="https://www.ncbi.nlm.nih.gov/gene/3953" target="TheNewWin">NCBI Gene</a> <span class="desc-text"><img alt="From the National Institutes of Health" title="From the National Institutes of Health" src="https://medlineplus.gov/images/nih.png" class="imgdesc" width="25" height="16"></span></li>
<li><a href="https://www.ncbi.nlm.nih.gov/clinvar?term=LEPR[gene]" target="TheNewWin">ClinVar</a> <span class="desc-text"><img alt="From the National Institutes of Health" title="From the National Institutes of Health" src="https://medlineplus.gov/images/nih.png" class="imgdesc" width="25" height="16"></span></li>
</ul>
</div>
</section>
</div>
<div class="mp-exp exp-full" data-bookmark="references">
<h2>References</h2>
<section>
<div class="mp-content">
<ul>
<li>Clement K, Vaisse C, Lahlou N, Cabrol S, Pelloux V, Cassuto D, Gourmelen M,
Dina C, Chambaz J, Lacorte JM, Basdevant A, Bougneres P, Lebouc Y, Froguel P,
Guy-Grand B. A mutation in the human leptin receptor gene causes obesity and
pituitary dysfunction. Nature. 1998 Mar 26;392(6674):398-401. doi: 10.1038/32911.
<a href="https://pubmed.ncbi.nlm.nih.gov/9537324" target="TheNewWin">Citation on PubMed</a></li>
<li>Dubern B, Clement K. Leptin and leptin receptor-related monogenic obesity.
Biochimie. 2012 Oct;94(10):2111-5. doi: 10.1016/j.biochi.2012.05.010. Epub 2012
May 22. <a href="https://pubmed.ncbi.nlm.nih.gov/22627381" target="TheNewWin">Citation on PubMed</a></li>
<li>Farooqi IS, Wangensteen T, Collins S, Kimber W, Matarese G, Keogh JM, Lank E,
Bottomley B, Lopez-Fernandez J, Ferraz-Amaro I, Dattani MT, Ercan O, Myhre AG,
Retterstol L, Stanhope R, Edge JA, McKenzie S, Lessan N, Ghodsi M, De Rosa V,
Perna F, Fontana S, Barroso I, Undlien DE, O&#x27;Rahilly S. Clinical and molecular
genetic spectrum of congenital deficiency of the leptin receptor. N Engl J Med.
2007 Jan 18;356(3):237-47. doi: 10.1056/NEJMoa063988. <a href="https://pubmed.ncbi.nlm.nih.gov/17229951" target="TheNewWin">Citation on PubMed</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670197/" target="TheNewWin">Free article on PubMed Central</a></li>
<li>Kimber W, Peelman F, Prieur X, Wangensteen T, O&#x27;Rahilly S, Tavernier J,
Farooqi IS. Functional characterization of naturally occurring pathogenic
mutations in the human leptin receptor. Endocrinology. 2008 Dec;149(12):6043-52.
doi: 10.1210/en.2008-0544. Epub 2008 Aug 14. <a href="https://pubmed.ncbi.nlm.nih.gov/18703626" target="TheNewWin">Citation on PubMed</a></li>
<li>Lee YS. The role of leptin-melanocortin system and human weight regulation:
lessons from experiments of nature. Ann Acad Med Singap. 2009 Jan;38(1):34-11.
<a href="https://pubmed.ncbi.nlm.nih.gov/19221669" target="TheNewWin">Citation on PubMed</a></li>
<li>Wasim M, Awan FR, Najam SS, Khan AR, Khan HN. Role of Leptin Deficiency,
Inefficiency, and Leptin Receptors in Obesity. Biochem Genet. 2016
Oct;54(5):565-72. doi: 10.1007/s10528-016-9751-z. Epub 2016 Jun 16. <a href="https://pubmed.ncbi.nlm.nih.gov/27313173" target="TheNewWin">Citation on PubMed</a></li>
</ul>
</div>
</section>
</div>
</div>
<div class="side">
<aside>
<section><div class="side-section">
<div class="mp-img">
<img class="scale-with-grid" src="https://medlineplus.gov/images/Genes.jpg" alt="DNA helix">
</div>
</div></section>
<section><div class="side-section">
</div></section>
<section><div class="side-section"><div class="mp-content"><div class="section-header"><h2>Genomic Location</h2></div><div class="section-body"><span>The <em>LEPR</em> gene is found on <a data-pid="20031" href="https://medlineplus.gov/genetics/chromosome/1/">chromosome 1</a>.</span></div></div>
</div></section>
<section><div class="side-section">
<div class="section-header">
<h2>Related Health Topics</h2>
</div>
<div class="section-body">
<ul class="relatedmp">
<li><a href="https://medlineplus.gov/genesandgenetherapy.html">Genes and Gene Therapy</a></li>
<li><a href="https://medlineplus.gov/geneticdisorders.html">Genetic Disorders</a></li>
</ul>
</div>
</div></section>
<section><div class="side-section">
<div class="section-header red">
<h2>MEDICAL ENCYCLOPEDIA</h2>
</div>
<div class="section-body" id="more_encyclopedia">
<ul class="relatedmp" style="list-style: none; padding: 0;">
<li><a href="https://medlineplus.gov/ency/article/002371.htm">Genes</a></li>
<li><a href="https://medlineplus.gov/ency/article/002048.htm">Genetics</a></li>
</ul>
</div>
</div></section>
<section><div class="side-section">
<div class="section-header">
<h2>Understanding Genetics</h2>
</div>
<div class="section-body">
<ul class="relatedmp">
<li><a href="https://medlineplus.gov/genetics/understanding/basics/dna/">What is DNA?</a></li>
<li><a href="https://medlineplus.gov/genetics/understanding/basics/gene/">What is a gene?</a></li>
<li><a href="https://medlineplus.gov/genetics/understanding/mutationsanddisorders/genemutation/">What is a gene variant and how do variants occur?</a></li>
</ul>
</div>
</div></section>
<section><div class="side-section">
<div class="section-header hide-offscreen">
<h2>Disclaimers</h2>
</div>
<div class="section-body no-header">
MedlinePlus links to health information from the National Institutes of Health and other federal government agencies. MedlinePlus also links to health information from non-government Web sites. See our <a href="https://medlineplus.gov/disclaimers.html">disclaimer</a> about external links and our <a href="https://medlineplus.gov/criteria.html">quality guidelines</a>.
</div>
</div></section>
</aside>
</div>
<div class="bottom">
<section>
<!--
<div class="from-ghr">
<img src="https://medlineplus.gov/images/fromGHR.png" alt="From Genetics Home Reference" />
<p>Genetics Home Reference has merged with MedlinePlus. Genetics Home Reference content now can be found in the "Genetics" section of MedlinePlus. <a href="https://medlineplus.gov/about/general/genetics/newhome/">Learn more</a></p>
</div>
-->
<p>The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.</p>
</section>
</div>
</article>
</div>
<div id="citation-how-to">
<button><span>Learn how to cite this page</span></button>
</div>
</div>
<footer>
<div id="mplus-footer">
<div class="footer1">
<ul class="secondarynav">
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
<li><a href="https://medlineplus.gov/whatsnew/">What's New</a></li>
<li><a href="https://medlineplus.gov/sitemap.html">Site Map</a></li>
<li><a href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&category=medlineplus&from=https%3A//medlineplus.gov/genetics/gene/lepr/" target="_blank"><span>Customer Support</span></a></li>
</ul>
<ul class="follow-footer">
<li>
<a href="https://medlineplus.gov/rss.html" class="follow-item">Subscribe to RSS<img src="https://medlineplus.gov/images/feed.png" class="social-media-toolkit-icon" alt="RSS" title="RSS"></a>
</li>
<li>
<span class="follow-label">Follow us</span>
<a href="https://twitter.com/medlineplus" class="follow-item" target="_blank">
<img src="https://medlineplus.gov/images/i_share_twitter.png" class="follow-icon" alt="X" title="X">
</a>
<a href="https://facebook.com/Mplus.gov/" class="follow-item" target="_blank">
<img src="https://medlineplus.gov/images/i_share_fb.png" class="follow-icon" alt="Facebook" title="Facebook">
</a>
<a href="https://www.instagram.com/mplusgov/" class="follow-item" target="_blank">
<img src="https://medlineplus.gov/images/Instagram_Glyph_Gradient_RGB.png" class="follow-icon" alt="Instagram" title="Instagram">
</a>
</li>
<li>
<a href="https://medlineplus.gov/social-media-toolkit/" class="social-media-toolkit-item">Social Media Toolkit<img src="https://medlineplus.gov/images/i_social_media_toolkit.png" class="social-media-toolkit-icon" alt="Social Media Toolkit" title="Social Media Toolkit"></a>
</li>
</ul>
</div>
<div class="footer2">
<ul>
<li><a href=" https://www.nlm.nih.gov/web_policies.html" target='_blank'>NLM Web Policies</a></li>
<li><a href="https://medlineplus.gov/about/using/usingcontent/" >Copyright</a></li>
<li><a href="https://medlineplus.gov/accessibility.html">Accessibility</a></li>
<li><a href="https://medlineplus.gov/about/using/criteria/">Guidelines for Links</a></li>
<li><a href="https://medlineplus.gov/plugins.html">Viewers & Players</a></li>
<li><a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" target="_blank">HHS Vulnerability Disclosure</a></li>
<li><a href="https://medlineplus.gov/medlineplus-connect/">MedlinePlus Connect for EHRs</a></li>
<li><a href="https://medlineplus.gov/about/developers/">For Developers</a></li>
</ul>
<div class="address">
<a href="https://www.nlm.nih.gov" target="_blank">National Library of Medicine</a>
<span>8600 Rockville Pike, Bethesda, MD 20894</span>
<a href="https://www.hhs.gov" target="_blank">U.S. Department of Health and Human Services</a>
<a href="https://www.nih.gov" target="_blank">National Institutes of Health</a>
</div>
<div class="date">
<span id="lastupdate">Last updated July 1, 2016</span>
</div>
<div class="return-top"><a href="#top" title="Return to top"><img class="return-top-icon" alt="Return to top" src="https://medlineplus.gov/images/return-top.png"></a></div>
</div>
</div>
</footer>
</div>
<script src="https://medlineplus.gov/jslib/jquery-3.6.0.min.js" type="text/javascript"></script>
<script src="https://medlineplus.gov/jslib/mplus-frontend-controls-new.js" type="text/javascript"></script>
<script src="https://medlineplus.gov/jslib/mplus-share.js?id=1112022" type="text/javascript"></script>
<!--[if lte IE 9]><script src="//www.nlm.nih.gov/medlineplus/jslib/jquery.placeholder.js" type="text/javascript"></script><![endif]-->
<script src="https://medlineplus.gov/jslib/control.js" type="text/javascript"></script>
<script src="https://medlineplus.gov/uswds/js/uswds.min.js" type="text/javascript"></script>
</body>
</html>