1
|
Kokkinopoulou I, Diakoumi A, Moutsatsou P. Glucocorticoid Receptor Signaling in Diabetes. Int J Mol Sci 2021; 22:ijms222011173. [PMID: 34681832 PMCID: PMC8537243 DOI: 10.3390/ijms222011173] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/04/2021] [Accepted: 10/12/2021] [Indexed: 12/20/2022] Open
Abstract
Stress and depression increase the risk of Type 2 Diabetes (T2D) development. Evidence demonstrates that the Glucocorticoid (GC) negative feedback is impaired (GC resistance) in T2D patients resulting in Hypothalamic-Pituitary-Adrenal (HPA) axis hyperactivity and hypercortisolism. High GCs, in turn, activate multiple aspects of glucose homeostasis in peripheral tissues leading to hyperglycemia. Elucidation of the underlying molecular mechanisms revealed that Glucocorticoid Receptor (GR) mediates the GC-induced dysregulation of glucose production, uptake and insulin signaling in GC-sensitive peripheral tissues, such as liver, skeletal muscle, adipose tissue, and pancreas. In contrast to increased GR peripheral sensitivity, an impaired GR signaling in Peripheral Blood Mononuclear Cells (PBMCs) of T2D patients, associated with hyperglycemia, hyperlipidemia, and increased inflammation, has been shown. Given that GR changes in immune cells parallel those in brain, the above data implicate that a reduced brain GR function may be the biological link among stress, HPA hyperactivity, hypercortisolism and hyperglycemia. GR polymorphisms have also been associated with metabolic disturbances in T2D while dysregulation of micro-RNAs—known to target GR mRNA—has been described. Collectively, GR has a crucial role in T2D, acting in a cell-type and context-specific manner, leading to either GC sensitivity or GC resistance. Selective modulation of GR signaling in T2D therapy warrants further investigation.
Collapse
|
2
|
Bentele UU, Meier M, Benz ABE, Denk BF, Dimitroff SJ, Pruessner JC, Unternaehrer E. The impact of maternal care and blood glucose availability on the cortisol stress response in fasted women. J Neural Transm (Vienna) 2021; 128:1287-1300. [PMID: 33978833 PMCID: PMC8423636 DOI: 10.1007/s00702-021-02350-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/03/2021] [Indexed: 01/05/2023]
Abstract
Individuals with a history of low maternal care (MC) frequently present a blunted, yet sometimes also show an increased cortisol stress response. Fasted individuals with low blood glucose levels who are exposed to acute stress typically show an attenuated response pattern in this endocrine marker. Despite well-documented metabolic dysregulations after low MC, a possible interaction of both factors has not been investigated yet. Here, we examined the effects of MC and blood glucose concentration on various aspects of the stress response. Fasted women (N = 122, meanage = 22.12, sdage = 2.56) who experienced either very high, high, or low MC (based on the Parental Bonding Instrument) were randomly assigned to consume grape juice (condition sugar), or water (condition water) prior to being exposed to the Trier-Social-Stress-Test for groups. Salivary cortisol and alpha amylase, blood glucose, and mood ratings were assessed repeatedly. Using multilevel mixed models, we replicated the boosting effect of glucose on the cortisol stress response. While we found neither an effect of MC, nor an interaction between MC and blood glucose availability on the cortisol stress response, we observed an effect of MC on the amylase stress response. We discuss the results in the light of links between various stress/energy systems that possibly mediate health-related MC effects.
Collapse
Affiliation(s)
- Ulrike U Bentele
- Department of Psychology, Division of Neuropsychology, University of Constance, Constance, Germany
| | - Maria Meier
- Department of Psychology, Division of Neuropsychology, University of Constance, Constance, Germany.
| | - Annika B E Benz
- Department of Psychology, Division of Neuropsychology, University of Constance, Constance, Germany
| | - Bernadette F Denk
- Department of Psychology, Division of Neuropsychology, University of Constance, Constance, Germany.,Centre for the Advanced Study of Collective Behaviour, University of Constance, Constance, Germany
| | - Stephanie J Dimitroff
- Department of Psychology, Division of Neuropsychology, University of Constance, Constance, Germany
| | - Jens C Pruessner
- Department of Psychology, Division of Neuropsychology, University of Constance, Constance, Germany.,Centre for the Advanced Study of Collective Behaviour, University of Constance, Constance, Germany
| | - Eva Unternaehrer
- Department of Psychology, Division of Neuropsychology, University of Constance, Constance, Germany.,Child- and Adolescent Research Department, Psychiatric University Hospitals Basel (UPK), University of Basel, Basel, Switzerland
| |
Collapse
|
3
|
Anderson GW, Kenyon CJ, Al-Dujaili EAS. Post-Prandial Changes in Salivary Glucocorticoids: Effects of Dietary Cholesterol and Associations with Bile Acid Excretion. Nutrients 2019; 11:nu11020360. [PMID: 30744113 PMCID: PMC6412185 DOI: 10.3390/nu11020360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 11/16/2022] Open
Abstract
Mechanisms to explain post-prandial increases in circulating glucocorticoids are not well understood and may involve increased adrenal secretion and/or altered steroid metabolism. We have compared salivary levels of cortisol and cortisone levels in healthy male and female volunteers fed either a low or cholesterol-rich midday meal. Urinary levels of steroids, bile acids and markers of lipid peroxidation were also measured. Males and females showed expected circadian changes in salivary steroids and postprandial peaks within 1h of feeding. After a high-cholesterol meal, postprandial cortisol increases were higher in males whereas post-prandial cortisone levels were higher in females. Urinary cortisol but not cortisone levels were higher on the day when males and females ate a high-cholesterol meal. Urinary bile acid excretion and anti-oxidant markers of lipid peroxidation, thiobarbituric acid reactive substances (TBARS), and total phenol content were not affected by dietary cholesterol but tended to be higher in males. Cross-tabulation of correlation coefficients indicated positive associations between urinary markers of peroxidation, bile acids, and cortisol:cortisone ratios. We conclude that dietary cholesterol (a substrate for steroidogenesis) does not have an acute effect on adrenal glucocorticoid synthesis and that gender but not a high-cholesterol meal may influence the interconversion of cortisol and cortisone. Longer term studies of the effects of dietary cholesterol are needed to analyze the associations between bile acids, steroid metabolism, and secretion and lipid peroxidation.
Collapse
Affiliation(s)
- Graham W Anderson
- Department of Dietetics, Nutrition & Biological Sciences, Queen Margaret University, Musselburgh, EH21 6UU, UK.
- BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK.
| | - Christopher J Kenyon
- BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK.
| | - Emad A S Al-Dujaili
- Department of Dietetics, Nutrition & Biological Sciences, Queen Margaret University, Musselburgh, EH21 6UU, UK.
- BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK.
| |
Collapse
|
4
|
Grant AD, Wilsterman K, Smarr BL, Kriegsfeld LJ. Evidence for a Coupled Oscillator Model of Endocrine Ultradian Rhythms. J Biol Rhythms 2018; 33:475-496. [PMID: 30132387 DOI: 10.1177/0748730418791423] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Whereas long-period temporal structures in endocrine dynamics have been well studied, endocrine rhythms on the scale of hours are relatively unexplored. The study of these ultradian rhythms (URs) has remained nascent, in part, because a theoretical framework unifying ultradian patterns across systems has not been established. The present overview proposes a conceptual coupled oscillator network model of URs in which oscillating hormonal outputs, or nodes, are connected by edges representing the strength of node-node coupling. We propose that variable-strength coupling exists both within and across classic hormonal axes. Because coupled oscillators synchronize, such a model implies that changes across hormonal systems could be inferred by surveying accessible nodes in the network. This implication would at once simplify the study of URs and open new avenues of exploration into conditions affecting coupling. In support of this proposed framework, we review mammalian evidence for (1) URs of the gut-brain axis and the hypothalamo-pituitary-thyroid, -adrenal, and -gonadal axes, (2) UR coupling within and across these axes; and (3) the relation of these URs to body temperature. URs across these systems exhibit behavior broadly consistent with a coupled oscillator network, maintaining both consistent URs and coupling within and across axes. This model may aid the exploration of mammalian physiology at high temporal resolution and improve the understanding of endocrine system dynamics within individuals.
Collapse
Affiliation(s)
- Azure D Grant
- The Helen Wills Neuroscience Institute, University of California, Berkeley, California
| | - Kathryn Wilsterman
- Department of Integrative Biology, University of California, Berkeley, California
| | - Benjamin L Smarr
- Department of Psychology, University of California, Berkeley, California
| | - Lance J Kriegsfeld
- The Helen Wills Neuroscience Institute, University of California, Berkeley, California.,Department of Psychology, University of California, Berkeley, California
| |
Collapse
|
5
|
Iranmanesh A, Gullapalli D, Singh R, Veldhuis JD. Hypothalamo-pituitary-adrenal axis after a single epidural triamcinolone injection. Endocrine 2017; 57:308-313. [PMID: 28674775 PMCID: PMC5554884 DOI: 10.1007/s12020-017-1357-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/14/2017] [Indexed: 01/03/2023]
Abstract
PURPOSE To quantify adrenocorticotropin and cortisol secretion after epidural glucocorticoid injection. METHODS Eight men (ages 25-63 year) were studied at baseline, 1, 4, and 12 weeks after triamcinolone (80 mg) injection epidurally. Adrenocorticotropin (pg/mL) and cortisol (µg/dL) were measured every 10 min for 4 h, and after Corticotropin-releasing hormone (CRH) (1 µg/kg) injection. RESULTS Epidural triamcinolone markedly suppressed: (1) pre-CRH injection ACTH (from 18 ± 3.1 to 4.8 ± 0.4: P < 0.01) and cortisol (from 12.2 ± 1.6 to 1.6 ± 0.3: P < 0.0001) at week 1, with recovery at 4 weeks, and (2) CRH-stimulated 3-h summed ACTH (from 633 ± 116 to 129 ± 10 pg/mL, P < 0.0001), and 3-h summed cortisol at week 1 (from 385 ± 29 to 56 ± 22 µg/dL, P < 0.0001) and 4 weeks (284 ± 53; P < 0.01). Serum cortisol was <18 µg/dL in eight of eight men at 4 weeks, and six of eight men at week 12. Urinary-free cortisol (µg/24 h) remained low at week 12: baseline (60 ± 6.5); week 1 (9.0 ± 1.3, P < 0.01); week 4 (36 ± 8.6) and week 12 (38 ± 4.1). Urinary cortisol/cortisone ratios rose at week 4 only. Serum triamcinolone peaked at week 1 (16/16 samples), declining at week 4 (13/16 samples) and week 12 (6/16 samples). LIMITATIONS Relatively small group. CONCLUSION Epidural triamcinolone suppresses unstimulated and CRH-stimulated ACTH and cortisol secretion for 1-4 weeks but urinary free cortisol ≥12 weeks. Suppression of ACTH and cortisol after glucocorticoid treatment is thus complex.
Collapse
Affiliation(s)
- Ali Iranmanesh
- Endocrine and Neurology Sections, Medical Service, Salem Veterans Affairs Medical Center, Salem, VA, 24153, USA
| | - Dakshinamurty Gullapalli
- Endocrine and Neurology Sections, Medical Service, Salem Veterans Affairs Medical Center, Salem, VA, 24153, USA
| | - Ravinder Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Johannes D Veldhuis
- Department of Medicine, Endocrine Research Unit, Mayo School of Graduate Medical Education, Clinical Translational Science Center, Mayo Clinic, Rochester, MN, 55905, USA.
| |
Collapse
|
6
|
Roelfsema F, Aoun P, Veldhuis JD. Pulsatile Cortisol Feedback on ACTH Secretion Is Mediated by the Glucocorticoid Receptor and Modulated by Gender. J Clin Endocrinol Metab 2016; 101:4094-4102. [PMID: 27548106 PMCID: PMC5095237 DOI: 10.1210/jc.2016-2405] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
CONTEXT Factors that regulate physiological feedback by pulses of glucocorticoids on the hypothalamic-pituitary unit are sparsely defined in humans in relation to gluco- or mineralocorticoid receptor pathways, gender, age, and the sex steroid milieu. OBJECTIVE The objective of the study was to test (the clinical hypothesis) that glucocorticoid (GR) and mineralocorticoid (MR) receptor-selective mechanisms differentially govern pulsatile cortisol-dependent negative feedback on ACTH output (by the hypothalamo-pituitary unit) in men and women studied under experimentally defined T and estradiol depletion and repletion, respectively. SETTING The study was conducted at the Mayo Center for Translational Science Activities. SUBJECTS Healthy middle-aged men (n = 16) and women (n = 25) participated in the study. INTERVENTIONS This was a randomized, prospective, double-blind, placebo- and saline-controlled study of pulsatile cortisol infusions in low cortisol-clamped volunteers with and without eplerenone (MR blocker) and mifepristone (GR blocker) administration under a low and normal T and estradiol clamp. During frequent sampling, a bolus of CRH-arginine vasopressin was infused to assess corticotrope responsiveness. Analytical Methods and Outcomes: Deconvolution and approximate entropy of ACTH profiles were measured. RESULTS Infusion of cortisol (but not saline) pulses diminished ACTH secretion. The GR antagonist, mifepristone, interfered with negative feedback on both ACTH burst mass and secretion regularity. Eplerenone, an MR antagonist, exerted no detectable effect on the same parameters. Despite feedback imposition, CRH-arginine vasopressin-stimulated ACTH secretion was also increased by mifepristone and not by eplerenone. Withdrawal vs addback of sex steroids had no effect on ACTH secretion parameters. Nonetheless, ACTH secretion was greater (P = .006) and more regular (P = .004) in men than women. CONCLUSION Pulsatile cortisol feedback on ACTH secretion in this paradigm is mediated by the glucocorticoid receptor, in part acting at the level of the pituitary, and influenced by sex.
Collapse
Affiliation(s)
- Ferdinand Roelfsema
- Department of Endocrinology and Metabolism (F.R.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; and Endocrine Research Unit (P.A., J.D.V.), Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905
| | - Paul Aoun
- Department of Endocrinology and Metabolism (F.R.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; and Endocrine Research Unit (P.A., J.D.V.), Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905
| | - Johannes D Veldhuis
- Department of Endocrinology and Metabolism (F.R.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; and Endocrine Research Unit (P.A., J.D.V.), Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905
| |
Collapse
|
7
|
Restifo MM, Frank N, Hermida P, Sanchez-Londoño A. Effects of withholding feed on thyrotropin-releasing hormone stimulation test results and effects of combined testing on oral sugar test and thyrotropin-releasing hormone stimulation test results in horses. Am J Vet Res 2016; 77:738-48. [DOI: 10.2460/ajvr.77.7.738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
8
|
Kahl S, Nowotny B, Piepel S, Nowotny PJ, Strassburger K, Herder C, Pacini G, Roden M. Estimates of insulin sensitivity from the intravenous-glucose-modified-clamp test depend on suppression of lipolysis in type 2 diabetes: a randomised controlled trial. Diabetologia 2014; 57:2094-102. [PMID: 25047649 DOI: 10.1007/s00125-014-3328-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/23/2014] [Indexed: 11/30/2022]
Abstract
AIMS/HYPOTHESIS The combined IVGTT-hyperinsulinaemic-euglycaemic clamp (Botnia clamp) allows the assessment of insulin secretion and sensitivity in one experiment. It remains unclear whether this clamp yields results comparable with those of the standard hyperinsulinaemic-euglycaemic clamp (SHEC) in diabetes patients. We hypothesised that the IVGTT induces responses affecting insulin sensitivity assessment. METHODS Of 22 randomised diet- or metformin-treated patients with well-controlled type 2 diabetes, 19 randomly underwent a Botnia clamp and an SHEC, spaced by 2 weeks, in one clinical research centre in a crossover study. The main outcomes were whole-body and hepatic insulin sensitivity as measured by the clamp and [6,6-(2)H2]glucose. Substrate utilisation was assessed from indirect calorimetry and beta cell function from insulin dynamics during IVGTT. RESULTS The values of whole-body insulin sensitivity obtained from Botnia clamp and SHEC were correlated (r = 0.87, p < 0.001), but also revealed intra-individual variations. Hepatic insulin sensitivity did not differ between experiments during the clamp, but differed after IVGTT. The contribution of glucose oxidation to glucose disposal increased by 2.2 ± 0.3 and 1.2 ± 0.4 mg kg fat-free mass (FFM)(-1) min(-1) (Botnia and SHEC, p < 0.05), whereas lipid oxidation decreased by 0.8 ± 0.1 and 0.4 ± 0.1 mg kg FFM(-1) min(-1) (p < 0.05) from baseline. Differences in NEFA (r = -0.60, p < 0.01), but not C-peptide (r = -0.16, p = 0.52) or hepatic insulin sensitivity between IVGTT and placebo before the clamps correlated with individual variations of insulin sensitivity. CONCLUSIONS/INTERPRETATION The Botnia clamp provides similar estimates of insulin sensitivity as SHEC in patients with type 2 diabetes, but changes in NEFA during IVGTT may affect insulin sensitivity and thereby the discrimination between insulin-sensitive and insulin-resistant individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT01397279 FUNDING: The study was funded by the Ministry of Science and Research of the State of North Rhine-Westphalia and the German Federal Ministry of Health, and supported in part by grants from the Federal Ministry for Research to the Centers for Diabetes Research, Helmholtz Alliance Imaging and Curing Environmental Metabolic Diseases and the Schmutzler-Stiftung.
Collapse
Affiliation(s)
- Sabine Kahl
- Department of Endocrinology and Diabetology, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Gyllenhammer LE, Weigensberg MJ, Spruijt-Metz D, Allayee H, Goran MI, Davis JN. Modifying influence of dietary sugar in the relationship between cortisol and visceral adipose tissue in minority youth. Obesity (Silver Spring) 2014; 22:474-81. [PMID: 23929660 PMCID: PMC3946447 DOI: 10.1002/oby.20594] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 07/30/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Cortisol has been associated with preferential visceral adipose tissue (VAT) deposition; however, findings in humans are mixed, which may be clarified when diet is considered. DESIGN AND METHODS Participants included 165 African-American and Latino, overweight adolescents (BMI% 97.2±3.2%, ages 13-18, 67% Latino, 66% female). Body composition was determined by dual energy X-ray absorptiometry, abdominal fat depots [VAT, subcutaneous (SAT)] by multiple-slice MRI, time-controlled serum sample to measure cortisol, and 2-day multi-pass 24-hour dietary recall. Linear regression analysis examined the cross-sectional relationship between cortisol, and the interaction of diet and cortisol on adiposity measures. Sex, race, age, and total body fat were a priori covariates. RESULTS There was a significant interaction between cortisol and sugar (total and added) in the prediction of VAT (P(interaction) ≤ 0.05). Amongst participants with high total or added-sugar intake, cortisol was significantly associated with VAT (ß = 0.031 P < 0.001; ß = 0.026 P < 0.001), with no relationship in low consumers of total or added-sugar. CONCLUSION Dietary sugar may play an important role in modifying the relationship between cortisol and VAT, such that cortisol is significantly associated with elevated VAT under conditions of high sugar intake.
Collapse
Affiliation(s)
- Lauren E Gyllenhammer
- Department of Preventive Medicine, Diabetes and Obesity Research Institute University of Southern California, Los Angeles, California, USA
| | | | | | | | | | | |
Collapse
|
10
|
Stimson RH, Mohd-Shukri NA, Bolton JL, Andrew R, Reynolds RM, Walker BR. The postprandial rise in plasma cortisol in men is mediated by macronutrient-specific stimulation of adrenal and extra-adrenal cortisol production. J Clin Endocrinol Metab 2014; 99:160-168. [PMID: 24092834 PMCID: PMC4392802 DOI: 10.1210/jc.2013-2307] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Circadian variation is a fundamental characteristic of plasma glucocorticoids, with a postprandial rise in cortisol an important feature. The diurnal rhythm is presumed to reflect alterations in hypothalamic-pituitary-adrenal axis activity; however, cortisol is produced not only by the adrenal glands but also by regeneration from cortisone by the enzyme 11β-hydroxysteroid dehydrogenase type 1, mainly in liver and adipose tissue. OBJECTIVE We tested the contribution of peripheral cortisol regeneration to macronutrient-induced circadian variation of plasma cortisol in humans. DESIGN This was a randomized, single-blinded, crossover study. SETTING The study was conducted at a hospital research facility. PARTICIPANTS Eight normal-weight healthy men participated in the study. INTERVENTIONS Subjects were given isocaloric energy isodense flavor-matched liquid meals composed of carbohydrate, protein, fat, or low-calorie placebo during infusion of the stable isotope tracer 9,11,12,12-[2H]4-cortisol. OUTCOME MEASURES AND RESULTS Plasma cortisol increased similarly after all macronutrient meals (by ∼90 nmol/L) compared with placebo. Carbohydrate stimulated adrenal secretion and extra-adrenal regeneration of cortisol to a similar degree. Protein and fat meals stimulated adrenal cortisol secretion to a greater degree than extra-adrenal cortisol regeneration. The increase in cortisol production by 11β-hydroxysteroid dehydrogenase type 1 was in proportion to the increase in insulin. The postprandial cortisol rise was not accounted for by decreased cortisol clearance. CONCLUSIONS Food-induced circadian variation in plasma cortisol is mediated by adrenal secretion and extra-adrenal regeneration of cortisol. Given that the latter has the more potent effect on tissue cortisol concentrations and that effects on adrenal and extra-adrenal cortisol production are macronutrient specific, this novel mechanism may contribute to the physiological interplay between insulin and glucocorticoids and the contrasting effects of certain diets on postprandial metabolism.
Collapse
Affiliation(s)
- Roland H Stimson
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Nor A Mohd-Shukri
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Jennifer L Bolton
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Ruth Andrew
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Rebecca M Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Brian R Walker
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| |
Collapse
|
11
|
Abstract
It has been shown that ingestion of glucose, amino acids, protein or mixed meals tends to increase serum and salivary cortisol concentrations in healthy adults. Recently, it has been demonstrated that morning glucose ingestion stimulates pulsatile cortisol and adrenocorticotropic hormone (ACTH) secretion, thus elevating their mean concentrations. In light of the above, a question arises: could the frequent food – and specifically glucose – consumption lead to hypercortisolism with possible clinical implications? And can the human body, under normal conditions raise defence mechanisms against the transient hypercortisolism caused by the frequent glucose consumption? Studies have revealed novel mechanisms, which are implicated in the glucocorticoid receptor (GR)-mediated action, providing a kind of glucocorticoid resistance. This glucocorticoid resistance could be mediated through both enhancing acetylation (via, among others, regulation of essential clock genes such as Per) and inhibiting deacetylation of GR (via possible regulation of sirtuin activity). Interestingly, the acetylation/deacetylation processes seem to be regulated by glucose. Thus, glucose apart from causing increased cortisol secretion can, simultaneously, counter-regulate this hypercortisolism, by promoting directly and/or indirectly a glucocorticoid resistance state. Undoubtedly, before extracting conclusions regarding the clinical significance of the increased cortisol secretion following glucose ingestion, we should first thoroughly investigate the ‘defence’ mechanisms provided by ‘nature’ to handle this hypercortisolism.
Collapse
Affiliation(s)
- Eva Kassi
- Department of Biological Chemistry, University of Athens Medical School, Athens, Greece
| | | |
Collapse
|
12
|
Iranmanesh A, Lawson D, Veldhuis JD. Distinct metabolic surrogates predict basal and rebound GH secretion after glucose ingestion in men. J Clin Endocrinol Metab 2012; 97:2172-9. [PMID: 22472562 PMCID: PMC3387415 DOI: 10.1210/jc.2011-3317] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT GH secretion declines rapidly after glucose ingestion and then recovers to higher-than-baseline levels (rebound GH release). HYPOTHESIS Selective metabolic markers predict the magnitude of glucose-suppressed GH release and postglucose rebound-like GH secretion. DESIGN Prospectively randomized crossover study of GH secretion after glucose vs. water ingestion. SETTING The study was conducted at a clinical translational research center. PARTICIPANTS Sixty-nine healthy men aged 19-78 yr with a body mass index of 18-39 kg/m(2) participated in the study. OUTCOMES OUTCOMES included nadir vs. peak GH concentrations and basal vs. pulsatile GH secretion. RESULTS Mean nadir GH concentrations were determined positively by sex hormone binding globulin (SHBG) after glucose administration (R(2) = 0.088, P = 0.0077). Peak rebound GH concentrations were related positively to adiponectin and negatively to computed tomography-estimated abdominal visceral fat (AVF) (R(2) = 0.182, P = 0.00049) after glucose ingestion. Deconvolution analysis showed that SHBG specifically predicted basal (nonpulsatile) GH secretion after glucose exposure (R(2) = 0.153, P = 0.00052). In contrast, together exercise history and adiponectin (both positively) and AVF (negatively) predicted pulsatile GH escape after glucose suppression (R(2) = 0.206, P = 0.00043). Moreover, adiponectin uniquely determined the size (mass), and AVF the mode (duration), of GH secretory bursts after glucose exposure (both P < 0.006). CONCLUSION Glucose ingestion provides a clinical model for investigating complementary metabolic surrogates that determine suppression and recovery of basal and pulsatile GH secretion in healthy men.
Collapse
Affiliation(s)
- Ali Iranmanesh
- Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905, USA
| | | | | |
Collapse
|
13
|
Iranmanesh A, Lawson D, Veldhuis JD. Glucose ingestion acutely lowers pulsatile LH and basal testosterone secretion in men. Am J Physiol Endocrinol Metab 2012; 302:E724-30. [PMID: 22252939 PMCID: PMC3311294 DOI: 10.1152/ajpendo.00520.2011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Chronic hyperglycemia inhibits the male gonadal axis. The present analyses test the hypothesis that acute glucose ingestion also suppresses LH and testosterone (T) secretion and blunts the LH-T dose-response function. The design comprised a prospectively randomized crossover comparison of LH and T secretion after glucose vs. water ingestion in a Clinical Translational Research Center. The participants were healthy men (n = 57) aged 19-78 yr with body mass index (BMI) of 20-39 kg/m(2). The main outcome measurements were deconvolution and LH-T dose-response analyses of 10-min data. LH-T responses were regressed on glucose, insulin, leptin, adiponectin, age, BMI, and CT-estimated abdominal visceral fat. During the first 120 min after glucose ingestion, for each unit decrease in LH concentrations, T concentrations decreased by 86 (27-144) ng/dl (r = 0.853, P < 0.001). Based upon deconvolution analysis, glucose compared with water ingestion reduced 1) basal (nonpulsatile; P < 0.001) and total (P < 0.001) T secretion without affecting pulsatile T output and 2) pulsatile (P = 0.043) but not basal LH secretion. By multivariate analysis, pulsatile LH secretion positively predicted basal T secretion after glucose ingestion (r = 0.374, P = 0.0042). In addition, the glucose-induced fall in pulsatile LH secretion was exacerbated by higher fasting insulin concentrations (P = 0.054) and attenuated by higher adiponectin levels (P = 0.0037). There were no detectable changes in the analytically estimated LH-T dose-response curves (P > 0.30). In conclusion, glucose ingestion suppresses pulsatile LH and basal T secretion acutely in healthy men. Suppression is influenced by age, glucose, adiponectin, and insulin concentrations.
Collapse
Affiliation(s)
- Ali Iranmanesh
- Endocrine Research Unit, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN 55905, USA
| | | | | |
Collapse
|