Cleasby Mark E, Livingstone Dawn E W, Nyirenda Moffat J, Seckl Jonathan R, Walker Brian R
Endocrinology Unit, Department of Medical Sciences, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK.
Eur J Endocrinol. 2003 Jan;148(1):129-38. doi: 10.1530/eje.0.1480129.
Glucocorticoids may contribute to the association between retarded growth in utero and insulin resistance in adulthood. Administration of dexamethasone (dex) to pregnant rats results in low birth weight offspring, which develop glucose intolerance, hyperinsulinaemia and hypercorticosteronaemia. This may be explained by tIssue-specific differences in expression of glucocorticoid receptors (GR) in adult offspring: GR is increased in visceral fat and liver, and decreased in hippocampus and soleus muscle. However, cause and effect between altered GR expression, hypercorticosteronaemia, and hyperinsulinaemia remains to be established.
Rats were treated with dex (100 microg/kg per day) or saline during the third week of pregnancy. In 5-8-Month-old male offspring, GR expression in insulin target tIssues was quantified by RNase protection assay in rats that were adrenalectomised (ADX group), sham operated (SHAM group), or adrenalectomised with supra-physiological corticosterone replacement (CORT group) (n=7-8 per group), and in rats treated orally with vehicle, metformin (43 mg/kg per day) or rosiglitazone (1 mg/kg per day), after 3 weeks.
Manipulation of corticosterone concentration did not affect GR mRNA in skeletal muscle or adipose. In liver, sham-operated animals showed lower GR mRNA, but there was no difference between adrenalectomised and hypercorticosteronaemic animals (SHAM 0.11+/-0.01 ratio to beta-actin, vs ADX 0.22+/-0.02, CORT 0.23+/-0.02, (values expressed as means+/-s.e.m.), P<0.001). Rosiglitazone reduced GR mRNA by approximately 30% in liver of dex- and saline-treated offspring (P<0.05), but had no effect on GR in adipose and skeletal muscle. Metformin abolished the 38% up-regulation of liver GR mRNA induced by antenatal dex and also reduced GR mRNA preferentially in muscle of dex-treated animals (0.14+/-0.01 vs 0.10+/-0.01; P=0.03).
We conclude that neither hypercorticosteronaemia nor hyperinsulinaemia are sufficient to cause the changes in GR expression in dex-programmed rats, implying that these changes may be primary in determining the programmed insulin resistant phenotype. Normalisation of GR expression by metformin may be important in the mode of action of this anti-diabetic agent and may be especially useful to reverse-programmed up-regulation of GR.
糖皮质激素可能与子宫内生长迟缓及成年期胰岛素抵抗之间的关联有关。给怀孕大鼠注射地塞米松(dex)会导致出生体重低的后代,这些后代会出现葡萄糖不耐受、高胰岛素血症和高皮质酮血症。这可能是由于成年后代糖皮质激素受体(GR)表达的组织特异性差异所致:GR在内脏脂肪和肝脏中增加,而在海马体和比目鱼肌中减少。然而,GR表达改变、高皮质酮血症和高胰岛素血症之间的因果关系仍有待确定。
在怀孕第三周,给大鼠注射dex(每天100微克/千克)或生理盐水。在5至8个月大的雄性后代中,通过核糖核酸酶保护试验对肾上腺切除(ADX组)、假手术(SHAM组)或肾上腺切除并给予超生理剂量皮质酮替代(CORT组)的大鼠(每组n = 7 - 8)以及口服载体、二甲双胍(每天43毫克/千克)或罗格列酮(每天1毫克/千克)3周后的大鼠胰岛素靶组织中的GR表达进行定量。
皮质酮浓度的改变对骨骼肌或脂肪中的GR mRNA没有影响。在肝脏中,假手术动物的GR mRNA较低,但肾上腺切除动物和高皮质酮血症动物之间没有差异(SHAM与β-肌动蛋白的比值为0.11±0.01,ADX为0.22±0.02,CORT为0.23±0.02,(数值表示为平均值±标准误),P < 0.001)。罗格列酮使dex处理和生理盐水处理后代肝脏中的GR mRNA降低约30%(P < 0.05),但对脂肪和骨骼肌中的GR没有影响。二甲双胍消除了产前dex诱导的肝脏GR mRNA 38%的上调,并且还优先降低了dex处理动物肌肉中的GR mRNA(0.14±0.01对0.10±0.01;P = 0.03)。
我们得出结论,高皮质酮血症和高胰岛素血症都不足以导致dex程序化大鼠中GR表达的变化,这意味着这些变化可能是决定程序化胰岛素抵抗表型的原发性因素。二甲双胍使GR表达正常化可能在这种抗糖尿病药物的作用模式中很重要,并且可能对逆转程序化的GR上调特别有用。