Pasieka Aoibhe M, Rafacho Alex
School of Kinesiology and Health Science, Muscle Health Research Centre, York University, Toronto, ON M3J 1P3, Canada.
Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil.
Metabolites. 2016 Aug 3;6(3):24. doi: 10.3390/metabo6030024.
Glucocorticoids (GCs) are steroid hormones that exert important physiological actions on metabolism. Given that GCs also exert potent immunosuppressive and anti-inflammatory actions, synthetic GCs such as prednisolone and dexamethasone were developed for the treatment of autoimmune- and inflammatory-related diseases. The synthetic GCs are undoubtedly efficient in terms of their therapeutic effects, but are accompanied by significant adverse effects on metabolism, specifically glucose metabolism. Glucose intolerance and reductions in insulin sensitivity are among the major concerns related to GC metabolic side effects, which may ultimately progress to type 2 diabetes mellitus. A number of pre-clinical and clinical studies have aimed to understand the repercussions of GCs on glucose metabolism and the possible mechanisms of GC action. This review intends to summarize the main alterations that occur in liver, skeletal muscle, adipose tissue, and pancreatic islets in the context of GC-induced glucose intolerance. For this, both experimental (animals) and clinical studies were selected and, whenever possible, the main cellular mechanisms involved in such GC-side effects were discussed.
糖皮质激素（GCs）是一类对新陈代谢具有重要生理作用的甾体激素。鉴于GCs还具有强大的免疫抑制和抗炎作用，人们开发了泼尼松龙和地塞米松等合成糖皮质激素用于治疗自身免疫性和炎症相关疾病。合成糖皮质激素在治疗效果方面无疑是有效的，但会对新陈代谢，尤其是葡萄糖代谢产生显著的不良影响。葡萄糖不耐受和胰岛素敏感性降低是与糖皮质激素代谢副作用相关的主要问题，这些副作用最终可能发展为2型糖尿病。许多临床前和临床研究旨在了解糖皮质激素对葡萄糖代谢的影响以及糖皮质激素作用的可能机制。本综述旨在总结在糖皮质激素诱导的葡萄糖不耐受情况下，肝脏、骨骼肌、脂肪组织和胰岛中发生的主要变化。为此，我们选择了实验（动物）和临床研究，并尽可能讨论了这些糖皮质激素副作用所涉及的主要细胞机制。
