Majer-Łobodzińska Agnieszka, Adamiec-Mroczek Joanna
Department and Clinic of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Poland.
Department and Clinic of Ophtalmology, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2017 Jan-Feb;26(1):143-148. doi: 10.17219/acem/41231.
Glucocorticoid receptor (GR) activity plays a significant role in the etiology of obesity and is essential for glucose homeostasis, the development of hyperinsulinaemia and subsequent increased fat deposition. Several polymorphisms in the GR gene have been described, and at least three of them seem to be associated with altered glucocorticoid sensitivity and changes in glucose homeostasis, and other metabolic parameters. The N363S polymorphism has been associated with increased sensitivity to glucocorticoides, increased insulin response to dexamethasone and increased plasma glucose level. BclI polymorphism is associated with increased abdominal obesity, hyperinsulinaemia and increased insulin resistance. Another polymorphism, ER22/23EK, in contrast to the others, is associated with relative resistance to glucocoricides actions and more beneficial metabolic profile-lower insulin resistance level, decreased lower cardiovascular risk and subseuent prolongation of life time. More research is still needed to understand the mechanisms behind these associations at the molecular level.
糖皮质激素受体（GR）活性在肥胖病因中起重要作用，对葡萄糖稳态、高胰岛素血症的发展及随后脂肪沉积增加至关重要。GR基因已发现多种多态性，其中至少三种似乎与糖皮质激素敏感性改变、葡萄糖稳态变化及其他代谢参数有关。N363S多态性与对糖皮质激素敏感性增加、对地塞米松的胰岛素反应增强及血糖水平升高有关。BclI多态性与腹部肥胖增加、高胰岛素血症及胰岛素抵抗增加有关。另一种多态性ER22/23EK与其他多态性不同，它与对糖皮质激素作用的相对抵抗及更有益的代谢特征相关——胰岛素抵抗水平较低、心血管风险降低及随后寿命延长。仍需要更多研究来在分子水平上理解这些关联背后的机制。
