Bone Research Program, ANZAC Research Institute, The University of Sydney, Gate 3, Hospital Road, Concord, NSW, 2139, Australia.
Department of Medicine III, Technische Universität Dresden Medical Center, Dresden, Germany.
Diabetologia. 2019 Aug;62(8):1463-1477. doi: 10.1007/s00125-019-4887-0. Epub 2019 May 16.
AIMS/HYPOTHESIS: Chronic glucocorticoid therapy causes insulin resistance, dyslipidaemia, abnormal fat accumulation, loss of muscle mass and osteoporosis. Here we describe a hitherto unknown sexual dimorphism in the metabolic response to chronic glucocorticoid exposure in mice. This led us to investigate whether glucocorticoid-induced insulin resistance and obesity were dependent on sex hormones.
Male and female CD1 mice were treated for 4 weeks with supraphysiological doses (~250 μg/day) of corticosterone, the main glucocorticoid in rodents, or equivalent volume of vehicle (drinking water without corticosterone). To investigate the effects of sex hormones, a separate group of mice were either orchidectomised or ovariectomised prior to corticosterone treatment, with or without dihydrotestosterone replacement. Body composition was determined before and after corticosterone treatment, and insulin tolerance was assessed after 7 and 28 days of treatment. Adipocyte morphology was assessed in white and brown adipose tissues by immunohistochemistry, and fasting serum concentrations of NEFA, triacylglycerols, total cholesterol and free glycerol were measured using colorimetric assays. Obesity- and diabetes-related hormones were measured using multiplex assays, and RNA and protein expression in adipose tissues were measured by RT-PCR and immunoblotting, respectively.
Chronic corticosterone treatment led to insulin resistance, fasting hyperinsulinaemia, increased adiposity and dyslipidaemia in male, but not female mice. In males, orchidectomy improved baseline insulin sensitivity and attenuated corticosterone-induced insulin resistance, but did not prevent fat accumulation. In androgen-deficient mice (orchidectomised males, and intact and ovariectomised females) treated with dihydrotestosterone, corticosterone treatment led to insulin resistance and dyslipidaemia. In brown adipose tissue, androgens were required for corticosterone-induced intracellular lipid accumulation ('whitening'), and dihydrotestosterone specifically exacerbated corticosterone-induced accumulation of white adipose tissue by increasing adipocyte hypertrophy. Androgens also suppressed circulating adiponectin concentrations, but corticosterone-induced insulin resistance did not involve additional suppression of adiponectin levels. In white adipose tissue, androgens were required for induction of the glucocorticoid target gene Gilz (also known as Tsc22d3) by corticosterone.
CONCLUSIONS/INTERPRETATION: In mice, androgens potentiate the development of insulin resistance, fat accumulation and brown adipose tissue whitening following chronic glucocorticoid treatment.
目的/假设:慢性糖皮质激素治疗会导致胰岛素抵抗、血脂异常、脂肪异常堆积、肌肉量减少和骨质疏松。在这里,我们描述了一种迄今为止未知的雄性和雌性小鼠对慢性糖皮质激素暴露的代谢反应的性别二态性。这促使我们研究糖皮质激素诱导的胰岛素抵抗和肥胖是否依赖于性激素。
雄性和雌性 CD1 小鼠接受了 4 周的超生理剂量(约 250μg/天)的皮质酮治疗,皮质酮是啮齿动物中的主要糖皮质激素,或用等量的载体(不含皮质酮的饮用水)处理。为了研究性激素的影响,一组小鼠在皮质酮治疗前接受了去势或卵巢切除术,并在有或没有二氢睾酮替代的情况下进行。在皮质酮治疗前后测定身体成分,在治疗 7 和 28 天后评估胰岛素耐量。通过免疫组织化学评估白色和棕色脂肪组织中的脂肪细胞形态,并使用比色法测定禁食血清中 NEFA、三酰甘油、总胆固醇和游离甘油的浓度。使用多重分析测定肥胖和糖尿病相关激素,通过 RT-PCR 和免疫印迹分别测定脂肪组织中的 RNA 和蛋白质表达。
慢性皮质酮治疗导致雄性而非雌性小鼠出现胰岛素抵抗、空腹高胰岛素血症、肥胖和血脂异常。在雄性中,去势可改善基础胰岛素敏感性并减弱皮质酮诱导的胰岛素抵抗,但不能阻止脂肪堆积。在雄激素缺乏的小鼠(去势雄性和完整及去势雌性)中,用二氢睾酮处理时,皮质酮治疗会导致胰岛素抵抗和血脂异常。在棕色脂肪组织中,雄激素是皮质酮诱导的细胞内脂质堆积(“白化”)所必需的,二氢睾酮特异性地通过增加脂肪细胞肥大来加剧皮质酮诱导的白色脂肪组织堆积。雄激素还抑制循环脂联素浓度,但皮质酮诱导的胰岛素抵抗不涉及脂联素水平的额外抑制。在白色脂肪组织中,雄激素是皮质酮诱导糖皮质激素靶基因 Gilz(也称为 Tsc22d3)表达所必需的。
结论/解释:在小鼠中,雄激素增强了慢性糖皮质激素治疗后胰岛素抵抗、脂肪堆积和棕色脂肪组织白化的发生。