Liver upregulation of genes involved in cortisol production and action is associated with metabolic syndrome in morbidly obese patients.

Abstract

BACKGROUND:

Hepatic 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity, which converts cortisone (inactive) to cortisol, is downregulated in obesity. However, this compensation fails in obese with metabolic abnormalities, such as diabetes. To further characterize the tissue-specific cortisol regeneration in obesity, we have investigated the mRNA expression of genes related to local cortisol production, i.e., 11β-HSD1, hexose-6-phosphate dehydrogenase (H6PDH) and cortisol action, glucocorticoid receptor (GR) and a cortisol target gene, phosphoenolpyruvate carboxykinase (PEPCK) in the liver, and visceral (VAT) and subcutaneous (SAT) adipose tissues from morbidly obese patients with and without metabolic syndrome (MS).

METHODS:

Fifty morbidly obese patients undergoing bariatric surgery, 14 men (mean age, 41.3 ± 3.5 years; BMI, 48.0 ± 3.6 kg/m(2)) and 36 women (mean age, 44.6 ± 1.9 years; BMI, 44.9 ± 1.2 kg/m(2)), were classified as having MS (MS+, n = 20) or not (MS-, n = 30). Tissue mRNA levels were measured by real-time polymerase chain reaction.

RESULTS:

Hepatic mRNA levels of these genes were higher in obese patients with MS (11β-HSD1, P = 0.002; H6PDH, P = 0.043; GR, P = 0.033; PEPCK, P = 0.032) and positively correlated with the number of clinical characteristics that define the MS. The expression of the four genes positively correlated among them. In contrast to the liver, these genes were not differently expressed in VAT or SAT, when MS+ and MS- obese patients were compared.

CONCLUSIONS:

Coordinated liver-specific upregulation of genes involved in local cortisol regeneration and action support the concept that local hepatic hypercortisolism contributes to development of MS in morbidly obese patients.

• Authors: Esther Torrecilla, Gumersindo Fernández-Vázquez, David Vicent, Franco Sánchez-Franco, Ana Barabash, Lucio Cabrerizo, Andrés Sánchez-Pernaute, Antonio J Torres, Miguel Angel Rubio
• Journal: Obesity surgery (Obes Surg) Vol. 22 Issue 3 Pg. 478-86 (Mar 2012) ISSN: 1708-0428 [Electronic] United States
• PMID: 21964795 (Publication Type: Journal Article)

Chemical References

• RNA, Messenger
• 11-beta-Hydroxysteroid Dehydrogenase Type 1
• Phosphoenolpyruvate Carboxykinase (ATP)
• Cortisone
• Hydrocortisone

Topics

• 11-beta-Hydroxysteroid Dehydrogenase Type 1 (genetics, metabolism)
• Adipose Tissue (enzymology)
• Adult
• Bariatric Surgery
• Cortisone (metabolism)
• Female
• Gene Expression Regulation
• Humans
• Hydrocortisone (biosynthesis, genetics, metabolism)
• Liver (enzymology)
• Male
• Metabolic Syndrome (enzymology, genetics)
• Obesity, Morbid (enzymology, genetics, surgery)
• Phosphoenolpyruvate Carboxykinase (ATP) (genetics, metabolism)
• RNA, Messenger
• Real-Time Polymerase Chain Reaction
• Up-Regulation