Abstract
Clinical observations have highlighted the link between glucocorticoids and obesity.
While exogenous glucocorticoids in excess predispose to the development of central
obesity, we have focused on cortisol metabolism within human adipose tissue. 11β-hydroxysteroid
dehydrogenase (11β-HSD) inter-converts the active glucocorticoid, cortisol, and inactive
cortisone. 11β-HSD1, the only isoform expressed in adipose tissue, acts predominantly
as an oxoreductase to generate cortisol. Expression is higher in omental compared
to subcutaneous preadipocytes and activity and expression are potently regulated by
growth factors and cytokines. Mice over-expressing 11β-HSD1 specifically within adipocytes
develop central obesity. However, the situation is less clear in humans. Globally,
there appears to be inhibition of the enzyme, but expression in human obesity is still
not fully characterized; its functional role in adipocyte biology remains to be elucidated.
In vitro, 11β-HSD1 appears to function in promoting adipocyte differentiation and limiting
preadipocyte proliferation, but the impact of these effects in vivo upon the regulation of fat mass remains to be defined. Clinical studies utilizing
selective 11β-HSD1 inhibitors may help to answer this question.
Key words
11β-Hydroxysteroid Dehydrogenase - Obesity - Adipose Tissue - Proliferation - Differentiation
- Cortisol - Preadipocyte
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Prof. P. M. Stewart, M.D., F.R.C.P., F.Med.Sci.
Division of Medical Sciences
University of Birmingham · Queen Elizabeth Hospital · Birmingham · United Kingdom
B15 2TH ·
Phone: + 44 (121) 627 2380
Fax: + 44 (121) 121 627 2384
Email: P.M.Stewart@bham.ac.uk