Exp Clin Endocrinol Diabetes 2002; 110(7): 313-318
DOI: 10.1055/s-2002-34996
Review

© Johann Ambrosius Barth

The Metabolic Syndrome X And Peripheral Cortisol Synthesis

V. Bähr 1 , A. F. Pfeiffer 1, 2 , S. Diederich 1
  • 1 Department of Endocrinology, Diabetes and Nutrition, University Hospital Benjamin Franklin, Free University of Berlin, Germany
  • 2 German Institute of Human Nutrition Potsdam, Department of Clinical Nutrition, Bergholz-Rehbrucke, Germany
Further Information

Publication History

received 14 January 02 first decision 21 March 02

accepted 22 April 02

Publication Date:
24 October 2002 (online)

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Summary

The metabolic syndrome X and Cushing's syndrome show similar symptoms but one major difference: Plasma cortisol is not elevated in the metabolic syndrome. Evidence is presented, that by the action of 11β-hydroxysteroid dehydrogenase 1 (11βHSD1) higher intracellular cortisol concentration may be created that may be relevant to induce insulin resistance and metabolic disturbances. Regulation of 11βHSD1 expression by hormones, growth factors, cytokines and transcription factors enables tissue specific adjustments of glucocorticoid receptor activation by cortisol. Specific inhibition of 11βHSD1 would help to understand aspects of the pathogenesis of syndrome X and to develop new therapeutic perspectives.