The Journal of Steroid Biochemistry and Molecular Biology
Steroids and the metabolic syndrome☆
Section snippets
Abdominal obesity, insulin resistance and the metabolic syndrome
Over the last 15 years, the concept underlying the common aggregation of major abnormalities associated with an insulin resistant state has emerged as a unique entity, the so-called metabolic syndrome. Although the concept that insulin resistance is different from the metabolic syndrome, nonetheless for many years these two conditions have often been used more or less as synonyms. This issue is, however, currently a matter of great controversy [1]. One of the reasons is certainly represented by
Pathophysiological aspects of abdominal obesity: the hypothalamic–pituitary–adrenal axis and sex hormone imbalance
Steroids play an important role in the regulation of adipose tissue metabolism, with relevant differences according to its distribution [7], [8], [9], [10]. Alterations of the hypothalamic–pituitary–adrenal (HPA) axis and sex hormone imbalance may have profound effects on adipose tissue morphology and function. In the following sections multiple alterations of these two classic endocrine compartments in the presence of central obesity are discussed.
Visceral obesity as a part of the “general maladaptation syndrome”
Life exists by maintaining a complex dynamic equilibrium or homeostasis that is constantly challenged by intrinsic and extrinsic adverse forces, the stressors. When faced with excessive stress, whether physical or emotional, a subject's adaptive responses acquire a relatively stereotypic nonspecific nature, referred to by Selye as “the general adaptation syndrome” [34]. Stress activates the HPA axis and sympathetic nervous and the sympathoadrenal systems [35]. Defence reactions involve release
Association between steroid imbalance, insulin resistance and the metabolic syndrome
What is reported in the previous paragraphs emphasises the fact that alterations of the glucocorticoid axis combined with a sex hormone imbalance may have a coordinating role in the pathophysiology of central obesity and associated metabolic alterations. In the following part of this review, we will focus on the studies showing an association between abnormalities of the HPA axis and those of sex hormones, particularly androgens, with the metabolic syndrome, T2DM and CVDs.
Summary and conclusions
The concept that central obesity and associated metabolic and cardiovascular co-morbidities may be part of the so-called “general adaptation syndrome” proposed by Salye 60 years ago has attracted scientific attention in the last 15 years, although the pathophysiology of this relationship in humans is poorly understood. However, animal data support this concept and emphasize the role of the two main stress endocrine systems, the HPA axis and the SNS, in the cascade on events leading to end
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Presented at the ‘12th International Congress on Hormonal Steroids and Hormones & Cancer’ (Athens, Greece, 13–16 September 2006).