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Submitted on December 8, 2004
Accepted on March 29, 2005
Division of Endocrinology, Metabolism and Nutrition, Department of Laboratory Medicine & Pathology, Department of Vascular & Interventional Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Information Engineering, University of Padua, Padua, Italy
* To whom correspondence should be addressed. E-mail: rizza.robert{at}mayo.edu.
To determine if obesity alone or in combination with type 2 diabetes increases splanchnic and/or leg cortisol production, 9 lean non-diabetic, 10 obese non-diabetic and 11 obese diabetic subjects were studied. Splanchnic and leg cortisol production were measured using the hepatic and leg catheterization technique combined with infusion of D4-cortisol. Rates of splanchnic cortisol production equaled or exceeded those occurring in extra-splanchnic tissues (e.g. the adrenals) in all three groups. However, since concurrent splanchnic cortisol uptake also occurred, net splanchnic cortisol release was minimal. Splanchnic cortisol production and splanchnic D3-cortisol production (an index of splanchnic 11
-hydroxysteroid dehydrogenase type 1 activity) did not differ among the three groups. In addition, splanchnic cortisol production did not correlate with either visceral fat or endogenous glucose production. On the other hand, splanchnic cortisol uptake was greater in the obese diabetic than lean non-diabetic subjects (25 ± 2.9 vs. 15.3 ± 2.5 µg/min; P < 0.05). Splanchnic, but not leg, D3-cortisol production was correlated with total body D3-cortisol production (r= 0.70; P < 0.001). We conclude that while large amounts of cortisol are produced within the splanchnic bed implying high intra-hepatic glucocorticoid concentrations, rates do not differ in lean and obese non-diabetic humans and are not influenced by the presence of type 2 diabetes mellitus. On the other hand, obesity but not diabetes increases splanchnic cortisol uptake.
hydroxysteroid dehydrogenase •
splanchnic and leg cortisol production •
cortisol extraction •
visceral fat •
total body fat
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