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Osteoblasts mediate the adverse effects of glucocorticoids on fuel metabolism
Tara C. Brennan-Speranza, … , Hong Zhou, Markus J. Seibel
Tara C. Brennan-Speranza, … , Hong Zhou, Markus J. Seibel
Published October 24, 2012
Citation Information: J Clin Invest. 2012;122(11):4172-4189. https://doi.org/10.1172/JCI63377.
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Research Article

Osteoblasts mediate the adverse effects of glucocorticoids on fuel metabolism

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Abstract

Long-term glucocorticoid treatment is associated with numerous adverse outcomes, including weight gain, insulin resistance, and diabetes; however, the pathogenesis of these side effects remains obscure. Glucocorticoids also suppress osteoblast function, including osteocalcin synthesis. Osteocalcin is an osteoblast-specific peptide that is reported to be involved in normal murine fuel metabolism. We now demonstrate that osteoblasts play a pivotal role in the pathogenesis of glucocorticoid-induced dysmetabolism. Osteoblast-targeted disruption of glucocorticoid signaling significantly attenuated the suppression of osteocalcin synthesis and prevented the development of insulin resistance, glucose intolerance, and abnormal weight gain in corticosterone-treated mice. Nearly identical effects were observed in glucocorticoid-treated animals following heterotopic (hepatic) expression of both carboxylated and uncarboxylated osteocalcin through gene therapy, which additionally led to a reduction in hepatic lipid deposition and improved phosphorylation of the insulin receptor. These data suggest that the effects of exogenous high-dose glucocorticoids on insulin target tissues and systemic energy metabolism are mediated, at least in part, through the skeleton.

Authors

Tara C. Brennan-Speranza, Holger Henneicke, Sylvia J. Gasparini, Katharina I. Blankenstein, Uta Heinevetter, Victoria C. Cogger, Dmitri Svistounov, Yaqing Zhang, Gregory J. Cooney, Frank Buttgereit, Colin R. Dunstan, Caren Gundberg, Hong Zhou, Markus J. Seibel

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Figure 13

Schematic model of the effects exogenous high-dose glucocorticoids on insulin sensitivity and glucose handling in mice.

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Schematic model of the effects exogenous high-dose glucocorticoids on in...
Under physiological conditions, osteocalcin improves insulin sensitivity in peripheral tissues such as the liver, allowing for efficient glucose handling in times of high insulin release. This action is impaired when glucocorticoids (GCs) interfere with osteoblast activity, suppressing the production and secretion of osteocalcin (and possibly other factors). The lack of osteocalcin leads to decreased insulin sensitivity, which results in impaired hepatic glucose output inhibition, peripheral glucose uptake, hyperglycemia, and a compensatory increase in insulin release, all of which are characteristic features of glucocorticoid-induced (pre-) diabetes. In the absence of osteocalcin, high insulin levels have reduced effects on end-organ glucose uptake.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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