Weefselspecifieke veranderingen in het cortisolmetabolisme en hun mogelijke rol in het metabool syndroom

– The intracellular enzyme 11β-hydroxysteroid dehydrogenase (11βHSD) catalyses the interconversion between the biologically-active cortisol and inactive cortisone. There are two distinct isozymes: 11βHSD type 1 behaves predominantly as a reductase in vivo and activates cortisone into cortisol, whereas 11βHSD type 2 functions as a dehydrogenase and inactivates cortisol into cortisone.

– At tissue level, 11βHSD type 1 amplifies the effect of glucocorticoids, whereby free cortisol is generated from the relative excess of circulating free cortisone.

– Both animal and human studies have demonstrated that alterations in 11βHSD type 1 activity in adipose tissue and liver are associated with the metabolic syndrome, thus possibly reflecting a tissue-specific (omental) Cushing’s syndrome.

– Pharmacological inhibition of 11βHSD type 1 activity provides an interesting mechanism for the development of novel therapeutic agents for type-2 diabetes mellitus.

Ned Tijdschr Geneeskd 2005;149:871-6