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Endocrine Abstracts (2013) 32 S30.2 | DOI: 10.1530/endoabs.32.S30.2

1Division of Oncological Endocrinology, Turin, Italy; 2Division of Endocrinology, Diabetology and Metabolism, Turin, Italy; 3Department of Clinical and Biological Sciences, Turin, Italy.


Glucocorticoids (GC) act at different target tissues by binding two different intracellular receptors, the glucocorticoid receptor (GR) and the mineralcorticoid receptor (MR), but the their effects vary considerably between subjects, due to a different sensitivity, which is at least partially, genetically determined. GCs are so named based on their actions on carbohydrate metabolism, namely on insulin-dependent processes. In particular, the effect of GC includes increased hepatic glucose production, decreased insulin-dependent glucose uptake into peripheral tissues, breakdown of muscle and fat to provide additional substrates for glucose production, and inhibition of insulin release from pancreatic β cells. On the other hand, they also deeply influence lipid and protein metabolism, thus modifying body composition. In fact, GC excess is characterized by a series of metabolic complications, including abdominal obesity, systemic arterial hypertension, impairment of glucose tolerance, dyslipidemia, and thrombotic diatesis, which increase cardiovascular risk and mortality rate. Moreover, the detrimental effects of GC on bone mass and turnover as well as the alterations at muscle level, inducing the steroid-mediated myopathy, are known as well. Although there is convincing evidence in the literature that clear hypercortisolemia is associated with several metabolic alterations, it is matter of debate whether subclinical GC excess is responsible for the above mentioned abnormalities. Moreover, the remission GC excess usually reduces but does not eliminate these systemic complications and does not completely normalize body composition, thus indicating that the detrimental effects of GC probably last for very long time and that an early diagnosis and cure may, possibly, prevent a negative prognosis of these patients.

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