Effects of Cortisol on Carbohydrate Metabolism

Beta Switch Program

Beta Switch Program by Sue Heintze

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Stimulation of Gluconeogenesis. By far the best-known metabolic effect of cortisol and other glucocorticoids on metabolism is their ability to stimulate gluconeo-genesis (formation of carbohydrate from proteins and some other substances) by the liver, often increasing the rate of gluconeogenesis as much as 6- to 10-fold. This results mainly from two effects of cortisol.

1. Cortisol increases the enzymes required to convert amino acids into glucose in the liver cells. This results from the effect of the glucocorticoids to activate DNA transcription in the liver cell nuclei in the same way that aldosterone functions in the renal tubular cells, with formation of messenger RNAs that in turn lead to the array of enzymes required for gluconeogenesis.

2. Cortisol causes mobilization of amino acids from the extrahepatic tissues mainly from muscle. As a result, more amino acids become available in the plasma to enter into the gluconeogenesis process of the liver and thereby to promote the formation of glucose.

One of the effects of increased gluconeogenesis is a marked increase in glycogen storage in the liver cells. This effect of cortisol allows other glycolytic hormones, such as epinephrine and glucagon, to mobilize glucose in times of need, such as between meals.

Decreased Glucose Utilization by Cells. Cortisol also causes a moderate decrease in the rate of glucose utilization by most cells in the body. Although the cause of this decrease is unknown, most physiologists believe that somewhere between the point of entry of glucose into the cells and its final degradation, cortisol directly delays the rate of glucose utilization. A suggested mechanism is based on the observation that glucocor-ticoids depress the oxidation of nicotinamide-adenine dinucleotide (NADH) to form NAD+. Because NADH must be oxidized to allow glycolysis, this effect could account for the diminished utilization of glucose by the cells.

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Essentials of Human Physiology

Essentials of Human Physiology

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