title: Role of metabolically active hormones in the insulin resistance associated with short-term glucocorticoid treatment.
abstract: BACKGROUND
  The mechanisms by which glucocorticoid therapy promotes obesity and insulin resistance are incompletely characterized. Modulations of the metabolically active hormones, tumour necrosis factor alpha (TNF alpha), ghrelin, leptin and adiponectin are all implicated in the development of these cardiovascular risk factors. Little is known about the effects of short-term glucocorticoid treatment on levels of these hormones.
  
  
  METHODS
  Using a blinded, placebo-controlled approach, we randomised 25 healthy men (mean (SD) age: 24.2 (5.4) years) to 5 days of treatment with either placebo or oral dexamethasone 3 mg twice daily. Fasting plasma TNFalpha, ghrelin, leptin and adiponectin were measured before and after treatment.
  
  
  RESULTS
  Mean changes in all hormones were no different between treatment arms, despite dexamethasone-related increases in body weight, blood pressure, HDL cholesterol and insulin. Changes in calculated indices of insulin sensitivity (HOMA-S, insulin sensitivity index) were strongly related to dexamethasone treatment (p < 0.001).
  
  
  CONCLUSIONS
  Our data do not support a role for TNF alpha, ghrelin, leptin or adiponectin in the insulin resistance associated with short-term glucocorticoid treatment.
authors.affiliation: Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine and Sandwell Medical Research Unit, Sandwell and West Birmingham Hospitals NHS Trust, West Midlands, UK. Jeetesh.patel@swbh.nhs.uk
authors.forename: Jeetesh V
authors.initials: JV
authors.lastname: Patel
authors.forename: David E
authors.initials: DE
authors.lastname: Cummings
authors.forename: John P
authors.initials: JP
authors.lastname: Girod
authors.forename: Alwin V
authors.initials: AV
authors.lastname: Mascarenhas
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hughes
authors.forename: Manjula
authors.initials: M
authors.lastname: Gupta
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Sethu
authors.initials: S
authors.lastname: Reddy
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Brotman
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D054439:Ghrelin; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000494:pharmacology*; D006262:Health; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood; D008297:Male; D036361:Peptide Hormones / Q000097:blood; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D052242:Adiponectin; D054439:Ghrelin; D005938:Glucocorticoids; D006728:Hormones; D020738:Leptin; D036361:Peptide Hormones; D014409:Tumor Necrosis Factor-alpha