Obesity-Induced Excess of 17-Hydroxyprogesterone Promotes Hyperglycemia Through Activation of Glucocorticoid Receptor
The Journal of Clinical Investigation RESEARCH ARTICLE Obesity-induced excess of 17-hydroxyprogesterone promotes hyperglycemia through activation of glucocorticoid receptor Yan Lu,1 E Wang,1 Ying Chen,1 Bing Zhou,1 Jiejie Zhao,1 Liping Xiang,1 Yiling Qian,1 Jingjing Jiang,1 Lin Zhao,1 Xuelian Xiong,1 Zhiqiang Lu,1 Duojiao Wu,2 Bin Liu,1,3 Jing Yan,4 Rong Zhang,4,5 Huijie Zhang,6 Cheng Hu,4,5,7 and Xiaoying Li1 1Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education and Department of Endocrinology and Metabolism, and 2Institute of Clinical Science, Shanghai Institute of Clinical Bioinformatics, Zhongshan Hospital, Fudan University, Shanghai, China. 3Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, College of Pharmacy, Jiangsu Ocean University, Lianyungang, China. 4Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, and 5Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai, China. 6Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. 7Institute for Metabolic Disease, Fengxian Central Hospital, Southern Medical University, Shanghai, China. Type 2 diabetes mellitus (T2DM) has become an expanding global public health problem. Although the glucocorticoid receptor (GR) is an important regulator of glucose metabolism, the relationship between circulating glucocorticoids (GCs) and the features of T2DM remains controversial. Here, we show that 17-hydroxyprogesterone (17-OHP), an intermediate steroid in the biosynthetic pathway that converts cholesterol to cortisol, binds to and stimulates the transcriptional activity of GR. Hepatic 17-OHP concentrations are increased in diabetic mice and patients due to aberrantly increased expression of Cyp17A1.
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