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. 2015 Nov 3;125(12):4587-91.
doi: 10.1172/JCI82723.

Evidence against hypothalamic-pituitary-adrenal axis suppression in the antidiabetic action of leptin

Evidence against hypothalamic-pituitary-adrenal axis suppression in the antidiabetic action of leptin

Gregory J Morton et al. J Clin Invest. .

Abstract

Leptin administration restores euglycemia in rodents with severe insulin-deficient diabetes, and recent studies to explain this phenomenon have focused on the ability of leptin to normalize excessive hypothalamic-pituitary-adrenal (HPA) axis activity. Here, we employed a streptozotocin-induced rat model (STZ-DM) of uncontrolled insulin-deficient diabetes mellitus (uDM) to investigate the contribution of HPA axis suppression to leptin-mediated glucose lowering. Specifically, we asked if HPA axis activation is required for diabetic hyperglycemia, whether HPA axis normalization can be achieved using a dose of leptin below that needed to normalize glycemia, and if the ability of leptin to lower plasma glucocorticoid levels is required for its antidiabetic action. In STZ-DM rats, neither adrenalectomy-induced (ADX-induced) glucocorticoid deficiency nor pharmacological glucocorticoid receptor blockade lowered elevated blood glucose levels. Although elevated plasma levels of corticosterone were normalized by i.v. leptin infusion at a dose that raises low plasma levels into the physiological range, diabetic hyperglycemia was not altered. Lastly, the potent glucose-lowering effect of continuous intracerebroventricular leptin infusion was not impacted by systemic administration of corticosterone at a dose that maintained elevated plasma levels characteristic of STZ-DM. We conclude that, although restoring low plasma leptin levels into the physiological range effectively normalizes increased HPA axis activity in rats with uDM, this effect is neither necessary nor sufficient to explain leptin's antidiabetic action.

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Figures

Figure 3
Figure 3. Suppression of hypercorticosteronemia is not required for leptin’s antidiabetic effects in STZ-DM.
(AD) Three-hour fasted plasma insulin and leptin (A), corticosterone (B) and ACTH levels (C) obtained mid-light cycle (13:00), and (D) daily-fed blood glucose levels in surgical ADX (ADX-STZ) diabetic rats that received both continuous icv infusion of leptin (beginning on day 4; ADX-STZ-lep), and either a low dose (physiological replacement; 35 mg pellet; Cort-low) or a high dose of corticosterone s.c. (to raise plasma corticosterone levels into the range of rats with STZ-DM; 2 × 35 mg pellet; Cort-high) (n = 8–11/group). Data represent mean ± SEM. Data were analyzed by a 2-tailed, unpaired Student’s t test. *P < 0.05 vs. Cort-low.
Figure 2
Figure 2. Hyperglycemia in rats with STZ-DM is not reversed by either glucocorticoid receptor blockade or physiological leptin replacement.
(AC) Overnight-fasted plasma insulin (A) and ACTH levels (B) obtained at 12:00 and fasted blood glucose levels (C) over a 3-hour period in either nondiabetic (Veh-veh) or STZ-diabetic rats (within the first 24 hours following STZ) after i.p. administration of either vehicle (STZ-veh) or the glucocorticoid receptor antagonist, mifepristone (STZ-mifepristone; 40 mg/kg) (n = 6–10/group). (D) Daily-fed blood glucose levels (12:00) 3 hours following daily i.p. administration of either vehicle or mifepristone (40 mg/kg) (n = 6–10/group). (EH) Overnight-fasted arterial plasma insulin (E) and leptin levels (F), as well as 21-hour fasted plasma corticosterone and ACTH levels (G) obtained at 15:00 and fasted blood glucose levels (H) over a 6-hour period from nondiabetic (Veh-veh) and STZ-diabetic rats (within the first 24 hours following STZ) during which either vehicle (STZ-veh) or leptin (STZ-lep; 150 μg/kg total) was infused i.v. at a dose designed to raise low plasma leptin levels into the high-normal range (n = 6–8/group). Data represent mean ± SEM. Data were analyzed by 1-way ANOVA with a least significant difference post hoc test. *P < 0.05 vs. Veh-veh; #P < 0.05 vs. STZ-veh.
Figure 1
Figure 1. Hypercorticosteronemia is not required for hyperglycemia in STZ-DM.
(AD) Three-hour fasted plasma insulin (A) and leptin (B), and corticosterone and ACTH levels (C) obtained mid-light cycle (13:00), and daily blood glucose levels (D) in the fed state at 09:00 in nondiabetic, sham-operated controls (Sham-veh) and in STZ-diabetic rats that were either sham-operated (Sham-STZ) or underwent surgical ADX (ADX-STZ) (n = 7–12/group). Data represent mean ± SEM. Data were analyzed by 1-way ANOVA with a least significant difference post hoc test. *P < 0.05 vs. Sham-veh; #P < 0.05 vs. Sham-STZ.

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