Mechanisms of glucocorticoid-induced insulin resistance: focus on adipose tissue function and lipid metabolism.

[cushing syndrome]

Glucocorticoids (GCs ) are critical in the regulation of the stress response , inflammation and energy homeostasis . Excessive GC exposure results in whole-body insulin resistance , obesity , cardiovascular disease , and ultimately decreased survival , despite their potent anti-inflammatory effects . This apparent paradox may be explained by the complex actions of GCs on adipose tissue functionality . The wide prevalence of oral GC therapy makes their adverse systemic effects an important yet incompletely understood clinical problem . This article reviews the mechanisms by which supraphysiologic GC exposure promotes insulin resistance , focusing in particular on the effects on adipose tissue function and lipid metabolism .