Steroids Help Explain Why Obesity Can Lead to Diabetes and Hypertension

A type of steroid called glucocorticoid has been shown to cause diabetes and hypertension (persistent high blood pressure). People who suffer from obesity are also known to produce significantly higher levels of glucocorticoids naturally than people of average weight.

Glucocorticoids are often prescribed to patients with asthma, skin disorders, malignancies, chronic pain, and other afflictions, due to its anti-inflammatory properties. The bad side: diabetes and hypertension are well-chronicled complications of this popular steroid. Past research gives “conservative” estimates of 25% for people treated with glucocorticoids developing type 2 diabetes, and up to 20% suffering from hypertension.

The exact reason for glucocorticoid steroids triggering diabetes and hypertension is unknown. It is known that obese individuals have excess glucocorticoids, and obesity often leads to insulin resistance, a condition associated with diabetes and hypertension.

A study was conducted on several groups of mice to show the connection between glucocorticoids and insulin-resistance. The study, conducted at the University of Washington School of Medicine in St. Louis, found that the protein peroxisome proliferator-activated receptor-alpha (PPAR-alpha), which is present in glucocorticoids, often leads to insulin resistance.

Mice and humans do have differences in their metabolic functions (though they are surprisingly parallel in many ways), but this “preliminary” study of mice suggests that there will indeed be a strong connection between certain types of steroids and insulin resistance found in humans as well.

One of the potentially influential conclusions of such a study would be that glucocorticoids, while very beneficial in treating numerous ailments, can often just be a trade-off in eliminating one ailment while acquiring another (diabetes and hypertension). In addition, and perhaps more importantly, understanding why this is the case would consequently lead to a further understanding of why obesity, an increasingly common worldwide disorder, leads to insulin resistance, and therefore diabetes and hypertension.

Source: Defeat Diabetes Foundation: Bernal-Mizrachi, Carlos. Weng, Sherry. Feng, Chu, et al. Nature Medicine. “Dexamethasone induction of hypertension and diabetes is PPAR-alpha dependent in LDL receptor-null mice.” August 2003.