Adipose Tissue and Adrenal Glands: Novel Pathophysiological Mechanisms and Clinical Applications

Figure 1

Adipocytes do not have significant HSD2 activity and yet maintain a relatively high level of HSD1 activity, allowing for increased intracellular active cortisol relative to inactive cortisone. Cortisol exerts its effects in adipocytes by binding to both glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) with similarly high affinity. Obesity has been associated with increased adipose HSD1 activity, further increasing intra-adipocyte cortisol concentrations.