Finasteride for androgenetic alopecia is not associated with sexual dysfunction: a survey-based, single-centre, controlled study.

BACKGROUND: The occurrence of sexual dysfunction side-effects associated with finasteride use in men with androgenetic alopecia (AGA) is thought to be less prevalent than is publicized. There is a need to investigate sexual dysfunction among finasteride users with population-based controls. OBJECTIVE: To evaluate the presence of sexual dysfunction in men using finasteride or not using finasteride. METHOD: Adult men visiting a dermatologist's office for any reason were asked to complete a survey including a modified version of the Arizona Sexual Experience Scale (ASEX) to assess the presence of sexual dysfunction with and without finasteride use. RESULTS: Data from 762 men aged 18-82 were collected: 663 finasteride users and 99 non-finasteride users. There were no significant differences between finasteride users and non-user controls in reporting sexual dysfunction using the ASEX. Regression analysis indicated that self-reporting libido loss and reduced sexual performance, not finasteride use, predict a higher ASEX score. CONCLUSION: The use of finasteride does not result in sexual dysfunction in men with AGA. These data are consistent with other large survey-based controlled studies.

Thyroid cytology and the risk of malignancy in thyroid nodules: importance of nuclear atypia in indeterminate specimens.

Fine needle aspiration (FNA) cytology is the best test for malignancy in thyroid nodules. However, cytologic interpretation of FNA specimens is often difficult, especially in the presence of indeterminate microfollicular cytologic patterns, which are thought to suggest follicular neoplasm (adenoma or carcinoma). To assess the risk of malignancy associated with specific cytologic patterns, we correlated preoperative FNA cytologic patterns (n = 484 reports including repeat aspirations) with final histological diagnoses for 368 surgical thyroid specimens obtained during the period 1994-1998. The overall prevalence of malignancy in the surgical specimens was 31% (113 cancers, including 96 papillary and 9 follicular carcinomas). For nodules with benign FNA cytologic diagnoses of nodular goiter and chronic thyroiditis there was a low risk of malignancy (6/99, or 6.1%). Nodules with indeterminate cytologic patterns in the absence of nuclear atypia (i.e., microfollicles without nuclear atypia) had a similarly low malignancy risk (3/46, or 6.5%). In contrast, 31/52 nodules with cytologic nuclear atypia consistent with follicular neoplasm were malignant (60%), including specimens with or without microfollicular cytology. Nodules with frankly malignant cytologic patterns were almost invariably cancer (54/55), and cytologic diagnoses of papillary carcinoma were confirmed at surgery in all 49 cases. These results indicate that indeterminate microfollicular cytologic patterns in the absence of nuclear atypia are associated with a low risk of malignancy, at least in this series. This finding suggests that many nodules with such microfollicular cytology might be managed conservatively with observation. In contrast, cytologic nuclear atypia consistent with a follicular neoplasm confers a high risk of cancer. In addition, frankly malignant cytologic diagnoses, especially papillary carcinoma, are highly reliable, and thus may be used as a guide for planning surgery appropriate for thyroid cancer.

Role of ultrasonography in the diagnosis and management of thyroid cancer.

OBJECTIVE: To review the role of ultrasonography in the detection and management of thyroid cancer. METHODS: Viewpoints are presented on the appropriate applications and the advantages of ultrasonography, based on an extensive personal experience with more than 1,500 ultrasound examinations for assessment of thyroid nodules and for follow-up surveillance of patients with thyroid cancer. RESULTS: Ultrasonography is ideal for thyroid imaging because of the high echogenicity of thyroid tissue, the superficial site of the thyroid that allows the use of high-frequency transducers yielding high resolution, and the low expense compared with other techniques. In patients with a thyroid nodule, ultrasonography can assist in distinguishing benign from malignant disease. Ultrasound studies will characterize the presence of cystic versus solid elements, the degree of echogenicity of solid elements, the existence of calcifications, and the regularity and definition of the nodule borders. Although individual sonographic features of thyroid nodules are not specific for benign or malignant lesions, a constellation of typical features has more diagnostic value. Hypoechogenicity, poorly defined irregular margins, and microcalcifications are characteristics that should increase the index of suspicion for a malignant nodule. Cytologic examination of fine-needle aspirates is the optimal diagnostic test, and ultrasonographic guidance for performance of the aspiration biopsy is often helpful and sometimes critical. Ultrasonography is also useful for detection of cervical lymph node metastatic lesions. Lymph nodes involved with metastatic thyroid cancer tend to become rounded and bulging, and they lose their hilar echoes as their structure becomes disrupted. CONCLUSION: Because of its high resolution and relatively reasonable cost, ultrasonography is valuable in the diagnosis and management of thyroid cancer.

GLUT1 glucose transporter expression in colorectal carcinoma: a marker for poor prognosis.

BACKGROUND: Malignant cells exhibit increased glycolytic metabolism, and in many cases increased glucose transporter gene expression. The authors hypothesized that GLUT1 glucose transporter expression is increased in colorectal carcinoma, and that the degree of expression might have prognostic significance. METHODS: GLUT1 glucose transporter immunostaining was studied in normal colon and benign colon adenomas and in 112 colorectal carcinomas from patients for whom long term clinical outcome was known. RESULTS: GLUT1 immunostaining was absent in normal colorectal epithelium and tubular adenomas, and absent or only weakly apparent in tubulovillous adenomas. The majority of carcinomas (101 of 112; 90%) had GLUT1 immunostaining. Tumors from 92 patients had low GLUT1 expression (< 50% of cells were GLUT1 positive) and 19 of these patients (21%) died of disease during follow-up. In contrast, tumors from 20 patients had high GLUT1 expression (> 50% of cells were GLUT1 positive) and 9 of these patients (45%) died of disease during follow-up. Disease specific mortality was greater in patients with high GLUT1 tumors (relative risk of 2.4; P=0.02). In a multivariate analysis to assess whether high GLUT1 staining correlated with increased mortality independently of Dukes stage, the risk of death from colon carcinoma in the group with high GLUT1 staining was 2.3 times that in the group with low GLUT1 staining, a difference that approached statistical significance (P=0.07). CONCLUSIONS: GLUT1 glucose transporter expression is associated strongly with neoplastic progression in the colon, and assessment of the extent of GLUT1 immunostaining in colorectal carcinoma identifies patients with a poorer prognosis.

GLUT1 glucose transporter: a highly sensitive marker of malignancy in body cavity effusions.

Malignant cells exhibit increased rates of glycolysis and glucose uptake, and several types of cancer have been reported to overexpress the GLUT1 glucose transporter. The diagnosis of malignancy in body cavity effusions remains a dilemma in certain cases, despite recent progress in diagnostic immunocytochemistry. We used immunostaining to detect the facilitative glucose transporter, GLUT1, in cytologic preparations of body cavity effusions and washes. With the use of standard avidin-biotin immunostaining for GLUT1, we examined cell blocks of body cavity effusions or washings from 31 carcinomas, 1 lymphoma, and 25 benign effusions or washes. GLUT1 staining occurred in the malignant cell population in 29 (93.5%) of 31 carcinomatous effusions or washes. The characteristic staining pattern consisted of dense, linear staining of the plasma membrane, with accentuation at cell-cell borders, with or without cytoplasmic staining. Erythrocytes showed positive GLUT1 membrane staining, consistent with previous reports. Of 25 benign effusions, 20 were nonstaining (excepting erythrocytes), and 5 contained rare single mesothelial cells, with equivocal to very weak membrane staining. Staining of these cells was readily distinguishable from the characteristic strong staining of malignant cells, and these cells were easily distinguished from tumor cells by their benign morphologic characteristics. At least three of these latter five specimens were from patients with cirrhosis. In all of the other cases, mesothelial cells, histiocytes, and other inflammatory cells did not stain. These findings suggest that GLUT1 immunostaining could be useful in diagnostic cytopathology. The findings also suggest that enhanced glycolysis, which requires increased glucose transport, might be a survival adaptation for tumor cells in effusions, a significant number of which are hypoxic.

GLUT1 glucose transporter expression in benign and malignant thyroid nodules.

Malignant cells exhibit increased rates of glycolysis and glucose uptake, the latter of which is mediated by glucose transport proteins. Because several types of cancer have been shown to express high levels of the GLUT1 glucose transporter isoform, we hypothesized that expression of GLUT1 might distinguish malignant from benign thyroid tissue. Archival thyroid tissue obtained at surgery was immunostained for GLUT1 protein. There were 38 benign cases (24 follicular adenoma, 1 Hürthle cell adenoma, 8 nodular goiter, 3 Hashimoto's thyroiditis, 2 Graves' disease) and 28 cases of thyroid cancer (17 papillary and its follicular variant, 6 follicular, 1 Hurthle cell, 2 anaplastic, 2 medullary). Normal thyroid tissue adjacent to nodules showed no thyrocyte staining in any case. No GLUT1 staining was seen in thyrocytes in benign nodular tissue, except for a single case of Hashimoto's thyroiditis in which a few Hurthle cells showed weak staining. Among the thyroid cancers, 13 of 28 (46%) showed tumor cell GLUT1 staining in at least some areas. This included 9 of 17 cases of papillary carcinoma and its follicular variant, 2 of 6 cases of follicular carcinoma and 2 of 2 cases of anaplastic carcinoma. Tumor cell GLUT1 staining was seen in two patterns: circumferential plasma membrane staining focally within the tumor, or asymmetric staining of the basilar aspect of tumor cells adjacent to stroma in some cases of papillary carcinoma. We conclude that GLUT1 expression is frequently detectable by immunostaining in thyroid cancer, but not in benign nodules or normal thyroid. GLUT1 expression may be a clinically useful molecular marker for thyroid cancer.

Thyroid nodules and the detection of thyroid cancer.

Although thyroid nodules are common and cause concern about possible malignancy, relatively few are thyroid cancers, and relatively few thyroid cancers are lethal. These considerations justify a selective approach in recommending surgical excision of nodules. Selection of patients should be based on assessment of cancer risk factors in the history and physical examination, and most importantly on fine-needle aspiration biopsy of the thyroid with cytologic examination. Other testing in most cases should be limited to serum thyroid-stimulating hormone and antithyroid antibodies and a thyroid sonogram. With the results of this evaluation a recommendation can be made for either immediate surgery or observation. This approach should reduce the number of operations for benign thyroid nodules and avoid excessive diagnostic testing.

Thyroid hormone increases the partitioning of glucose transporters to the plasma membrane in ARL 15 cells.

The stimulation of glucose transport by 3,5,3'-triiodo-L-thyronine (T3) in the liver-derived ARL 15 cell line is only partly attributable to increased GLUT-1 glucose transporter gene expression. To test the hypothesis that T3 increases the partitioning of GLUT-1 to the cell surface, we quantitated surface GLUT-1 using the photolabel ATB-[3H]BMPA. In control cells only approximately 20% of total cellular GLUT-1 was present at the cell surface. T3 treatment (100 nM) for 6 h increased the rate of 2-deoxy-[3H]glucose (2-DG) uptake by 30, 92, and 95% in three experiments and increased surface GLUT-1 photolabeling by 17, 81, and 72%, respectively, with no increase in total cellular GLUT-1. T3 treatment for 48 h increased 2-DG uptake by 143, 172, and 216% in three experiments and increased cell surface GLUT-1 photolabeling by 88, 161, and 184%, respectively, with smaller increases in total cellular GLUT-1. T3 treatment for 48 h thus increased the fraction of cellular GLUT-1 at the plasma membrane from 21 +/- 2 to 35 +/- 3% (SE). We conclude that most of the early (6-h) stimulation of glucose transport by T3 in ARL 15 cells is mediated by an increase in the partitioning of GLUT-1 to the plasma membrane. With more chronic T3 treatment (48 h), the enhanced surface partitioning of GLUT-1 is persistent and is superimposed on an increase in total cellular GLUT-1, accounting for a further increase in glucose transport.

The human blood-brain barrier glucose transporter (GLUT1) is a glucose transporter of gray matter astrocytes.

Human and monkey brain sections were examined by immunohistochemical light and electron microscopy to determine the distribution of GLUT1, a glucose transporter isoform associated with erythrocytes and endothelial cells of the human blood-brain barrier. Protein immunoblotting of fractionated human brain membranes was performed to determine the distribution of molecular forms of the transporter. GLUT1 staining was abundant in erythrocytes and cerebral endothelium of gray and white matter but was also present diffusely in gray matter neuropil when viewed by light microscopy. Immunoelectron microscopy confirmed the gray matter and vascular localization of GLUT1, with specific GLUT1 staining seen in erythrocytes, gray and white matter endothelial cells, astrocyte foot processes surrounding gray matter blood vessels, and in astrocyte processes adjacent to synaptic contacts. No astrocytic staining was identified in white matter. Astrocyte GLUT1 staining was identified only in mature gray matter regions; undifferentiated regions of preterm (22-23 weeks gestation) cortex had GLUT1 staining only in blood vessels and erythrocytes, as did germinal matrix. Immunoblots of adult human frontal cortex revealed that two forms of GLUT1 (45 and 52 kDa) were present in unfractionated brain homogenates. Immunoblots of vessel-depleted frontal lobe revealed only the 45 kDa form in gray matter fractions, and depleted in membranes prepared from white matter regions. We conclude that the GLUT1 isoform of glucose transporter is present both in endothelium of the blood-brain barrier and in astrocytes surrounding gray matter blood vessels and synapses. Furthermore, the form present in astrocytes is likely to have a lower molecular weight than the form found in cerebral endothelium. The GLUT1 transporter may play an important role not only in astrocyte metabolism, but also in astrocyte-associated pathways supporting neuronal energy metabolism.

Glucocorticoid-induced insulin resistance: dexamethasone inhibits the activation of glucose transport in rat skeletal muscle by both insulin- and non-insulin-related stimuli.

To test the hypothesis that glucocorticoids inhibit muscle glucose transport apart from changes in early insulin-signaling events, we determined the effect of glucocorticoid treatment on the activation of glucose transport by both insulin and non-insulin-related stimuli (insulin-like growth factor [IGF] I and hypoxia) in rat skeletal muscle. Male Sprague-Dawley rats were treated with dexamethasone (Dex) (0.8 mg/kg for 2 days) and compared with pair-fed controls. 2-[3H]deoxyglucose (2-[3H]DG) uptake in isolated soleus muscles was measured under conditions in which uptake reflects glucose transport activity. In control muscles, 2-[3H]DG uptake was stimulated 10-fold by insulin (10 nmol/l) or IGF-I (50 nmol/l) and sixfold by hypoxia. Dex treatment decreased 2-[3H]DG uptake at all concentrations of insulin tested, reducing maximal insulin-stimulated 2-[3H]DG uptake by 41 +/- 11% (mean +/- SE, P < 0.05) and basal 2-[3H]DG uptake by 38 +/- 6% (P < 0.01). Dex treatment also inhibited 2-[3H]DG uptake at all concentrations of IGF-I tested, reducing maximal IGF-I-stimulated 2-[3H]DG uptake by 29 +/- 2% (P < 0.01), and decreased hypoxia-stimulated 2-[3H]DG uptake by 61% (P < 0.01). Dex treatment increased soleus GLUT4 protein content by 11%. Thus, Dex treatment reduces basal glucose transport and decreases the maximal response of skeletal muscle glucose transport to insulin, the related hormone IGF-I, and the non-insulin-related stimulus hypoxia. These findings support the hypothesis that, in addition to altering early insulin-signaling events, glucocorticoids may also act by inhibiting the glucose transport system, per se, perhaps by affecting GLUT4 subcellular trafficking.

Thyroid hormone increases basal and insulin-stimulated glucose transport in skeletal muscle. The role of GLUT4 glucose transporter expression.

In skeletal muscle, the main site of insulin-mediated glucose disposal, the major muscle glucose transporter GLUT4 is induced by thyroid hormone. To test the hypothesis that thyroid hormone alters muscle glucose transport, we examined the effect of L-triiodothyronine (T3) on glucose transport and GLUT4 protein content in isolated rat skeletal muscles. Euthyroid rats were treated with or without T3 for 3 days, and [3H]2-deoxy-D-glucose (2-DG) uptake in soleus and extensor digitorum longus (EDL) muscles was measured under conditions in which transport was rate limiting for uptake in the absence or presence of 10 nmol/l insulin. In control animals, insulin stimulated 2-DG uptake sevenfold in soleus and fivefold in EDL. T3 treatment increased basal 2-DG uptake in soleus and EDL by 115 +/- 29% and 136 +/- 23%, respectively, and increased insulin-stimulated 2-DG uptake in soleus and EDL by 55 +/- 9 and 42 +/- 12%, respectively. Immunoblot analysis revealed that T3 treatment increased GLUT4 protein content in soleus by 43 +/- 6% and in EDL by 56 +/- 13%. These data demonstrate that thyroid hormone increases basal and insulin-stimulated glucose transport in skeletal muscle. The percentage increase in insulin-stimulated transport in T3-treated muscles is similar to the increase in GLUT4 protein content, whereas the percentage change in basal transport greatly exceeds the change in GLUT4. Thus, increased insulin-stimulated glucose transport in T3-treated muscle can be accounted for by the induction of GLUT4 protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Regulation of GLUT2 glucose transporter expression in liver by thyroid hormone: evidence for hormonal regulation of the hepatic glucose transport system.

The extent to which the glucose transport system in hepatocytes is regulated in states of altered hepatic glucose metabolism is unclear. Because thyroid hormone is known to increase hepatic glucose output, we hypothesized that thyroid hormone might up-regulate expression of the principal hepatic glucose transporter, GLUT2, facilitating increased glucose efflux across the hepatocyte plasma membrane. GLUT2 protein concentration in crude liver membranes was twice as high in chronically hyperthyroid vs. hypothyroid animals, with intermediate levels in euthyroid controls. Similar results were obtained for total GLUT2 protein, measured in detergent extracts of liver. Northern analysis of total liver RNA demonstrated parallel changes in GLUT2 messenger RNA (mRNA) concentration per g tissue (hypothyroid, 76 +/- 6%; euthyroid, 100 +/- 11%; hyperthyroid, 158 +/- 12%; data expressed as percentage of mean euthyroid values). The daily administration of a large dose of T3 (100 micrograms/100 g BW) to hypothyroid rats caused a prompt increase in hepatic GLUT2 mRNA concentration (2.5-fold at 1 day), but only a modest and gradual change in hepatic GLUT2 protein concentration (+40% at 4 days), suggesting that the GLUT2 protein in liver may have a long half-life. We conclude that thyroid hormone regulates hepatic GLUT2 mRNA and protein expression. Up-regulation of GLUT2 protein expression by thyroid hormone may serve to facilitate increased hepatic glucose output. These results suggest that the hepatic GLUT2 glucose transporter, like the enzymes of gluconeogenesis and glycolysis, is indeed a regulatory target for hormones that control hepatic glucose metabolism.

Effects of thiazolidinediones on glucocorticoid-induced insulin resistance and GLUT4 glucose transporter expression in rat skeletal muscle.

Thiazolidine-2,4-diones, a new class of oral antihyperglycemic agents, have been shown to be effective in improving insulin sensitivity in a number of animal models of insulin resistance, and recent investigation has suggested that the mechanism of action of these agents may include upregulation of the GLUT4 (insulin-regulatable) glucose transporter. We studied the efficacy of two of these agents, pioglitazone and englitazone, in preventing glucocorticoid-induced insulin resistance in rats, and examined the potential role of changes in GLUT4 expression in their action in skeletal muscle. Rats were treated with 0.1 mg/d dexamethasone for 6 to 7 days with or without either pioglitazone (10 mg/kg/d) or englitazone (50 mg/kg/d). Both thiazolidinediones decreased the elevated fasting serum glucose and insulin levels in dexamethasone-treated animals. Dexamethasone treatment alone decreased insulin-stimulated 2-deoxyglucose uptake into isolated soleus muscles to 35% of control values. The addition of pioglitazone or englitazone increased insulin-stimulated 2-deoxyglucose uptake by 74% and 57%, respectively. Whereas dexamethasone treatment alone increased GLUT4 protein content in rat soleus muscle by 25%, additional treatment with pioglitazone or englitazone did not further significantly alter GLUT4 levels. We conclude that thiazolidinediones enhance insulin responsiveness in skeletal muscle during glucocorticoid treatment, but their mode of action in this setting is not via upregulation of GLUT4 expression.

Tissue distribution of the human GLUT3 glucose transporter.

The tissue distribution of the GLUT3 glucose transporter protein was examined in human tissues using a rabbit antiserum directed against the C-terminal peptide sequence of human GLUT3. This anti-serum was shown to recognize the human GLUT3 protein in Chinese hamster ovary cells transfected with GLUT3 cDNA and to immunoprecipitate an authentic glucose transport protein in brain and testis membranes, as assessed by glucose-inhibitable photolabeling with [3H] cytochalasin-B. The GLUT3 protein, migrating with an apparent mol wt of approximately 48 kilodaltons, was strongly expressed in brain and testis membranes as well as in spermatozoa. It was not detectable in membranes from erythrocytes, adipocytes, heart, skeletal muscle, liver, kidney, spleen, thyroid, and prostate. Very low levels may be present in placenta. In brain, GLUT3 protein was strongly expressed in grey matter regions and was only weakly expressed in white matter, suggesting that it may be important in providing glucose to regions of high metabolic activity, i.e. to areas associated with synaptic transmission. None was found in peripheral (femoral) nerve. It appeared to be stable for up to 47 h in autopsy brain tissue kept at 4 C. The tissue distribution of human GLUT3 protein thus appears to be highly restricted (brain and testis/spermatozoa), in contrast with a previous report. Its function may be to provide a high affinity glucose transport system in cells that are highly dependent on glucose as a fuel source.

Insulin resistance in polycystic ovary syndrome: decreased expression of GLUT-4 glucose transporters in adipocytes.

We have found that women with polycystic ovary syndrome (PCOS) have decreased sensitivity and responsiveness to insulin. The present study was performed to determine whether this impaired insulin responsiveness was associated with diminished GLUT-4 glucose transporter content in adipocytes. Insulin-stimulated glucose transport and GLUT-4 abundance were measured in abdominal adipocytes from obese (n = 9) and lean (n = 7) PCOS as well as obese (n = 8) and lean (n = 8) control women matched for age and weight. No woman had impaired glucose tolerance. The maximal insulin-stimulated increment in adipocyte glucose transport was independently decreased by obesity and by PCOS. As expected, GLUT-4 content in adipocyte membranes was decreased in obesity (by 40%, P < or = 0.01). GLUT-4 content was also significantly decreased in PCOS (by 36%, P < or = 0.01), independent of obesity. There was a highly significant correlation (R = 0.66, P < = 0.001) between GLUT-4 content and insulin-stimulated glucose transport in adipocytes from individual women across the study population. We conclude that the diminished adipocyte insulin responsiveness in PCOS is associated with decreased GLUT-4 abundance. This represents a newly recognized phenotypic feature of the insulin resistance of PCOS. Moreover, in human adipocytes, GLUT-4 abundance is highly correlated with insulin responsiveness.

Glucose transport stimulation by thyroid hormone in ARL 15 cells: partial role of increased GLUT1 glucose transporter gene transcription.

We have previously reported that the stimulation of glucose transport by thyroid hormone in the rat liver-derived ARL 15 cell line is attributable, at least in part, to increased abundance of cellular glucose transporters with a corresponding increase in the mRNA coding for the GLUT1 glucose transporter isoform. To elucidate further the mechanism by which thyroid hormone increases glucose transport, we examined the time-course of the effect of L-triiodothyronine (T3) on 3H-2-deoxyglucose uptake, GLUT1 protein abundance, and GLUT1 mRNA abundance in ARL 15 cells. At 6 h of T3 treatment, 3H-2-deoxyglucose uptake was increased by 40 +/- 11%, whereas the abundance of GLUT1 protein in cell extracts had not yet changed at this time. At 48 h, GLUT1 protein was increased by 58 +/- 10%, whereas 3H-2-deoxyglucose uptake at this time was increased by 116 +/- 14%. GLUT1 mRNA levels rose within 4 h of T3 treatment, preceding the increase in GLUT1 protein, and more than doubled by 24 h. In additional experiments to determine the mechanism by which T3 increases GLUT1 mRNA, T3 treatment for 48 h increased the rate of transcription of the GLUT1 gene, determined by nuclear run-on analysis, by 55 +/- 11%. T3 treatment did not significantly alter the half-life of GLUT1 mRNA. In the presence of inhibitors of protein synthesis, GLUT1 mRNA increased at 6 h (5-7-fold), but there was no further induction of this mRNA by T3 in the presence of these inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential regulation of glucose transporter isoforms by thyroid hormone in rat heart.

Since thyroid hormone stimulates cardiac metabolism, for which glucose is an important fuel, we examined the effects of thyroid hormone on glucose transporter gene expression in rat heart. Treatment of hypothyroid animals with T3 for up to 6 days caused a 2-fold increase in GLUT4 mRNA at 1 day, and a 4-fold increase at 6 days (per unit DNA). GLUT4 protein, however, was not increased. In contrast, GLUT1 mRNA was transiently decreased by T3 treatment at 1 and 3 days, but returned to normal by 6 days. Concomitantly, GLUT1 protein decreased to 18% of the control value at 6 days. In chronically hypothyroid or hyperthyroid rats, GLUT4 mRNA varied directly with thyroid status, but GLUT4 protein was invariant, consistent with the acute effects of T3 treatment. Moreover, hypothyroidism increased GLUT1 mRNA and protein expression. We conclude that, in contrast to previous observations in skeletal muscle, GLUT4 protein content in rat heart is not altered by thyroid hormone. Cardiac GLUT1 expression is increased in hypothyroidism, and suppressed by thyroid hormone, at both the protein and mRNA levels. The observed discrepancy between GLUT4 mRNA and protein levels suggests that post-transcriptional regulatory events play a major role in GLUT4 expression in rat heart.

Role of glucose transporters in glucocorticoid-induced insulin resistance. GLUT4 isoform in rat skeletal muscle is not decreased by dexamethasone.

The diabetogenic effects of glucocorticoid excess are due in part to peripheral resistance to insulin. To test the hypothesis that glucocorticoid-induced peripheral insulin resistance might be attributable to a decreased number of glucose transporters, we examined the effects of dexamethasone treatment on the expression of the GLUT4 (insulin regulatable) glucose transporter in skeletal muscle, the major site of insulin-mediated glucose uptake. Dexamethasone treatment of rats (1 mg/day for 1 wk) induced hyperglycemia and hyperinsulinemia. At dosages of either 0.1 or 1 mg/day, insulin-stimulated 2-deoxyglucose uptake in isolated soleus muscle was reduced by greater than or equal to 50%, demonstrating the presence of insulin resistance in skeletal muscle. Immunoblots of crude membranes from deep quadriceps muscle showed that dexamethasone treatment (1 mg/day) increased the amount of GLUT4 protein by 84%. GLUT4 mRNA abundance was similarly increased when expressed per unit RNA but was unchanged when expressed on a DNA basis because the tissue RNA content was decreased by dexamethasone. In contrast to quadriceps, GLUT4 protein concentration in soleus and extensor digitorum longus extracts was not significantly increased by dexamethasone treatment. Because glucocorticoids cause selective atrophy of type IIb muscle fibers, which express relatively less GLUT4 protein, the apparent increase in GLUT4 content in quadriceps muscle from dexamethasone-treated animals may have resulted from inadvertent increased sampling of GLUT4-enriched type I and IIA fibers, caused by a glucocorticoid-induced decrease in the relative mass of the GLUT4-poor type IIb fibers. We conclude that glucocorticoids do not decrease GLUT4 content in skeletal muscle and that glucocorticoid-induced insulin resistance in this tissue is not due to suppression of glucose transporter gene expression.