| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Department of Neuroendocrinology (K.M., T.F., D.M., H.H., F.K.), Yokohama City University Graduate School of Medicine, Kanazawa-ku, Yokohama 236-0004; and International University of Health and Welfare (F.K.), Amity-Nogizaka Minamiaoyama, Minato-ku, Tokyo 107-0062, Japan
Address all correspondence and requests for reprints to: Dr. Toshiya Funabashi, Department of Neuroendocrinology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. E-mail: toshiya{at}med.yokohama-cu.ac.jp.
| Abstract |
|---|
|
|
|---|
| Introduction |
|---|
|
|
|---|
Recent studies have identified distinct neurons in the lateral hypothalamic area (LHA) containing melanin-concentrating hormone (MCH) neurons (13) that generate hunger (14, 15). Neuropeptide Y (NPY), which is produced by neurons in the arcuate nucleus of the hypothalamus (16), is another neuropeptide that prominently induces feeding (17, 18). The hypothalamic circuit between the LHA and the arcuate nucleus is thus an important component of the central system controlling feeding behavior (19). In this circuit, judging from studies that genetically disrupted the orexigenic neuropeptides, MCH neurons in the LHA play a key role. Mice lacking the gene encoding MCH are lean (20), whereas mice overexpressing the MCH gene are susceptible to obesity (21). It has also been suggested that MCH neurons are involved in the glucosensing system, because hypothalamic MCH mRNA levels are increased by hypoglycemic conditions such as fasting, insulin injection, and 2-deoxy-D-glucose treatment (14, 22, 23). In contrast to MCH, mice lacking the gene encoding prepro-orexin or NPY display normal growth (24, 25, 26).
It is probable that sex differences in feeding behavior are at least in part attributable to sex differences in the neurons involved in feeding behavior. Because MCH neurons in the LHA play an important role in the regulation of feeding behavior, we hypothesized that there might be a sex difference in the activity of MCH neurons in the LHA during fasting and/or after glucose injection. In support of this view, hypothalamic MCH neurons are suggested to be involved in estrogen-induced weight loss in male rats (27). We therefore examined the response of MCH neurons to an iv injection of glucose after 48 h of fasting in adult male and female rats, using the expression of phosphorylated cAMP response element-binding protein (pCREB) immunoreactivity as a marker of neural activity. On the assumption that a sex difference in MCH neurons existed, we also examined whether it could be affected by gonadal steroid hormones such as testosterone and/or estrogen.
In the present study, we used pCREB as a marker for neural activity increased of the generally used c-Fos, because an increase in the expression of c-Fos needs transcription and/or translation to occur (28), it takes a long time to see changes, and it would be difficult to examine acute changes in response to glucose. In contrast, CREB is a constitutively expressed transcription factor and can be immediately activated by phosphorylation via a cAMP- and calcium-dependent cascade (29, 30). Thus, we thought that pCREB was a suitable marker to examine neural activity that changes within a short period in response to dynamic changes such as blood glucose concentrations.
| Materials and Methods |
|---|
|
|
|---|
Determination of blood glucose and insulin concentrations
To determine changes in blood glucose and insulin concentrations after glucose injection (400 mg/kg), intact males, orchidectomized (ORX) males, females at proestrus and diestrus 2, and ovariectomized (OVX) females were implanted with a silicone cannula in the right atrium under ether anesthesia. Male and female rats were castrated 4 wk before the experiment. After cannula implantation, they were fasted for 48 h and injected with 400 mg/kg glucose dissolved in 200 µl saline after the first blood sampling of 100 µl. Control rats were injected with the same volume of saline. Thereafter, blood was sampled 5, 10, 15, 30, 60, and 120 min after the injection though the same cannula. An equal volume of heparinized saline (2 IU/ml) was injected after each sampling. As another control, blood samples were obtained from intact males, ORX males, females at proestrus, and OVX females that were not fasted. Blood glucose concentrations were determined with an instant blood glucose assay apparatus (ACCU-CHEK Comfort, Roche, Tokyo, Japan). Serum insulin concentrations were measured with an ELISA kit (Morinaga Institute of Biological Sciences, Yokohama, Japan).
Experiment 1: sex difference in the activity of MCH neurons
To determine whether there is a sex difference in the activity of MCH neurons, some male and female rats were fed normally and injected iv with 200 µl saline (Fed+Saline group), and other male and female rats were fasted for 48 h and given an iv injection of 200 µl saline (Fast+Saline group) or glucose (Fast+Glucose group; 400 mg/kg) dissolved in 200 µl saline at 10001200 h. The injection was made through the silicon cannula in the right atrium as described above. The dose of glucose used in the present study was based on a previous study which showed that this treatment could reverse the inhibition of pulsatile LH secretion caused by insulin-induced hypoglycemia (31). For females, three groups, composed of rats at diestrus 2 (D2 group), proestrus (P group), or estrus (E group), were prepared to check the effect of the stage of the estrous cycle. The rats in the D2 group had been fasted from the day of estrus, those in the P group had been fasted from the day of last diestrus 1, and those in the E group had been fasted from the day of last diestrus 2. Thus, 12 groups of rats (four groups containing three treatment groups each) were prepared, and they were processed blindly for immunohistochemistry.
In all groups, rats were killed 5 min after saline or glucose injection by an iv injection of an overdose of pentobarbital (100 mg/kg). Perfusion through the cardiac ventricle was quickly started with 2% paraformaldehyde and 4% acrolein in phosphate buffer (PB; pH 7.5) at approximately 4 C. After perfusion, the brains were removed from the cranium, fixed overnight at 4 C in PB containing 2% paraformaldehyde, and incubated overnight at 4 C in 30% sucrose in PB. The brains were then frozen with powdered dry ice and stored at 70 C until immunohistochemical processing.
Experiment 2: time-dependent changes in the activity of MCH neurons after glucose injection
To examine time-dependent changes in the activity of MCH neurons after iv glucose injection, male rats were fasted for 48 h and injected iv with glucose (400 mg/kg) dissolved in 200 µl saline at 10001200 h. Rats were killed 15, 30, and 60 min after glucose injection (Fast+Glucose 15 min group, Fast+Glucose 30 min group, and Fast+Glucose 60 min group) by iv injection of an overdose of pentobarbital. Female rats at diestrus 2, which had been fasted for 48 h from the day of estrus, were similarly killed. All subsequent procedures to obtain brains were as described for experiment 1.
Experiment 3: effects of testosterone and estrogen on the response of MCH neurons to glucose
To determine whether gonadal steroid hormones affected the response of MCH neurons to glucose, male and female rats were castrated under ether anesthesia and used for the experiment 4 wk later. ORX and OVX rats were implanted sc with a silicone tube (inside diameter, 2.0 mm; outside diameter, 3.0 mm; length, 30 mm) containing 100% testosterone crystals (ORX+T group and OVX+T group), a silicone tube (inside diameter, 2.0 mm; outside diameter, 3.0 mm; length, 15 mm) containing 20% 17ß-estradiol crystals (ORX+E2 group and OVX+E2 group), or a silicone tube (inside diameter, 2.0 mm; outside diameter, 3.0 mm; length, 30 mm) containing cholesterol alone (ORX group and OVX group) as a control. All silicone tubes had been previously soaked in saline for more than 24 h to facilitate rapid hormone release. It was shown previously that a tube containing this dose of 17ß-estradiol produced a serum 17ß-estradiol concentration equivalent to that observed at proestrus in intact female rats (32), and a tube containing testosterone produced a serum testosterone concentration equivalent to that observed in intact male rats (33). After implantation of the tubes, some rats were fed normally, and other rats were fasted for 48 h. Normally fed rats were injected iv with 200 µl saline (Fed+Saline group), and fasted rats were injected iv with 200 µl saline (Fast+Saline group) or glucose (Fast+Glucose group; 400 mg/kg) dissolved in 200 µl saline at 10001200 h. All rats were killed 5 min after iv injection. Thus, a total of 18 groups of rats (six groups containing three treatment groups each: ORX, ORX+T, ORX+E2, OVX, OVX+T, and OVX+E2 groups x Fed+Saline, Fast+Saline, and Fast+Glucose groups) was prepared. All subsequent procedures to obtain brains were as described for experiment 1.
Immunohistochemistry
Thirty-micrometer frozen coronal sections were cut with a Bright cryostat (Jencons Ltd., Leighton Buzzard, UK), and every fourth section was used for the study. The sections were incubated with 1% sodium borohydride in PBS and then with 0.3% H2O2 in 20% methanol in PBS. They were incubated overnight with rabbit polyclonal antibody to pCREB diluted 1:900 (Cell Signaling Technology, Beverly, MA) in PBS containing 1.5% normal goat serum and 0.1% Triton X-100. The next day they were incubated with biotinylated antirabbit IgG diluted 1:200 in PBS containing 1.5% normal goat serum and 0.05% Triton X-100, and thereafter incubated with streptavidin-biotin-peroxidase complex (Vectastain Elite ABC Kit, Vector Laboratories, Inc., Burlingame, CA). Bound peroxidase was visualized by incubating sections for 30 min in 0.05% 3,3'-diaminobenzidine with H2O2. For double staining, sections were then incubated overnight with rabbit polyclonal antibody to MCH diluted 1:1800 (Phoenix Pharmaceuticals, Belmont, CA) in PBS containing 1.5% normal goat serum and 0.1% Triton X-100. They were additionally incubated with biotinylated antirabbit IgG diluted 1:200 in PBS containing 1.5% normal goat serum and 0.05% Triton X-100, then with Cy3-labeled streptavidin (Amersham Biosciences, Little Chalfont, UK). Finally, they were mounted on glass slides, dehydrated in graded alcohol, cleared in xylene, and coverslipped with Permount (Fisher Scientific, Fairlawn, NJ). A total of eight series of immunohistochemical procedures was performed, and in each of them, the incubation time of 3,3'-diaminobenzidine staining and other experimental conditions were checked carefully for reproducibility.
Histological analysis
The counting was performed by an investigator blind to the experimental conditions and expectations. We initially used every fourth section through the LHA, and thus approximately 10 sections/rat were stained with MCH and pCREB antibodies. Using a fluorescence microscope, five sections per rat were finally selected for counting MCH-immunoreactive cells (MCH neurons) and pCREB-immunoreactive cells (pCREB cells) in the dorsolateral hypothalamic group of the LHA, because the distribution of MCH neurons varies from anterior to posterior in the diencepalon, and this group of the LHA comprises the numerically predominant grouping of MCH-expressing cells in the diencephalon (13). Sections were carefully matched across all animals in all experimental groups. The number of MCH neurons in the LHA (square region of 1.7 x 1.0 mm) was counted bilaterally with a fluorescence microscope at 20 x 10 magnification. MCH cells in which a nucleus was clearly visible and surrounded by fluorescent cytoplasmic staining were counted. In the same sections, pCREB cells were also observed, and the number of MCH neurons expressing pCREB-immunoreactive nuclei (double-stained neurons; Fig. 1
) was counted. Cells were defined as double stained for MCH and pCREB when a blue-black nucleus was surrounded by fluorescent cytoplasm at 20 x 10 magnification. Then the average ratio (percentage) of the number of double-stained neurons to the number of MCH neurons in each rat was calculated. Both the average number of MCH neurons per section in each rat and the average percentage of double-stained neurons per section in each rat were used for statistical analysis. In male rats and female rats of the P group in experiment 1, we counted the number of pCREB cells in the LHA.
|
| Results |
|---|
|
|
|---|
|
|
|
In all Fed+Saline groups, pCREB cells with blue-black nuclei were scattered in the LHA and the arcuate nucleus of the hypothalamus (data not shown), and the ratio of double-stained neurons was approximately 10% (Fig. 2
).
|
In the Fast+Glucose group, the number of pCREB cells in the LHA varied among animal groups (data not shown). Post hoc comparison in the male group showed a significantly greater ratio of double-stained neurons in the Fast+Glucose group than in the Fed+Saline group (P < 0.05), but there was no significant difference between the Fast+Glucose group and the Fast+Saline group, indicating that glucose injection did not affect the increase in the ratio of double-stained neurons caused by fasting in intact male rats (Fig. 2
). In contrast, pCREB cells were relatively few in the LHA in all female groups after glucose injection (data not shown). Post hoc comparisons in all female groups showed a significantly smaller ratio of double-stained neurons in the Fast+Glucose group than in the Fast+Saline group (Fig. 2
; P < 0.05). In both the P and E groups, the ratio of double-stained neurons did not differ between the Fast+Glucose group and the Fed+Saline group, indicating that glucose injection completely blocked the fasting-induced increase in the ratio of double-stained neurons (Fig. 2
). In the D2 group, in contrast, the ratio of double-stained neurons was significantly greater in the Fast+Glucose group than in the Fed+Saline group (Fig. 2
; P < 0.05), indicating that 48 h after fasting, glucose injection was less effective in the D2 group than in the P and E groups.
Experiment 2
The data from experiment 2 were analyzed with the data from experiment 1 (the Fast+Saline and Fast+Glucose groups of intact male rats, and the D2 group of female rats; Fig. 3
).
|
In the D2 group of female rats, pCREB cells in the LHA were few in the Fast+Glucose 15 min group, and the ratio of double-stained neurons was approximately 10% (Fig. 3
, lower panel). The number of pCREB cells was relatively large in the Fast+Glucose 30 min group and the Fast+Glucose 60 min group. One-way ANOVA showed a significant effect of treatment on the ratio of double-stained neurons in the D2 group (F4,19 = 11.30; P < 0.01). Post hoc comparison in the D2 group showed a significantly smaller ratio of double-stained neurons in the Fast+Glucose 5 min group and the Fast+Glucose 15 min group than in the Fast+Saline group (P < 0.05). These results indicated that glucose injection significantly decreased the ratio of double-stained neurons 5 and 15 min after injection in female rats, but the effect disappeared 30 min after injection.
Experiment 3
In all Fed+Saline groups and Fast+Saline groups, the ratios of double-stained neurons were approximately 10% and 40%, respectively (Fig. 4
). One-way ANOVA showed a significant effect of treatment on the ratio of double-stained neurons in each animal group: the ORX group (F2,10 = 15.14; P < 0.001), the ORX+T group (F2,10 = 4.61; P < 0.05), the ORX+E2 group (F2,12 = 38.14; P < 0.0001), the OVX group (F2,9 = 6.62; P < 0.05), the OVX+T group (F2,11 = 11.03; P < 0.005), and the OVX+E2 group (F2,9 = 6.41; P < 0.05). In all animal groups, post hoc comparison showed a significantly greater ratio of double-stained neurons in the Fast+Saline group than in the Fed+Saline group (Fig. 4
; P < 0.05). Because the ratio of double-stained neurons in the Fed+Saline groups and the Fast+Saline groups in experiment 3 was comparable to that in experiment 1, these results indicated that 48-h fasting significantly increased the ratio of double-stained neurons regardless of the presence or absence of gonadal steroid hormones.
|
In the OVX+T and OVX+E2 groups, post hoc comparisons showed that the ratio of double-stained neurons in the Fast+Glucose group was significantly smaller than that in the Fast+Saline group (P < 0.05) and that the ratio of double-stained neurons in the Fast+Glucose group was not different from that in the Fed+Saline group (P > 0.5). In the OVX groups, post hoc comparison showed that the ratio of double-stained neurons in the Fast+Glucose group was not different from that in the Fast+Saline group (P > 0.5) and that the ratio of double-stained neurons in the Fast+Glucose group was significantly larger than that in the Fed+Saline group (P < 0.05). These results indicated that ovariectomy increased the ratio of double-stained neurons 5 min after glucose injection, but both testosterone and estrogen replacement blocked the ovariectomy-induced increase in the ratio of double-stained neurons in female rats.
| Discussion |
|---|
|
|
|---|
Although hypoglycemia caused by treatments such as fasting, insulin injection, or 2-deoxy-D-glucose injection increases the expression of hypothalamic MCH mRNA (14, 22, 23), there is little information on the second messenger system that would be stimulated by hypoglycemic conditions. For example, Fos expression was increased in the LHA by insulin-induced hypoglycemia, but there were few MCH neurons that expressed Fos protein (22, 37). Thus, it is unclear whether Fos proteins are involved in the control of the expression of MCH mRNA in the LHA by hypoglycemia. In experiment 1, we showed that under normal feeding conditions in male and female rats at all stages of the estrous cycle examined, approximately 10% of MCH neurons expressed pCREB-immunoreactive nuclei in the LHA, indicating that only a small population of MCH neurons is active in the LHA. However, we found that fasting for 48 h increased the ratio of double-stained neurons to approximately 40% in both sexes. Furthermore, we showed that this fasting-induced increase was independent of the presence of testosterone or estrogen. This is the first demonstration that MCH neurons express pCREB in their nuclei in response to fasting and is in good accord with the results of a previous study showing that fasting for 48 h increased pCREB levels in nuclear extracts from the rat hypothalamus, although which neurons expressed the pCREB was not shown (38). An analog of cAMP and agents that increase levels of endogenous cAMP and promote phosphorylation of CREB (29) were reported to elicit a vigorous feeding response when microinjected into the LHA (39). Thus, pCREB can be a reliable marker of activation of MCH neurons by 48-h fasting, and phosphorylation of CREB, probably promoted by an increase in cAMP, may contribute at least in part to the orexigenic activity of MCH neurons. We thus suggest that there is no sex difference in the fasting-induced activation of MCH neurons.
We also examined changes in the activity of MCH neurons after glucose injection in 48-h fasted rats in experiment 1 and found that a significant decrease in the ratio of double-stained neurons was induced after 5 min only in female rats at all stages of the estrous cycle examined. In contrast to female rats, MCH neurons in male rats failed to respond to glucose within 5 min. Additional time-course studies in experiment 2 demonstrated that MCH neurons in male rats responded to glucose 1530 min after glucose injection, whereas those in female rats, at the stage that was most insensitive to glucose, MCH neurons responded after 515 min. In this study we found a clear sex difference in the response of MCH neurons to glucose; the response of MCH neurons to glucose was delayed in male rats compared with that in female rats. This is not due to differences in blood glucose concentrations, because there was no sex difference in blood glucose concentrations after glucose injection between intact male and female rats. Furthermore, this is not due to sex differences in insulin secretion in response to glucose, because there was no sex difference in the effect of castration on insulin secretion and thus it could not explain the results of experiment 3. One possible reason for this delay in the decrease in pCREB may be that the sensitivity of MCH neurons to glucose in male rats is less than that in female rats, and thus MCH neurons do not respond to an increase in glucose concentrations in blood, resulting in a delay of the decrease in pCREB. According to the glucostatic theory that an increase in glucose in blood is a signal for meal termination (33), the dietary glucose may inactivate the orexigenic activity of MCH neurons and induce meal termination more rapidly in female rats than in male rats. This may account for the sex difference in meal size, which is smaller in females than in males (1, 2). Although glucose-sensing neurons may respond to physiological changes in blood glucose and regulate integrative metabolic functions, such as counterregulatory responses, food intake, and metabolic rate (40), the glucostatic theory by itself is not sufficient to explain the complex regulation of feeding behavior (41). Glucose is, obviously, only one of several peripheral metabolic signals involved in the regulation of feeding behavior under physiological conditions (42). Hence, we speculate that the inactivation of MCH neurons by metabolic signals after feeding is faster in females than in males.
We currently do not know how glucose acts on MCH neurons. However, judging from an electrophysiological study showing that some neurons in the LHA respond to changes in glucose concentration in vitro (43), a direct effect of glucose on MCH neurons is likely. Effects of afferent signals from glucose sensors localized at different central and peripheral structures are also likely (41, 44). In the hypothalamus, NPY neurons in the arcuate nucleus have been shown to be glucose-sensitive neurons in an in vitro electrophysiological study (45). Considering the hypothalamic circuit involving the LHA and arcuate nucleus (19), it is probable that glucose affects MCH neurons indirectly via NPY neurons in the arcuate nucleus.
We also found in the present study that the response of MCH neurons to glucose varied depending on the stage of the estrous cycle, i.e. the magnitude of decrease in the number of double-stained neurons after glucose injection was greater at proestrus and estrus than at diestrus 2. An additional time-course study confirmed that the ratio of double-stained neurons at diestrus 2 decreased 15 min after glucose injection to approximately 10%, which was similar to the levels at proestrus and estrus 5 min after glucose injection, indicating that the response of MCH neurons to glucose at diestrus 2 was the most delayed. As discussed above, if the decrease in the activity of MCH neurons is related to meal termination, it follows that meal termination occurs more rapidly at proestrus and estrus than at diestrus 2. In support of this, the meal size was smaller at proestrus or estrus than at diestrus (2, 4). Therefore, MCH neurons may also participate in the fluctuation of feeding behavior during the estrous cycle.
Our findings in experiment 3 indicate that the sex difference in MCH neurons is at least in part attributable to the presence of gonadal steroid hormones in adults. That is, the presence of testosterone in males and that of estrogen in females are critical to the male- and female-type responses of MCH neurons to glucose. In male rats, we found that orchidectomy significantly enhanced the response of MCH neurons to glucose, but testosterone replacement attenuated the effect. Because orchidectomy decreased food intake (46), and this effect was reversed by testosterone replacement in ORX rats (7, 47, 48), we speculate that testosterone attenuates the response of MCH neurons to metabolic signals and then increases food intake in males. In contrast, estrogen replacement did not cause any significant effect on orchidectomy-induced enhancement of the response to glucose in male rats. This result is in good accord with a report that food intake in ORX rats is relatively insensitive to the influence of estrogen compared with that in OVX rats (8). The results of the present study in male rats therefore suggest that estrogen could no longer enhance the response of MCH neurons to glucose, because orchidectomy caused the response to reach its maximum.
In female rats, ovariectomy attenuated the response of MCH neurons to glucose, and estrogen replacement prevented ovariectomy-induced attenuation of the response. These results are in good accord with previous studies in which ovariectomy in adult female rats increased food intake (7, 46), and this effect was reversed by estrogen replacement (6). Thus, it can be easily hypothesized that estrogen enhances the response of MCH neurons to metabolic signals in females and causes decreases in food intake and body weight. In support of this, estrogen inhibited the expression of MCH mRNA in the LHA of female (49) and male (27) rats. In contrast to the effect of testosterone in ORX rats, testosterone enhanced the response of MCH neurons in OVX rats as estrogen did. This effect of testosterone in OVX rats could be explained by postulating that testosterone enhances the response of MCH neurons after being converted to estrogen. In support of this speculation, it has been suggested that in male rats, the reduced food intake and weight gain seen during high-dose testosterone treatment are due to aromatization of testosterone to estrogen (8). In light of previous reports that females are more sensitive to the effect of estrogen on food intake than males (8, 50) and males are more sensitive to the effect of testosterone on food intake (47, 50), the present study indicates that the dominant effect of testosterone on the response of MCH neurons in females is not testosterone-induced attenuation, but is estrogen-induced enhancement. In males, in contrast, the dominant effect of testosterone on the response of MCH neurons is not estrogen-induced enhancement, but is testosterone-induced attenuation. Hence, the present study may provide a neural basis for the sex difference in feeding behavior, although the mechanisms of action of estrogen and testosterone need to be determined in future studies.
Recent reports demonstrating that estrogen attenuates neuroendocrine responses to hypoglycemia in women (51) and female rats (52) suggest that estrogen enhances the effects of glucose in the brain. In light of the results of the present study, estrogen may enhance glucose transport and its metabolism in the brain (53, 54, 55). This suggests that one mechanism by which estrogen exerts its widely reported protective effects in the brain (56) is by enhancing glucose transport and metabolism.
| Footnotes |
|---|
First Published Online May 19, 2005
Abbreviations: AUC, Area under the curve; LHA, lateral hypothalamic area; MCH, melanin-concentrating hormone; NPY, neuropeptide Y; ORX, orchidectomized; OVX, ovariectomized; PB, phosphate buffer; pCREB, phosphorylated cAMP response element-binding protein.
Received January 19, 2005.
Accepted for publication May 10, 2005.
| References |
|---|
|
|
|---|
This article has been cited by other articles:
![]() |
F. O'Mahony, R. Alzamora, H.-L. Chung, W. Thomas, and B. J. Harvey Genomic Priming of the Antisecretory Response to Estrogen in Rat Distal Colon throughout the Estrous Cycle Mol. Endocrinol., November 1, 2009; 23(11): 1885 - 1899. [Abstract] [Full Text] [PDF] |
||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |