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Departments of Physiology (C.A., E.S.-V., A.H.) and Pharmacology (E.E.), Institute of Neuroscience and Physiology and Department of Molecular and Clinical Medicine, Institute of Medicine (T.L., B.G., M.L.), The Sahlgrenska Academy, Göteborg University, 405 30 Göteborg, Sweden
Address all correspondence and requests for reprints to: Camilla Alexanderson, Institute of Neuroscience and Physiology, Department of Physiology/Endocrinology, Sahlgrenska Academy, Göteborg University, Box 434, 405 30 Göteborg, Sweden. E-mail: camilla.alexanderson{at}neuro.gu.se.
| Abstract |
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| Introduction |
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The sexual differentiation of the fetus reflects a complex interplay between genetic and hormonal factors (6, 7). A key player is testosterone, which virilizes the male fetus during certain critical periods before and, in some species such as rodents, shortly after birth. Female fetuses exposed to excessive levels of testosterone during these periods may display permanent abnormalities with respect to, e.g. the urogenital tract, brain morphology, and behavior in adulthood (6, 8, 9). In humans, this phenomenon is illustrated by the characteristics of girls with congenital adrenal hyperplasia (10). Testosterone affects the urogenital tract mainly through its metabolite dihydrotestosterone (DHT), acting through androgen receptors (ARs) (11); however, the masculinization of the brain may be mediated either by DHT through the AR or by the other major testosterone metabolite, estradiol, acting through
- and β-estrogen receptors (ERs). The relative roles of these receptors in this context are species dependent. For example, the AR plays a larger role in the rhesus monkey (9), whereas the ER appears to be more important in rodents (12).
In line with the well-established influence of sex steroids on adult metabolism, the prevalence of metabolic disorders differs between men and women, as does normal fat distribution (13). Because prenatal and neonatal factors may influence the susceptibility to metabolic disturbances in adulthood, and because steroids play an important role in the early programming of the organism, the possibility that early exposure to sex steroids may influence metabolism later on in life is worth exploring. We have previously provided support for the existence of such an influence by showing that administration of one dose of testosterone to female pups, corresponding to the level of androgen secretion in newborn male rats, triggers insulin resistance and centralization of body fat in adulthood (14). Similarly, prenatal androgenization has been reported to influence various metabolic indices, including insulin sensitivity, in female rhesus monkeys and sheep (15, 16, 17, 18, 19, 20, 21, 22, 23). Moreover, congenital adrenal hyperplasia in humans is associated with enhanced body mass index and reduced insulin sensitivity, although it is unclear whether these aberrations are due to the disorder per se or to the glucocorticoids used to treat these subjects (10).
This study had two aims. First, we wanted to confirm and extend our previous observation that early exposure of testosterone (3 h after birth) may influence metabolism in the adult female rat by assessing to what extent this treatment influences not only insulin sensitivity and body fat distribution, as previously shown, but also, e.g. lipid profile and adipocyte size. And second, we wanted to assess whether this early influence of testosterone is mediated by AR, ER, or both AR and ER by comparing the effects of testosterone with those of estradiol and DHT, respectively.
| Materials and Methods |
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Study procedures
Within 3 h after birth, female pups were weighed and sc injected with 1 mg testosterone propionate (Apoteksbolaget, Stockholm, Sweden) (n = 10), 1 mg DHT propionate (Steraloids, Newport, RI) (n = 10), or 0.5 mg estradiol benzoate (Apoteksbolaget) dissolved in vehicle (n = 5). Controls (n = 12) received vehicle only. Within 1 wk after delivery, pups were redistributed so that each lactating mother had six to seven pups from different experimental groups.
Fasting plasma samples were collected for cholesterol and triglyceride (TG) analyses at 7 wk of age. At 9 wk, tail blood samples were collected for analyses of serum testosterone and estradiol. At 15 wk, insulin sensitivity was measured with a euglycemic-hyperinsulinemic clamp. At the end of the study, rats were decapitated, and mesenteric and inguinal adipose tissues were removed for measurements of depot weight and adipocyte size.
Vaginal smears
The estrous status was determined from vaginal smears taken daily at 8–9 wk of age. The rat estrous cycle (estrus, diestrus 1, diestrus 2, and proestrus) usually lasts about 4 d (24). Cycles of 4–5 d with a characteristically clear ovulation and a rich amount of epithelial cells without leukocytes in the smears were considered normal. Sampling for sex hormone analyses and clamp measurements in controls were performed in the estrous phase.
Euglycemic-hyperinsulinemic clamp
At 15 wk of age, the rats underwent a euglycemic-hyperinsulinemic clamp as described (25). Briefly, the rats were anesthetized with thiobutabarbital sodium (Inactin; Sigma, St. Louis, MO; 130 mg/kg body weight). Catheters were inserted into the left carotid artery for blood sampling and into the right jugular vein for infusion of glucose and insulin. Body temperature was maintained at 37 C with a heating blanket. After a bolus injection, insulin (100 U/ml, human Actrapid; Novo Nordisk Pharma, Copenhagen, Denmark) was continuously infused at a rate of 8 mU/min·kg. To maintain plasma glucose concentration at 6 mmol/liter, a 20% glucose solution was infused at a rate guided by the glucose concentration in 10-µl blood samples obtained every 5 min for 40 min and then every 10 min. The mean glucose infusion rate was calculated from values during the last 90–120 min. At 110 and 120 min of infusion, 50-µl blood samples were taken for determination of insulin concentration. A total of less than 1.5 ml blood was used for the determinations; this was compensated for by the infusion volumes.
Analytical methods
Plasma insulin was analyzed with human insulin ELISA kits (Mercodia, Uppsala, Sweden). Serum testosterone and estradiol were determined with RIA kits (testosterone RIA kit, DSL-4100; third-generation estradiol RIA, DSL-39100; Diagnostic Systems Laboratories, Webster, TX). Serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and TG were determined enzymatically with Konelab autoanalyzer version 2.0. Low-density lipoprotein cholesterol (LDL-C) was calculated as TC – (HDL-C + TG)/2, and the atherogenic index was calculated as (TC – HDL-C)/HDL-C, as described (26).
Adipocyte size
Approximately 0.4 g adipose tissue was cut into small pieces and treated with 1.05 mg/ml collagenase (type A; Roche, Mannheim, Germany) in MEM (Invitrogen, Carlsbad, CA) containing 5.5 mM glucose, 25 mM HEPES, 4% bovine albumin (fraction V; Sigma), and 0.15 µM adenosine (pH 7.4) for 60 min at 37 C as described (27). After filtration through a 250-µm nylon mesh, the adipocytes were washed three times and suspended in fresh medium. The mean adipocyte size and the size distribution of the cell population were determined by computerized image analysis (KS400 software; Carl Zeiss, Oberkochen, Germany) (28). In brief, the cell suspension was placed between a siliconized glass slide and a coverslip and transferred to the microscope stage. Nine random visual fields were photographed with a CCD camera (Axiocam; Carl Zeiss). The surface of the relevant areas was measured automatically, and the diameter of the corresponding circles was calculated. Uniform microspheres 98.00 µm in diameter (Bangs Laboratories, Fishers, IN) were used as a reference.
Statistical analysis
Results are expressed as mean ± SEM. Unpaired t tests were used for pairwise comparisons and ANOVA and Fishers test for multiple comparisons. Adipocyte size distributions were compared by using two-sample Kolmogorov-Smirnov (KS) statistics (29). An exact P value for the comparison of two groups A and B was calculated through permutations. For n subjects in group A and m subjects in group B, KS statistics were calculated for all possible ways of dividing n + m subjects into two groups of sizes n and m. The observed KS statistic was then ranked against the KS statistics from all of the possible permutations. The permutation P value is the percentage of possible KS statistics that are at least as extreme as the KS statistic from the original data. For these comparisons, statistical calculations were performed with the R language (http://www.R-project.org). P < 0.05 was considered significant; all tests are two sided.
| Results |
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Vaginal smears
Because the vaginal openings were absent in all the hormone-treated groups, estrous cyclicity could not be assessed by vaginal smears. All control rats had a normal estrous cycle of 4–5 d.
Fat depots
The mesenteric adipose tissue was heavier in testosterone-exposed rats than in controls. However, the inguinal adipose tissue weight was similar in the testosterone group and controls. The weights of mesenteric and inguinal fat depots in the other treatment groups did not differ from those of controls (Table 1
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| Discussion |
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Adipose tissue, adipocyte size, and size distribution
In our study, we used a new computer-based method that can detect subtle variations in the size distribution of adipocytes isolated by collagenase digestion (28). Exposure to either testosterone or estradiol, but not to DHT, increased the size of mesenteric adipocytes and shifted the size distribution curve to the right. In the testosterone-treated rats, this was accompanied by a significant increase in the weight of the mesenteric adipose tissue (whereas no effect on the inguinal adipose tissue was observed). In the estradiol-treated animals, the weight of both the mesenteric and the inguinal adipose tissue trended higher, but neither of these effects reached the level of statistical significance. This may, however, reflect low statistical power because there were fewer rats in the estradiol group than in the other groups. Therefore, our data on the possible effects of estradiol treatment on fat tissue weight should be interpreted with caution.
The lack of effect of DHT on adipocyte size and on the weight of the adipose tissue suggests that the effect of testosterone on these parameters is mediated by ER rather than AR. Thus, it is reasonable to conclude that early ER activation leads to enhanced size of the mesenteric adipocytes. Such an effect might be expected to lead to an increase in the weight of the mesenteric tissue; however, the effect of estradiol on the weight of the mesenteric adipose tissue did not reach statistical significance. This may, as mentioned, be due to low power, but it is also possible that activation of ER without simultaneous activation of AR may lead to an increase in adipocyte size but to an accompanying reduction in adipocyte number, the latter effect being counteracted by the parallel activation of AR obtained in the testosterone-treated but not in the estradiol-treated animals. The possibility that early ER activation indeed leads to a reduction in adipocyte number gains support by a previous study in which estrogen administered 2–12 d postnatally reduced the number of fat cells (30); however, in this study, where adipocyte size was not measured, the adipose mass was reduced. To shed further light on this issue, studies assessing both the size and the number of adipocytes are clearly warranted.
Several observations support the notion that sex steroids influence the size as well as the number of adipocytes. Evidence from experiments in knockout mice hence suggests that absence of either the ER
or the AR causes adipocyte hypertrophy and hyperplasia (as well as impaired insulin sensitivity) (31, 32, 33); moreover, aromatase knockout mice, which cannot synthesize estrogens and have high testosterone levels, also are obese and have enlarged adipocytes (34). The fact that the change in sex steroid activity induced by genetic manipulation in these different knockout strains is present throughout development and adult life, however, makes it hazardous to compare these effects with those observed in our study in rats, where only one dose of sex steroids was given.
Adult women with high androgen levels are often characterized by an accumulation of visceral fat (35), suggesting that androgens promote abdominal obesity in females. This conclusion, which is supported by the effects of testosterone in female-to-male transsexuals (36), may be regarded as contradictory to our study, which shows that rats given neonatal testosterone have increased mesenteric adipose tissue but reduced testosterone levels. If the influence of early testosterone administration on adipose tissue is interpreted in terms of masculinization, early administration of testosterone must be expected to enhance the responsiveness of fat tissue to androgens in the adult organism. In line with this possibility, it has been suggested that one effect of the early influence of androgens on the brain is to enhance its responsiveness to testosterone in the adult organism (37). To what extent early androgen exposure may sensitize also the fat tissue to the influence of testosterone should be the subject of forthcoming studies. In this context, it should, however, also be considered that some studies indeed suggest that lowering androgen levels may lead to enhanced body weight in hyperandrogenic women (38).
Lipid metabolism
Our analysis of serum lipids showed increases in the atherogenic index and in TC, LDL, and TG levels in testosterone-exposed rats, increased TG levels in the estradiol-treated rats, but no abnormalities in the DHT group. The apparent effects of testosterone and estradiol on serum lipids may be explained by the influence of estrogen on the tightly regulated hepatic enzymes involved in cholesterol synthesis, uptake, and clearance. Studies in aromatase knockout mice, for example, which display age-progressive obesity, hepatic steatosis, and hypercholesterolemia (39), have shown that estrogen participates in the regulation of hepatic cholesterol metabolism only in females, indicating that this important homeostatic pathway is sexually dimorphic (40). Notably, studies in rats have shown that neonatally administered testosterone exerts a programming influence on the activity of hepatic enzymes involved in the metabolism of androgens (41, 42). It would therefore be of interest to investigate the programming effects of sex steroids on hepatic lipid metabolism (e.g. the transcriptional regulation of cholesterol synthesis enzymes).
Insulin sensitivity
In our euglycemic-hyperinsulinemic clamp studies, insulin sensitivity was reduced in all three groups of rats. The effects of a single postnatal dose of testosterone on insulin sensitivity are in agreement with our previous findings (14). Because the clamp technique mainly measures the insulin sensitivity of muscle (43), the testosterone injection might have irreversibly changed mechanisms involved in muscle tissue insulin sensitivity. DHT-treated animals displayed a reduction in insulin sensitivity of comparable magnitude as seen in testosterone-treated animals; in the estradiol-exposed group, this effect was even more pronounced. This hence seems to be an effect that may be elicited by activation of either ER or AR in the postnatal phase. That both AR and ER
(but not β) may influence insulin sensitivity gains support also from previous mouse knockout studies (33, 44).
Interestingly, administration of testosterone to adult female rats led to insulin resistance in muscle after 48 h (45) and abdominal obesity after 12 wk of treatment (25), the same phenotype we found in our study. These findings suggest that androgens are directly involved in the insulin signaling cascade, an involvement that seems to be independent of the effect on visceral obesity (which may further reduce the insulin sensitivity) (25, 45). As discussed above, the observation that testosterone-treated rats had low testosterone levels, but displayed metabolic and anthropometric changes normally associated with high levels of testosterone in females, may seem contradictory but could tentatively be due to an altered responsiveness to this hormone. It is noteworthy that all hormone-treated groups displayed insulin resistance, despite considerable differences in their testosterone levels, which were reduced in the testosterone-treated rats but not in the other groups.
Prenatally androgenized female rhesus monkeys have been shown to display a metabolic phenotype similar to that observed in the testosterone-treated animals in our study, with insulin resistance, increased abdominal fat, and dyslipidemia (46). Unfortunately the possible effects of estradiol or DHT have not been assessed in this model.
Enlargement of abdominal adipocytes, an independent predictor of type 2 diabetes, is associated with insulin resistance and may represent a failure of the adipose tissue mass to expand and thus to accommodate an increased energy influx (47, 48). In addition, hypertrophic adipocytes display adipokine gene expression likely to enhance the progression of insulin resistance (49, 50). There are indications that the size of visceral adipocytes is a strong marker for impaired insulin action, whereas the sc adipocyte size appears to have a weaker impact (51, 52, 53). Consequently, the reduced insulin sensitivity in rats exposed to estradiol or testosterone, but not in those exposed to DHT, may reflect, at least in part, the increased size of mesenteric adipocytes.
| Conclusions |
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By administering a dose of testosterone yielding hormone levels corresponding to those normally observed postnatally in male rats, which are much higher than those normally observed in females, we aimed to shed light on mechanisms underlying normal sexual dimorphism with respect to metabolism. The fact that sex steroids are capable of exerting an early programming influence on the metabolism on the adult organism, however, suggests that also more modest aberrations in the hormonal environment of the female fetus may influence the susceptibility to metabolic aberrations and somatic illness in adulthood.
| Acknowledgments |
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| Footnotes |
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Disclosure Statement: The authors have nothing to disclose.
First Published Online July 26, 2007
Abbreviations: AR, Androgen receptor; DHT, dihydrotestosterone; ER, estrogen receptor; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TC, total cholesterol; TG, triglycerides.
Received March 6, 2007.
Accepted for publication July 17, 2007.
| References |
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and β in differentiation of mouse sexual behavior. Neuroscience 138:921–928[CrossRef][Medline]
knockout mice. Proc Natl Acad Sci USA 97:12729–12734
plays an important role in the regulation of glucose homeostasis in mice: Insulin sensitivity in the liver. Diabetologia 49:588–597[CrossRef][Medline]This article has been cited by other articles:
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C. Alexanderson, E. Eriksson, E. Stener-Victorin, M. Lonn, and A. Holmang Early postnatal oestradiol exposure causes insulin resistance and signs of inflammation in circulation and skeletal muscle J. Endocrinol., April 1, 2009; 201(1): 49 - 58. [Abstract] [Full Text] [PDF] |
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M. Demissie, M. Lazic, E. M. Foecking, F. Aird, A. Dunaif, and J. E. Levine Transient prenatal androgen exposure produces metabolic syndrome in adult female rats Am J Physiol Endocrinol Metab, August 1, 2008; 295(2): E262 - E268. [Abstract] [Full Text] [PDF] |
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