We used primary cultures of rat hepatocytes to evaluate the effects of glucocorticoids on insulin-responsive hepatic lipogenesis. The data indicate that hepatocytes incubated for 20 h with dexamethasone (0.1 M) alone are profoundly resistant to the ability of insulin to stimulate lipogenesis acutely. In contrast, primary cultures of hepatocytes incubated with dexamethasone plus insulin are hyper-responsive to the ability of insulin to stimulate lipogenesis chronically. This potentiation of insulin action by a glucocorticoid occurs at physiological concentrations of the two hormones. Exposure to dexamethasone plus insulin for more than 4h is required for the two hormones to enhance insulin action either by overcoming the insulin resistance induced by dexamethasone alone or by stimulating insulin action induced by insulin alone. Despite the marked potentiation of insulin action, hepatocytes exposed to dexamethasone plus insulin are less sensitive to insulin, as demonstrated by a shift to the right in the dose-response curve for insulin-stimulated lipogenesis. The resistance of hepatocytes to the acute effects of insulin after exposure to dexamethasone alone and the potentiation of insulin action and decreased sensitivity to insulin after exposure to insulin plus dexamethasone are all mediated by post-insulin-binding events. These studies demonstrate potentiation of insulin action in the liver by physiological concentrations of glucocorticoids and may have physiological significance for the regulation of normal hepatic lipogenesis, for the hyperlipidaemia observed with the pharmacological use of glucocorticoids, and for disease states in man associated with hyperinsulinaemia and hypercortisolism.

We have recently proposed that "down regulation" of the insulin receptor may be one of the many biological responses of a cell to insulin. In an attempt to further explore this hypothesis we have studied insulin action, binding, and degradation in freshly isolated hepatocytes from rats rendered insulin resistant by the administration of dexamethasone, 1.0 mg/kg every other day, for 1 and 4 wk, and in dexa-methasone-treated (0.1 ,uM for 24 h) primary cultures of hepatocytes from normal rats. Dexamethasone treatment for 1 and 4 wk resulted in significant hyperinsulinemia and euglycemia when compared with age-and weight-matched control animals. Freshly isolated hepatocytes from rats treated with dexamethasone for 1 wk bound less insulin than cells from control animals. This decrease in insulin binding was reflected in a decrease in the total number of cellular insulin receptors upon solubilization of the cells. Insulin action was evaluated by the ability of insulin to stimulate the uptake of a-aminoisobutyric acid. The basal rate of aminoisobutyrate uptake in freshly isolated hepatocytes was enhanced by 1 wk of dexamethasone treatment, and although there was an apparent shift to the right in the dose-response curve for insulin-stimulated aminoisobutyrate uptake, at no insulin concentration was there a significant difference in the uptake by hepatocytes from control and dexa-methasone-treated animals. This was true whether expressed as a percentage or absolute increment above basal. Insulin degradation was enhanced in hepato-cytes from animals treated with dexamethasone for 1 wk but could not account for the observed changes in insulin binding. Hepatocytes from animals treated with dexameth-asone for 4 wk were resistant to insulin with regard to aminoisobutyrate uptake, yet both insulin binding and insulin degradation returned to the levels observed in hepatocytes from control animals. Primary cultures of hepatocytes from normal rats exposed to dexamethasone, 0.1 ,uM, in vitro for 24 h were similar to hepatocytes from rats treated with dexamethasone for 4 wk in that they were insulin resistant with regard to aminoisobutyrate uptake and had normal to increased insulin binding. Insulin degradation was also similar. These cells were resistant to the ability of insulin, 0.1 ,uM, to down regulate its receptor whereas parallel cultures treated with insulin in the absence of dexamethasone had a 52% decrease in insulin binding. These data indicate that hepatocytes that are insulin responsive respond to in vivo hyperinsulinemia by a decrease in the number of insulin receptors and by increased insulin degradation. Hepatocytes rendered resistant to insulin both in vivo and in vitro are resistant to these effects of insulin. These studies emphasize the importance of postbinding events in the modulation of insulin binding, action, and degradation, and support the hypothesis that down regulation of the hepatocyte insulin receptor is one of the many biological actions of insulin. They also help explain how a cell can be insulin re...

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Hormonal and substrate regulation of hepatic glycogen accumulation was evaluated in primary cultures of hepatocytes prepared from 1-day-fasted rats. Hepatocytes were cultured in media containing 5 mM-glucose and 10 mM-lactate and then exposed to 100 nM-dexamethasone for 4 h before an increase in glucose concentration and the addition of insulin. When this protocol was used to mimic the post-prandial state in vivo, net glycogen accumulation (over 2 h) and insulin (10 nM) effects were linear at physiological (5-10 mM) and supraphysiological (20-30 mM) glucose concentrations. To define the role of substrates in glycogen accumulation, hepatocytes were incubated in a buffered salt solution containing 10 mM-glucose and either 10 mM-lactate or 5 mM-glutamine, or both. In the absence of hormones, net glycogen accumulation was increased by 59%, 83%, and 127% by the addition of lactate, glutamine, and lactate plus glutamine respectively, compared with incubations with glucose alone, and 6-fold in the presence of substrates, insulin and dexamethasone. Labelling with [3-3H]glucose and [U-14C]glucose showed that in the absence of hormones approx. 50% of glycogen formation came from glucose via the direct pathway and the remainder from glucose via the indirect pathway or from non-glucose precursors, or both. Insulin-dependent enhancement of glycogen formation is through stimulation of both the direct and indirect pathways, and dexamethasone-dependent stimulation occurs through stimulation of both these pathways of glycogen formation from glucose as well as from non-glucose precursors. Lactate serves as a gluconeogenic C3 precursor for the observed enhanced glycogen formation, whereas glutamine-dependent enhancement of glycogen accumulation occurs primarily through a stimulation of the direct and indirect pathways of glycogen formation from glucose.

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