11 -hydroxysteroid dehydrogenase type 1 (11 -HSD1) catalyzes the interconversion of biologically inactive 11 keto derivatives (cortisone, 11-dehydrocorticosterone) to active glucocorticoids (cortisol, corticosterone) in fat, liver, and other tissues. It is located in the intraluminal compartment of the endoplasmic reticulum. Inasmuch as an oxo-reductase requires NADPH, we reasoned that 11 -HSD1 would be metabolically interconnected with the cytosolic pentose pathway because this pathway is the primary producer of reduced cellular pyridine nucleotides. To test this theory, 11 -HSD1 activity and pentose pathway were simultaneously measured in isolated intact rodent adipocytes. Established inhibitors of NAPDH production via the pentose pathway (dehydroandrostenedione or norepinephrine) inhibited 11 -HSD1 oxo-reductase while decreasing cellular NADPH content. Conversely these compounds slightly augmented the reverse, or dehydrogenase, reaction of 11 -HSD1. Importantly, using isolated intact microsomes, the inhibitors did not directly alter the tandem microsomal 11 -HSD1 and hexose-6-phosphate dehydrogenase enzyme unit. Metabolites of 11 -HSD1 (corticosterone or 11-dehydrocorticosterone) inhibited or increased pentose flux, respectively, demonstrating metabolic interconnectivity. Using isolated intact liver or fat microsomes, glucose-6 phosphate stimulated 11 -HSD1 oxo-reductase, and this effect was blocked by selective inhibitors of glucose-6-phosphate transport. In summary, we have demonstrated a metabolic interconnection between pentose pathway and 11 -HSD1 oxo-reductase activities that is dependent on cytosolic NADPH production. These observations link cytosolic carbohydrate flux with paracrine glucocorticoid formation. The clinical relevance of these findings may be germane to the regulation of paracrine glucocorticoid formation in disturbed nutritional states such as obesity.The intracellular peri-receptor availability of glucocorticoids is not determined simply by their circulating concentrations and protein binding interactive kinetics. Ostensibly, the intracellular concentration of the active glucocorticoids (cortisol, corticosterone) is governed more so by 11 -hydroxysteroid dehydrogenase type 1 (11 -HSD1), 2 a bidirectional enzyme that facilitates the equilibrium between the aforesaid active steroids and their biologically inactive 11-keto derivatives (cortisone, 11-dehydrocorticosterone) (1-3). 11 -HSD1 is ubiquitous (4), located in microsomes (5), and has a low substrate affinity (6) (K m in M) involving pyridine nucleotide cofactors, with NADP(H) having a greater affinity than NAD(H) (6, 7). Recently, 11 -HSD1 has garnered attention as a potential participant in the pathoetiology of obesity, insulin resistance, and type II diabetes (2,3,8,9). Specifically, the dysregulation of 11 -HSD1 in particular tissues may augment intracellular active glucocorticoid concentrations. In addition, it is certainly plausible that in human obesity, although normal circulating blood cortisol levels are foun...