The prereceptor activation of glucocorticoid production in adipose tissue by NADPH-dependent 11-hydroxysteroid dehydrogenase type 1 (11-HSD1) has emerged as a potential mechanism in the pathogenesis of visceral obesity and metabolic syndrome. Hexose-6-phosphate dehydrogenase (H6PDH) is an endoplasmic reticulum lumen-resident enzyme that generates cofactor NADPH and thus mediates 11-HSD1 activity. To determine the role of adipose H6PDH in the prereceptor modulation of 11-HSD1 and metabolic phenotypes, we generated a transgenic (Tg) mouse model overexpressing H6PDH under the control of the enhancerpromoter region of the adipocyte fatty acid-binding protein (aP2) gene (aP2/H6PDH Tg mice). Transgenic aP2/H6PDH mice exhibited relatively high expression of H6PDH and elevated corticosterone production with induction of 11-HSD1 activity in adipose tissue. This increase in corticosterone production in aP2-H6PDH Tg mice resulted in mild abdominal fat accumulation with induction of C/EBP mRNA expression and slight weight gain. Transgenic aP2/H6PDH mice also exhibited fasting hyperglycemia and glucose intolerance with insulin resistance. In addition, the aP2/H6PDH Tg mice have elevated circulating free fatty acid levels with a concomitant increased adipose lipolytic action associated with elevated HSL mRNA and Ser 660 HSL phosphorylation within abdominal fat. These results suggest that increased H6PDH expression specifically in adipose tissue is sufficient to cause intra-adipose glucocorticoid production and adverse metabolic phenotypes. These findings suggest that the aP2/H6PDH Tg mice may provide a favorable model for studying the potential impact of H6PDH in the pathogenesis of human metabolic syndrome.11-hydroxysteroid dehydrogenase type 1; transgenic mouse VISCERAL FAT DEPOSITION IS FREQUENTLY ASSOCIATED with metabolic syndrome, including visceral obesity, insulin resistance, hypertension, and dyslipidemia (13,22,39). However, the underlying mechanisms of these metabolic perturbations are poorly understood. Patients with glucocorticoid (GC) excess (Cushing's syndrome) promote visceral fat deposition and develop metabolic syndrome (1, 21). In adipose tissue, GCs promote lipolysis by stimulating two key enzymes, hormonesensitive lipase (HSL) and adipose triglyceride lipase (ATGL), to increase hydrolysis of triacylglycerol and release free fatty acids (FFA) in the circulation that is linked to hyperlipidemia and global insulin resistance (8, 24, 46). However, tissuespecific GC availability is regulated by an intracellular endoplasmic reticulum (ER) lumen-resident enzyme, 11-hydroxysteroid dehydrogenase type 1 (11-HSD1), that converts inert cortisone (11-dehydrocorticosterone in rodents) to the active glucocorticoid receptor (GR)-ligand cortisol (corticosterone in rodents) and thereby amplifies intracellular GC reproduction, particularly in adipose tissues (7,41,23,33). Increased adipose GC activation by 11-HSD1 leads to visceral obesity and features of the metabolic syndrome (29). Prereceptor amplification of GC ...