Targeting the Pre-Receptor Metabolism of Cortisol as a Novel Therapy in Obesity and Diabetes

The 2010 review explored the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) as a target for treating obesity and type 2 diabetes (T2D). Elevated 11β-HSD1 activity is linked to obesity and metabolic syndrome, and inhibiting this enzyme has shown positive metabolic effects in rodent models, such as resistance to diet-induced obesity and better glucose tolerance and insulin sensitivity. Early human studies with selective 11β-HSD1 inhibitors indicate potential benefits, but more research is needed to confirm safety and effects on the hypothalamo-pituitary-adrenal axis. The review underscores the need for new treatments due to the significant health and economic burdens of obesity and T2D.