Acute Effects Of Insulin Research Articles

Short-Term Infusions of Insulin, Triacylglycerol and Glucose do not Cause Acute Increases in Plasminogen Activator Inhibitor-1 Concentrations in Man

1. To investigate the acute effects of insulin and triacylglycerol ('triglyceride') on circulating plasminogen activator inhibitor-1 concentrations, seven healthy volunteers were studied during hyperinsulinaemic clamps in the presence of euglycemia (mean glucose concentration 5 mmol/l) and hyperglycaemia (mean glucose concentration 9 mmol/l) with and without triacylglycerol infusions. 2. During euglycemia, plasma insulin levels rose from baseline values [median (range)] of 13 (6.6-20.6) m-units/l to 89 (74-105) m-units/l and 99 (74-109) m-units/l after 1 and 2 h of insulin infusion, respectively. Concentrations of plasminogen activator inhibitor-1 fell from 27.5 (10-47) ng/ml to 25.0 (14.5-55) ng/ml and 15.5 (11.5-28.5) ng/ml (P less than 0.02) over the same time. 3. During hyperglycaemia, plasma insulin concentrations were 12.1 (9.3-17.1) m-units/l at the run-in period and rose to 87 (73-112) m-units/l and 91 (84-97) m-units/l after 1 and 2 h of insulin infusion, respectively. Concentrations of plasminogen activator inhibitor-1 again showed a gradual fall from 24.7 (22-50) ng/ml to 14 (8.3-25.5) ng/ml and 13 (6.0-35.0) ng/ml (P less than 0.02) over the same period. 4. Infusion of Intralipid in the presence of hyperinsulinaemia with either euglycemia or hyperglycaemia was associated with a similar fall in concentrations of plasminogen activator inhibitor-1 over the study period. 5. The results from this study indicate that short-term increases in insulin, glucose or triacylglycerol do not cause acute increases in plasma concentrations of plasminogen activator inhibitor-1.

Dual effect of metformin in cultured rat hepatocytes: Potentiation of insulin action and prevention of insulin-induced resistance

The ability of the biguanide hypoglycemic agent metformin to improve the acute effects of insulin on glucose and/or lipid metabolism was investigated in both insulin-responsive and insulin-resistant cultured rat hepatocytes: (1) metformin (20 μg/mL, 16 hours) increased the insulin-dependent stimulation of glycogen and lipid synthesis through an exclusive enhancement of the responsiveness without modification of the cell sensitivity to the hormone; (2) metformin neither altered basal glycogenesis from [U- 14C]glucose and basal lipogenesis from [1- 14C]acetate nor insulin binding. There results indicate the ability of this drug to selectively potentiate the acute action of insulin at a postreceptor step in normal liver cells. A prolonged incubation with insulin (16 hours, 5 × 10 −7 mol/L) led the hepatocytes to a state of resistance evidenced by a 50% decrease in their maximal responsiveness and sensitivity to a subsequent acute stimulation by the hormone, as assessed on lipogenesis. Addition of metformin (20 μg/mL) during the overnight incubation of hepatocytes with insulin prevented the decrease in cell responsiveness and sensitivity to the hormone for the stimulation of lipogenesis, thus showing that metformin was able to hamper the development of the resistant state to the hormone in this pathway. These results strongly suggest that metformin improves type 2 diabetes through an effect at the hepatic level on both insulin action and insulin-induced resistance.

Insulin, insulin sensitivity and hypertension

The sensitivity of tissue to insulin is of physiological, pathophysiological and therapeutic relevance. The quantity of insulin and the response to insulin are paramount complementary factors in the regulation of glucose metabolism, and may, at least under certain pathophysiological conditions, also affect cardiovascular function. Hypertension has a high prevalence among subjects with decreased insulin sensitivity and/or hyperinsulinaemia due to obesity, impaired glucose tolerance, non-insulin-dependent diabetes mellitus, and certain other conditions. There is evidence that, even in the absence of obesity or diabetes mellitus, essential hypertension tends to be associated with insulin resistance. The latter elicits a compensatory increase in insulin secretion. Hyperinsulinaemia also occurs in diabetes type 1 as a consequence of insulin treatment. Considering the acute effects of insulin on sympathetic nervous activity, transmembranous cation transport, renal sodium reabsorption, cellular proliferation and lipid metabolism, insulin resistance and/or hyperinsulinaemia may possibly contribute to the genesis of essential, obesity-associated and diabetes-associated hypertension, and may also promote dyslipidaemia in these disorders.

Insulin-induced increase in heart rate and its prevention by propranolol

Acute hyperinsulinaemia in the absence of changes in blood glucose increases heart rate in man. Animal studies have suggested that beta-adrenergic blockade does not prevent the insulin-induced increase in heart rate. The aim of the present study was to investigate the acute effect of insulin on heart rate and blood pressure in non diabetic subjects and, in particular, to determine whether beta-adrenergic receptor blockade would significantly influence the effect. On separate days 9 healthy young volunteers were pretreated with either 80 mg propranolol or placebo p.o. After a 60-90 min period of heart rate and blood pressure stabilization, a placebo injection was given intravenously and heart rate and blood pressure were then monitored every 5 min. After 30 min insulin Actrapid MC 0.2 IU/kg body weight was given i.v. A 20% glucose infusion was given to maintain blood glucose at its fasting level. After insulin administration, a rapid and statistically significant increase in heart rate was observed when the patients were pretreated with placebo; pretreatment with propranolol completely prevented this effect. Serum insulin levels were significantly higher than baseline at all times and there was no significant change in blood glucose. The results are consistent with the hypothesis that the insulin-induced increase in heart rate in man may result from stimulation of cardiac sympathetic activity.

Inability to stimulate skeletal muscle or whole body protein synthesis in Type 1 (insulin-dependent) diabetic patients by insulin-plus-glucose during amino acid infusion: studies of incorporation and turnover of tracer L-[1-13C]leucine

Despite its anabolic effects on protein balance, acute administration of insulin has been reported to have no effect on skeletal muscle or whole body protein synthesis in man. However, insulin also reduces plasma and intramuscular amino acid availability, which may limit protein synthesis. We have therefore measured the acute effects of insulin on skeletal muscle (anterior tibialis) protein synthesis and whole body leucine turnover in eight insulin-withdrawn Type 1 (insulin-dependent) diabetic patients. They were studied initially when insulin deficient, but during infusion of mixed amino acids at a rate sufficient to raise plasma amino acids by 30% i.e. to 4 mmol/l in total; measurements were continued when insulin was infused together with an increased rate of amino acids to maintain insulinopoenic plasma amino acid concentrations. Using 13C-alpha-ketoisocaproate in plasma as an index of the intracellular precursor labelling, incorporation of [1-13C]leucine into skeletal muscle protein was 0.068 +/- 0.007%/h during insulin withdrawal and was unaltered during insulin infusion. The value is higher than observed in muscle of healthy man, possibly because of a stimulatory effect of endogenous intramuscular amino acids. Also, calculated on the basis of alpha-ketoisocaproate labelling, non-oxidised whole body leucine disappearance (i.e. whole body protein synthesis) was 110 +/- 4 mumol.kg-1.h-1 during insulin withdrawal; this also was unchanged during insulin infusion. Despite stable or increased plasma concentrations of most amino acids, the intramuscular concentrations of a number of amino acids decreased during insulin infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Glucose transport activity in L6 muscle cells is regulated by the coordinate control of subcellular glucose transporter distribution, biosynthesis, and mRNA transcription.

Chronic (24 h) insulin treatment and/or glucose deprivation of differentiated rat L6 skeletal muscle cells resulted in an increase in glucose transport activity and a 2-3-fold increase in the number of plasma membrane-associated cytochalasin B binding sites and immunoreactive glucose transporters. In contrast to the acute effect of insulin, chronic treatment did not decrease the number of cytochalasin B binding sites or immunoreactive glucose transporter proteins present in intracellular low density microsomes. Although acute insulin stimulation of glucose transport activity was not affected by cycloheximide, chronic insulin stimulation of glucose transport activity and glucose transporter protein were decreased. In contrast, the stimulation of glucose transport activity by both acute and chronic glucose deprivation were cycloheximide-insensitive. Previously we have reported that chronic insulin treatment transiently induces the rat brain/HepG2 glucose transporter subtype (GLUT-1) mRNA, whereas glucose deprivation induces a substained increase (Walker, P. S., Ramlal, T., Donovan, J. A., Doering, T. P., Sandra, A., Klip, A., and Pessin, J. E. (1989) J. Biol. Chem. 264, 6587-6595). Consistent with these data, nuclear run-on analysis demonstrated a transient 3-fold increase in the rate of GLUT-1 glucose transporter mRNA transcription induced by either chronic insulin treatment or glucose deprivation. The combination of chronic insulin treatment with glucose deprivation resulted in a more persistent 3-4-fold increase in transcription rate than either treatment alone. These data demonstrate that prolonged insulin- and glucose-dependent regulation of glucose transporter function occurs by a complex mechanism which includes enhanced GLUT-1 mRNA transcription and glucose transporter synthesis, as well as changes in the subcellular distribution of glucose transporter proteins.

Acute effects of insulin and glucagon on hepatic casein kinase 2 in adult fed rats: Correlation of the effects on casein kinase 2 with the changes in glycogen synthase activity

Administration of insulin to adult fed rats caused an inactivation of hepatic casein kinase 2 as determined by the decrease in the activity ratio measured at a low (0.1 mg/ml) and a high (1.0 mg/ml) concentration of β-casein. Maximal inactivation occurred 45 min after injection and the dose for half-maximal effect was 44 μg/kg. The effect of insulin was due to an increase in the apparent K m value for the protein substrate but the magnitude of the effect depended on the substrate used, decreasing in the order β-casein > glycogen synthase ⪢ whole casein. The activation of casein kinase 2 by glucagon (M. Pérez, J. Grande, and E. Itarte (1988) FEBS Lett. 238, 273–276) was also more marked with β-casein and glycogen synthase than with whole casein. A good correlation was observed between the time- and dose-dependent activation of glycogen synthase and inactivation of casein kinase 2 promoted by insulin. Similarly, the inactivation of glycogen synthase by glucagon correlated with the activation of casein kinase 2 caused by this hormone. The possible involvement of casein kinase 2 on the mechanism(s) through which these hormones control hepatic glycogen synthase is discussed.

Insulin increases energy expenditure and respiratory quotient in the rat

The effects of insulin on energy expenditure are a matter of dispute. Various authors have reported increases or decreases. Irrespective of their nature, it is not clear whether the effects of insulin on energy expenditure are secondary to insulin-induced hypoglycemia or changes in motor activity. The present study investigated the acute effects of insulin on energy expenditure, energy substrate utilisation, motor activity and blood glucose levels. Four U/kg of fast acting insulin had no effect on any of the metabolic or motor activity measures in spite of producing a 30% reduction in blood glucose levels. In contrast, 8 U/kg of insulin increased energy expenditure and respiratory quotient, with the latter effect indicating increased reliance on carbohydrates as a source of energy. This dose reduced blood glucose levels by 68%, yet had no significant effect on motor activity. Insulin, therefore, enhances thermogenesis and carbohydrate utilisation in a manner that can be dissociated from any effects on motor activity. These effects occur at a high dose and they are not counteracted by even massive hypoglycemia. It, therefore, appears that in terms of energy expenditure insulin may be characterised as catabolic, whereas in terms of substrate utilisation it may be characterised as anabolic.

Isoproterenol stimulates phosphorylation of the insulin-regulatable glucose transporter in rat adipocytes.

We have examined the acute effects of insulin and isoproterenol on the phosphorylation state of the insulin-regulatable glucose transporter (IRGT) in rat adipocytes. The IRGT was immunoprecipitated from either detergent-solubilized whole-cell homogenates or subcellular fractions of 32P-labeled fat cells and subjected to sodium dodecyl sulfate/polyacrylamide gel electrophoresis. The 32P-labeled IRGT was detected by autoradiography as a species of apparent Mr 46,000. Insulin stimulated translocation of the IRGT from low-density microsomes to the plasma membrane but did not affect phosphorylation of the transporter in either fraction. Isoproterenol inhibited insulin-stimulated glucose transport by 40% but was without effect on the subcellular distribution of the transporter in either the presence or absence of insulin. Isoproterenol stimulated phosphorylation of the IRGT 2-fold. Incubating cells with dibutyryl-cAMP and 8-bromo-cAMP also stimulated phosphorylation 2-fold, and the transporter was phosphorylated in vitro when IRGT-enriched vesicles were incubated with cAMP-dependent protein kinase and [gamma-32P]ATP. These results suggest that isoproterenol stimulates phosphorylation of the IRGT via a cAMP-dependent pathway and that phosphorylation of the transporter may modulate its ability to transport glucose.

Effect of chronic diabetes on myocardial fuel metabolism and insulin sensitivity.

To assess the effect of chronic insulin-deficient diabetes on myocardial fuel substrate metabolism in vivo, we measured the myocardial balance of glucose, free fatty acids (FFAs), and amino acids in nine postabsorptive conscious dogs 4-6 wk after treatment with streptozocin. The acute effect of insulin on the myocardial balance of these same substrates was measured in six dogs by use of the euglycemic insulin clamp technique. To further examine the effect of insulin on heart amino acid balance, we studied three additional dogs given a constant infusion of amino acids during the insulin clamp to blunt the insulin-induced hypoaminoacidemia. In these dogs, the fasting plasma glucose concentration was markedly elevated (258 +/- 3 mg/dl). In the basal period, there was no significant glucose uptake by the heart [arterial vs. coronary sinus concentration difference (delta) = 1.0 +/- 2.0 mg/dl]; furthermore, physiologic hyperinsulinemia did not stimulate glucose uptake (delta = 2.0 +/- 2.5 mg/dl). Postabsorptively, arterial FFAs were elevated (1550 +/- 320 microM) in diabetic animals, and there was a significant net extraction of FFAs by the heart (net uptake 26 +/- 9 mumol/min; extraction ratio 30 +/- 8%). During the insulin clamp, arterial FFAs declined (645 +/- 240 microM), as did heart FFA uptake (11 +/- 6 mumol/min), and the net extraction ratio for FFAs was unchanged (30 +/- 7%). Similarly, the arterial branched-chain amino acid (BCAA) concentration was elevated in the postabsorptive state, and there was a significant myocardial uptake of these amino acids and of alanine.(ABSTRACT TRUNCATED AT 250 WORDS)

Insulin-glycerolipid mediators and gene expression.

Insulin is an anabolic polypeptide hormone with pleiotrophic effects. During the decades since the initial description by Banting and Best, the acute effects of insulin have been widely studied with particular focus on the mechanism or mechanisms of insulin activation of hexose transport and regulation of metabolic enzyme activity. However, recently there has been a major expansion of investigation to include insulin regulation of gene expression with multiple insulin-sensitive specific mRNAs now reported. In this review, we explore the involvement of insulin-induced changes in plasma membrane glycerolipid metabolism in the transmembrane signaling process required for insulin regulation of mRNA levels. Insulin increases diacylglycerol levels in insulin-responsive cells, and synthetic diacylglycerols or their phorbol ester diacylglycerol analogs, such as 4 beta,9 alpha,12 beta,13 alpha, 20-pentahydroxytiglia-1,6-dien-3-one 12 beta-myristate 13-acetate (TPA), mimic insulin regulation of ornithine decarboxylase mRNA, c-fos mRNA, and phosphoenolpyruvate carboxykinase mRNA levels. This suggests that insulin regulation of specific mRNA levels may be mediated by insulin-induced changes in phospholipid metabolism and that diacylglycerol may play a pivotal role in insulin regulation of gene expression.

Phorbol ester inhibition of insulin-stimulated deoxyribonucleic acid synthesis in BC3H-1 myocytes.

Insulin and 12-O-tetradecanoyl phorbol 13-acetate (TPA) each acutely stimulates hexose transport, amino acid uptake, and pyruvate dehydrogenase activity in the BC3H-1 myocyte in a nonadditive fashion, suggesting that the acute effects of insulin and TPA are mediated through a common mechanism of action. Here we have demonstrated that while chronic incubation with insulin stimulated DNA synthesis by 3- to 6-fold, TPA, in contrast, did not stimulate DNA synthesis and, indeed, caused a 70% inhibition of insulin-stimulated DNA synthesis in a dose-dependent fashion. In differentiated myocytes, insulin maximally stimulated hydroxyurea-sensitive [3H]thymidine incorporation into DNA at 200-400 nM with an ED50 of 5-8 nM, suggesting that insulin stimulates DNA synthesis via the insulin receptor rather than through growth factor receptors. Phorbol ester inhibition of insulin-stimulated DNA synthesis was specific for the active tumor-promoting phorbols and the synthetic diacylglycerol 1-oleoyl-2-acetyl-sn-glycerol. Maximal TPA inhibition of insulin-stimulated DNA synthesis was observed at 100 nM with an ID50 of 30 nM TPA, values analogous to those required for TPA stimulation of hexose transport in the myocyte. Chronic incubation with TPA did not inhibit insulin-stimulated protein synthesis, acute K+ flux, K+ accumulation, cytosolic thymidine levels, or insulin binding, indicating that TPA inhibits a specific intracellular event mediating DNA synthesis and suggesting that the acute and chronic effects of insulin in BC3H-1 myocytes are regulated by distinct pathways.

Effect of insulin on the glucose utilization in isolated cardiac myocytes from adult rat.

The acute effects of insulin on glucose utilization in isolated rat quiescent cardiac myocytes were studied. Insulin (80 nM) increased the rate of glucose clearance by 2-3 times in the presence of glucose ranging from 0.3 microM to 5.5 mM. Glucose transport, which was measured in terms of both D-glucose uptake in the presence of 0.3 microM D-glucose and initial rate of uptake of 3-O-methylglucose, was stimulated 3-fold in the presence of insulin. At higher glucose concentrations (greater than 100 microM), a decrease in glucose clearance rate due to a shift of the rate-limiting step from glucose transport to a post-transport step in the pathway of glucose metabolism was observed. At the physiological concentration of glucose (5.5 mM), about 73% of glucose was metabolized into lactate, about 10% was oxidized into CO2 and the rest (17%) remained inside the cells. The pentose phosphate pathway did not contribute to the glucose metabolism in these cells. Insulin (80 nM) significantly increased the uptake of glucose (112%), and the conversions of glucose into lactate (16%), glycogen (64%), and triglyceride (18%), but not into CO2 (3%). Insulin transiently increased the percentage of I-form of glycogen synthase by 16% above basal, but did not affect the percentage of a-form of glycogen phosphorylase. The content of glucose 6-phosphate in the cells was increased by 46% above the basal value in the presence of insulin. These results indicate that insulin has different acute stimulatory effects on various steps in the metabolic pathway of glucose in isolated quiescent cardiac myocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Glucocorticoid-induced insulin resistance in vitro: inhibition of insulin-stimulated methylaminoisobutyric acid uptake.

We have previously developed an in vitro model for the induction of insulin resistance by glucocorticoids using 3T3-L1 fat cells (Grunfeld, Baird, Van Obberghen and Kahn 1981). In this model, glucocorticoid treatment was shown to decrease insulin binding and inhibit the acute stimulation of deoxyglucose uptake by insulin. We now extend the findings in this model to examine insulin stimulated methylaminoisobutyric acid (MAIB) uptake, an event whose expression requires m-RNA and protein synthesis and takes many hours. As previously seen with insulin stimulation of deoxyglucose uptake, one day of exposure to dexamethasone had little effect on insulin stimulation of MAIB uptake. Significant inhibition of insulin-stimulated MAIB uptake was seen after 2 days of exposure, and 3 days were required for the maximum effect of the glucocorticoid. The half-maximal concentration of dexamethasone required for inhibition was 1.6 nM. Exposure to dexamethasone produced a 57% decrease in the maximal response to insulin and a small but consistant shift in the sensitivity to insulin. As seen with the acute effects of insulin, the major locus of glucocorticoid action in inhibiting insulin stimulated MAIB uptake is also after the binding of insulin to its receptor. These data indicate that the inhibitory effects of glucocorticoids on insulin action in fat cells extend to those effects of insulin which require gene expression and are not merely limited to short-term metabolic actions of insulin.

Regulation of glycogen metabolism in primary cultures of rat hepatocytes. Restoration of acute effects of insulin and glucose in cells from diabetic rats.

Defects in the deposition of glycogen and the regulation of glycogen synthesis in the livers of severely insulin-deficient rats can be reversed, in vivo, within hours of insulin administration. Using primary cultures of hepatocytes isolated from normal and diabetic rats in a serum-free chemically defined medium, the present study addresses the chronic action of insulin to facilitate the direct effects of insulin and glucose on the short term regulation of the enzymes controlling glycogen metabolism. Primary cultures were maintained in the presence of insulin, triiodothyronine, and cortisol for 1-3 days. On day 1 in alloxan diabetic cultures, 10(-7) M insulin did not acutely activate glycogen synthase over a period of 15 min or 1 h, whereas insulin acutely activated synthase in cultures of normal hepatocytes. By day 3 in hepatocytes isolated from alloxan diabetic rats, insulin effected an approximate 30% increase in per cent synthase I within 15 min as was also the case for normal cells. The acute effect of insulin on synthase activation was independent of changes in phosphorylase alpha. Whereas glycogen synthase phosphatase activity could not be shown to be acutely affected by insulin, the total activity in diabetic cells was restored to normal control values over the 3-day culture period. The acute effect of 30 mM glucose to activate glycogen synthase in cultured hepatocytes from normal rats after 1 day of culture was missing in hepatocytes isolated from either alloxan or spontaneously diabetic (BB/W) rats. After 3 days in culture, glucose produced a 50% increase in glycogen synthase activity during a 10-min period under the same conditions. These studies clearly demonstrate that insulin acts in a chronic manner in concert with thyroid hormones and steroids to facilitate acute regulation of hepatic glycogen synthesis by both insulin and glucose.

The Acute Effects of Insulin on Plasma Triglyceride and Cholesterol Observed with the Glucose Clamp Technique

The Acute Effects of Insulin on Plasma Triglyceride and Cholesterol Observed with the Glucose Clamp Technique

Acute effects of insulin on surface insulin receptors in isolated hepatocytes. Evidence for a recycling pathway

Isolated rat hepatocytes were incubated for 1 h at 37 degrees C with 10 nM insulin. Following washout of insulin, cells were incubated with [125I] monoiodoinsulin at 15 degrees C to assess surface insulin binding. Preincubation with 10 nM insulin did not cause a decrease in insulin binding. Scatchard analysis confirmed that insulin receptor number remained constant. In the presence of 200 microM chloroquine or 25 microM monensin, surface insulin binding after preincubation with 10 nM insulin fell to 81.1 +/- 1.2% or 39.0 +/- 2.7% of control, respectively. It is suggested that the maintenance of insulin receptor number following acute insulin treatment in vitro is due to an insulin receptor recycling pathway, possibly involving lysosomes and/or the Golgi apparatus.

β-Adrenergic desensitization by chronic insulin exposure in 3T3-L1 cultured adipocytes

Cultured 3T3-L1 cells provide a model system for studies of the long-term regulation of lipolysis. Insulin acutely inhibits isoproterenol-stimulated lipolysis primarily by decreasing the apparent affinity apparent Km for isoproterenol. In contrast, chronic insulin exposure inhibits lipolysis by a reduction in the maximal effect of isoproterenol Vmax. The decrease in Vmax can be observed with insulin concentrations that are as low as 10 −9 mol/L at the time of addition. The effect is stable to washing, and the cells' responsiveness to isoproterenol returns partially with continued culture. Chronic insulin exposure also markedly reduced dibutyryl-cAMP-stimulated lipolysis indicating an insulin-induced change distal to cAMP concentration in the cascade of reactions controlling lipolysis in these cells. Time course and insulin dose-response experiments indicate an additional proximal alteration. These results indicate that: (1) 3T3-L1 cells are a useful model for studying the long-term regulation of lipolysis. (2) Chronic insulin exposure inhibits lipolysis by a mechanism that differs from the acute effect of insulin. (3) The chronic effects of insulin may be mediated through changes at multiple levels in the lipolytic cascade.

Acute effects of insulin on cardiovascular function and noradrenaline uptake and release.

Cette etude a pour but de regrouper les differentes etudes sur les effets de l'insuline sur la fonction cardiovasculaire et sur la liberation de noradrenaline, ainsi que les modifications de la glycemie, les modifications du volume plasmatique et de l'hematocrite, la morphologie des cellules endotheliales des capillaires

The effects of glucocorticoids on insulin-stimulated lipogenesis in primary cultures of rat hepatocytes.

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 microM) 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 4 h 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.