Blockade of mineralocorticoid receptor ameliorates oral contraceptive-induced insulin resistance by suppressing elevated uric acid and glycogen synthase kinase-3 instead of circulating mineralocorticoid

Arch Physiol Biochem. 2020 Jul;126(3):225-234. doi: 10.1080/13813455.2018.1509220. Epub 2018 Oct 13.

Abstract

Context: Estrogen-progestin combined oral contraceptive (COC) has been connected to mineralocorticoid receptor (MR) activation and adverse cardiometabolic events. We consequently hypothesised that insulin resistance (IR), hyperuricemia, and elevated circulating GSK-3 induced by COC is through activation of MR via mineralocorticoid and glucocorticoid pathways.Methods: Female Wistar rats aged 12 weeks received (po) vehicle and COC (1.0 μg ethinylestradiol plus 5.0 μg levonorgestrel) with or without MR blocker (0.25 mg/kg spironolactone; Spl), daily for eight weeks.Results: Data showed that COC treatment led to increased IR, 1-hour postload glucose level, insulinemia, triglyceride/HDL-cholesterol ratio, total cholesterol/HDL-cholesterol ratio, uric acid, GSK-3, aldosterone, corticosterone values, impaired glucose tolerance and pancreatic β-cell function. However, MR blockade by Spl ameliorated all these alterations except that of aldosterone.Conclusion: The results demonstrate that COC induces IR, hyperuricemia and high GSK-3 levels through activation of MR via glucocorticoid dependent pathway.

Keywords: Glucocorticoids; Oral contraceptive steroids; glycogen synthase kinase-3; hyperuricemia; insulin resistance.

MeSH terms

  • Albumins / chemistry
  • Animals
  • Contraceptives, Oral / adverse effects*
  • Contraceptives, Oral / pharmacology
  • Estrogens / adverse effects
  • Estrogens / pharmacology
  • Female
  • Glucose Tolerance Test
  • Glycogen Synthase Kinase 3 / antagonists & inhibitors*
  • Insulin Resistance*
  • Insulin-Secreting Cells / metabolism
  • Intra-Abdominal Fat / drug effects
  • Mineralocorticoid Receptor Antagonists / chemistry*
  • Mineralocorticoids / blood*
  • Progestins / adverse effects
  • Progestins / pharmacology
  • Rats
  • Rats, Wistar
  • Receptors, Mineralocorticoid
  • Uric Acid / blood*

Substances

  • Albumins
  • Contraceptives, Oral
  • Estrogens
  • Mineralocorticoid Receptor Antagonists
  • Mineralocorticoids
  • Progestins
  • Receptors, Mineralocorticoid
  • Uric Acid
  • Glycogen Synthase Kinase 3