Physiological glucocorticoid levels regulate glutamine and insulin-mediated glucose metabolism in skeletal muscle of the rat. Studies with RU 486 (mifepristone).

This study examined the effects of antagonism of the peak level of glucocorticoids in vivo, which occurs as rats enter the feeding/activity (dark) period on glucose and glutamine metabolism in incubated isolated rat soleus muscle preparations. Thus the rats were treated with the potent glucocorticoid antagonist RU 486 2 h before and 1 and 2 h into the dark period. Both the content of glutamine in skeletal muscle in vivo and plasma glucose and glutamine concentrations were elevated midway through the dark period, compared with the beginning of the period. RU 486 prevented the increases in plasma glucose and glutamine and caused a significant decrease in both the rate of release of glutamine in soleus muscle in vitro and the content of glutamine in gastrocnemius muscle. The sensitivity of soleus muscle to insulin in vitro is markedly decreased when isolated midway through the dark period (i.e. at 03:00 h) [Leighton, Kowalchuk, Challiss & Newsholme (1988) Am. J. Physiol. 255, E41-E45]. We now show that the concentrations of insulin required to stimulate lactate formation and glycogen synthesis half-maximally were 95 and 250 muunits/ml respectively, and treatment of rats with RU 486 decreased these values to 55 and 90 muunits of insulin/ml respectively. Thus antagonism of the action of the normal circadian rise in the level of glucocorticoids in rats reverses insulin insensitivity in soleus muscles in vitro.