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Background  The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11βHSD1) converts inactive cortisone into active cortisol in insulin target tissues. In people with type 2 diabetes, skeletal muscle (SkM) 11βHSD1 is upregulated by the potent glucocorticoid dexamethasone. The  HSD11B1  gene has two promoters designated P1 and P2. CCAAT/enhancer-binding protein beta (C/EBPβ) is known to regulate expression of 11βHSD1 via the P2 promoter. In this study, we investigated the potential role of altered DNA methylation of the P1 and P2 promoters in the observed dexamethasone-induced upregulation of SkM 11βHSD1 oxoreductase activity in human diabetic subjects. SkM biopsies from 15 people with type 2 diabetes were collected before and after treatment with oral dexamethasone 4 mg/day for 4 days and SkM 11βHSD1, C/EBPβ and P1 and P2 promoter region mRNA levels were measured by quantitative RT-PCR. 11βHSD1 oxoreductase activity was quantified by measuring the conversion of radiolabeled  3 H-cortisone to cortisol by thin layer chromatography. Analysis of  HSD11B1  promoter methylation (P1 and P2) was performed using Sequenom MassARRAY EpiTYPER analysis.    Results  Dexamethasone treatment resulted in a significant increase in 11βHSD1 mRNA levels ( P  = 0.003), oxoreductase activity ( P  = 0.017) and C/EBPβ mRNA ( P  = 0.015), and increased expression of both the P1 ( P  = 0.008) and P2 ( P  = 0.016) promoter regions . The distal P1 promoter region showed a significant reduction in methylation following dexamethasone ( P  = 0.026). There was a significant negative correlation between the change in methylation at this site and the increment in 11βHSD1 oxoreductase activity ( r  = −0.62,  P  = 0.014).    Conclusions  Our findings of reduced methylation in the  HSD11B1  P1 promoter in association with increased 11βHSD1 oxoreductase activity implicate complex multi-promoter epigenetic mechanisms in the regulation of 11βHSD1 levels in SkM.

clinical epigenetics

Evidence for transcript-specific epigenetic regulation of glucocorticoid-stimulated skeletal muscle 11β-hydroxysteroid dehydrogenase-1 activity in type 2 diabetes