Context: Adrenal and extra-adrenal @entity701 production may be involved in the development of @entity209 ( @entity1585 ). Objective: To investigate the activity of the @entity2339 and the expression of 11b- @entity26798 , GRa and GRb in the liver, Subcutaneous Adipose Tissue (SAT) and Visceral Adipose Tissue (VAT), in severely @entity28 @entity1 , with and without @entity1585 . Methods: Thirty seven (n=37) severely @entity28 @entity1 [Body Mass Index >= 40 kg/m2], 19 with @entity1585 ( @entity1585 ) and 18 without ( @entity1585 - group), were studied before and during bariatric surgery. Prior to the day of surgery, urinary free @entity701 (UFC) and diurnal variation of serum and salivary @entity701 were estimated. During surgery, biopsies of the liver, VAT and SAT were obtained. Expression of 11b- @entity26798 , GRa and GRb were evaluated by RT-PCR. Results: UFC and area under the curve for 24hours profiles of serum and salivary @entity701 were lower in the @entity1585 - group. In the @entity1585 - group, mRNA levels of 11b- @entity26798 in liver exhibited a negative correlation to liver GRa (LGRa) and VAT expression of 11b- @entity26798 was lower than the @entity1585 . Conclusions: We observed a downregulation of the liver GRa expression and lower VAT mRNA levels of 11b- @entity26798 in the @entity1585 - group, indicating a lower selective tissue @entity701 production and action that could protect these @entity1 from the metabolic consequences of @entity28 . In the @entity1585 - group a lower activity of the @entity2339 was also detected. Taken together, @entity701 in tissue and systematic level might play a role in the development of @entity1585 in severely @entity28 @entity1 .

XXXX in tissue and systemic level as a contributing factor to the development of @entity209 in severely @entity28 @entity1 .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity26798 :: ('26871', 'Gene') :: ['HSD1'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obesity', 'obese'] @entity2339 :: ('MESH:D007029', 'Disease') :: ['HPA axis', 'Hypothalamic-Pituitary-Adrenal (HPA) axis'] @entity1585 :: ('MESH:D065703', 'Disease') :: ['MetS', 'MetS+ group'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol'] @entity209 :: ('MESH:D008659', 'Disease') :: ['metabolic syndrome']
@entity701 :: (MESH:D006854,Chemical) :: ['Cortisol']
