Which of the following are normal systemic effects of glucocorticoids?

a. Enhanced proteolysis

b. Increased gluconeogenesis

d. Decreased rate of intestinal epithelial replication

The many systemic effects of glucocorticoids are related to regulation of intermediary metabolism. In this regard, perhaps the most important action is the effect of steroids on protein breakdown. A direct proteolytic effect of steroids is suggested by several lines of evidence.

Glucocorticoids enhance gluconeogenesis by both a direct effect on gluconeogenic hepatic enzymes and also by provision of substrate for gluconeogenesis by proteolysis. Glucocorticoid influence leads to the accentuation of lipolysis. The truncal obesity seen in steroid excess is related to the predominance of the lipogenic effect of insulin on truncal adipocytes over the lipolytic effect of glucocorticoids. The opposite relation may hold for the receptors in fat of the extremities and would explain the comparatively scant fat in these areas with steroid excess.

The most notable effect of glucocorticoids in the intestinal tract is a decrease in the rate of mucosal cell replication. In addition, decreased mucosal and pancreatic prostaglandin synthesis occur. This may have important implications for the cytoprotective mechanisms in the stomach.