Cortisol and catabolism: a new perspective.

In normal man there is a fine balance between anabolic and catabolic processes. Both are under hormonal control, with insulin acting as the prime anabolic agent and a group of hormones, glucagon, the two catecholamines and glucocorticoids, regulating catabolism. Growth hormone has a mixed anabolic and catabolic function directed primarily at amino acid and protein conservation. Recently there has been considerable interest in the role of these different hormones in pathological catabolic states, such as uncontrolled diabetes, severe burns, trauma and the postoperative state. As accurate methods have appeared for the measurement of these hormones, so each has been spotlighted and their roles have become more clearly defined. Recently glucagon has received much attention, for a period being considered as part of the cause of diabetes (Unger & Orci, 1975), and it has also been considered to be of major importance in determining the degree of catabolism in burns (Wilmore, Lindsey, Moylan, Faloona, Pruitt & Unger, 1974), starvation and other catabolic states (Unger, 1971). The importance of glucagon has undoubtedly been overemphasized and it is perhaps pertinent to reexamine the role of the other catabolic hormones, in particular the glucocorticoids, which have long been ignored and underemphasized as metabolic regulatory hormones. Much of the difficulty in ascribing roles to individual hormones has arisen from imprecise usage of the term catabolism. Many early workers equated catabolism with loss of muscle