Estrogen – serotonin interaction and its implication on insulin resistance

ABSTRACT Introduction: Metabolic disease, including diabetes mellitus (DM), is a major burden worldwide. Obesity and insulin resistance (IR) are closely associated with DM. The action of estrogen and serotonergic neurons are known to improve insulin sensitivity and glucose homeostasis. Therefore, this report provides a comprehensive review focuses on the interaction between estradiol (E2) produced in the brain and serotonergic neurons in the development of IR. Methods: A literature review. Relevant studies were thoroughly reviewed and summarized to review a possible association between neuroestrogen and serotonin signaling in the development of IR. Results: DM is a common endocrine disease characterized by hyperglycemia. Evidence indicates that DM is strongly associated with IR. Previously, it has been reported that brain E2 modulates serotonergic neurons. Interestingly, both, E2 and serotonergic neurons are known to regulate insulin secretion and sensitivity through the central mechanism. This review highlights the importance of understanding the possible mechanisms of neuroestrogen – serotonergic neurons in modulating insulin sensitivity. Conclusion: Taken together, brain E2 possibly acts independently through estrogen receptor (ER) expressed in the hypothalamus or by stimulating serotonergic neurons to improve insulin sensitivity