Abstract
Type 2 diabetes mellitus (T2DM) is associated with increased total plasma free fatty acid (FFA) concentrations and an elevated risk of cardiovascular disease. The exact mechanisms by which the plasma FFA profile of subjects with T2DM changes is unclear, but it is thought that dietary fats and changes to lipid metabolism are likely to contribute. Therefore, establishing the changes in concentrations of specific FFAs in an individual’s plasma is important. Each type of FFA has different effects on physiological processes, including the regulation of lipolysis and lipogenesis in adipose tissue, inflammation, endocrine signalling and the composition and properties of cellular membranes. Alterations in such processes due to altered plasma FFA concentrations/profiles can potentially result in the development of insulin resistance and coagulatory defects. Finally, fibrates and statins, lipid-regulating drugs prescribed to subjects with T2DM, are also thought to exert part of their beneficial effects by impacting on plasma FFA concentrations. Thus, it is also interesting to consider their effects on the concentration of FFAs in plasma. Collectively, we review how FFAs are altered in T2DM and explore the likely downstream physiological and pathological implications of such changes.
Highlights
In 2017, the worldwide occurrence of diabetes (both type-1 and type-2 diabetes mellitus (T2DM))was estimated to be at 425 million individuals, with this number predicted to rise to 629 million by2045 [1]
The frequently observed elevated levels of plasma free fatty acid (FFA) in obese patients result in metabolic changes, which can lead to numerous pathologies including insulin resistance and Type 2 diabetes mellitus (T2DM)
If the plasma FFA pool is high in palmitic acid, the hypothalamic-pituitary-adrenal axis is stimulated to release more cortisol, a process that contributes to insulin resistance [144]
Summary
In 2017, the worldwide occurrence of diabetes (both type-1 and type-2 diabetes mellitus (T2DM)). Altered blood glucose levels have important consequences in the body. They are directly or indirectly associated with many physiological processes including the control of glycogen and lipid metabolism, the control of food intake (satiety), maintenance of body weight and the regulation of inflammation, vasodilatation and basic cell growth and replication. As the metabolism of fats and carbohydrates are intimately intertwined, altered free fatty acid (FFA) levels in plasma and their metabolism are both a cause [2,3] and a consequence [4] of insulin resistance and T2DM, with many deleterious downstream effects such as chronic inflammation, loss of pancreatic β-cells, atherosclerosis, and heart disease being caused or exacerbated by elevated FFAs. In healthy individuals, FFA metabolism is tightly regulated.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
