Non-esterified Fatty Acid Availability Research Articles

The impact of forearm immobilization and acipimox administration on muscle amino acid metabolism and insulin sensitivity in healthy, young volunteers.

Although the mechanisms underpinning short-term muscle disuse atrophy and associated insulin resistance remain to be elucidated, perturbed lipid metabolism might be involved. Our aim was to determine the impact of acipimox administration [i.e., pharmacologically lowering circulating nonesterified fatty acid (NEFA) availability] on muscle amino acid metabolism and insulin sensitivity during short-term disuse. Eighteen healthy individuals (age: 22 ± 1 years; body mass index: 24.0 ± 0.6 kg·m-2) underwent 2 days forearm immobilization with placebo (PLA; n = 9) or acipimox (ACI; 250 mg Olbetam; n = 9) ingestion four times daily. Before and after immobilization, whole body glucose disposal rate (GDR), forearm glucose uptake (FGU; i.e., muscle insulin sensitivity), and amino acid kinetics were measured under fasting and hyperinsulinemic-hyperaminoacidemic-euglycemic clamp conditions using forearm balance and l-[ring-2H5]-phenylalanine infusions. Immobilization did not affect GDR but decreased insulin-stimulated FGU in both groups, more so in ACI (from 53 ± 8 to 12 ± 5 µmol·min-1) than PLA (from 52 ± 8 to 38 ± 13 µmol·min-1; P < 0.05). In ACI only, and in contrast to our hypothesis, fasting arterialized NEFA concentrations were elevated to 1.3 ± 0.1 mmol·L-1 postimmobilization (P < 0.05), and fasting forearm NEFA balance increased approximately fourfold (P = 0.10). Forearm phenylalanine net balance decreased following immobilization (P < 0.10), driven by an increased rate of appearance [from 32 ± 5 (fasting) and 21 ± 4 (clamp) preimmobilization to 53 ± 8 and 31 ± 4 postimmobilization; P < 0.05] while the rate of disappearance was unaffected by disuse or acipimox. Disuse-induced insulin resistance is accompanied by early signs of negative net muscle amino acid balance, which is driven by accelerated muscle amino acid efflux. Acutely elevated NEFA availability worsened muscle insulin resistance without affecting amino acid kinetics, suggesting increased muscle NEFA uptake may contribute to inactivity-induced insulin resistance but does not cause anabolic resistance.NEW & NOTEWORTHY We demonstrate that 2 days of forearm cast immobilization in healthy young volunteers leads to the rapid development of insulin resistance, which is accompanied by accelerated muscle amino acid efflux in the absence of impaired muscle amino acid uptake. Acutely elevated fasting nonesterified fatty acid (NEFA) availability as a result of acipimox supplementation worsened muscle insulin resistance without affecting amino acid kinetics, suggesting increased muscle NEFA uptake may contribute to inactivity-induced insulin resistance but does not cause anabolic resistance.

Postprandial Responses of Energy Substrates in Dogs Fed High Fat‐ vs High Protein‐Low Carbohydrate Ketogenic Foods Relative to a High Carbohydrate Food

ObjectiveReduction of dietary carbohydrate (CHO) can increase circulating ketone availability and may aid disease management including inflammatory bowel disease, cancer, diabetes and cognitive decline. Companion animal dogs are prone to all of these maladies. Postprandial to a mixed macronutrient meal, non‐esterified fatty acids (NEFA) and beta‐hydroxybutyrate (BHB) decrease. In contrast, both glucose and blood urea nitrogen (BUN) increase. Triglycerides (TG) comprise circulating fat energy after a fat‐containing meal although medium chain TG (MCT) are preferentially catabolized to ketones. The postprandial responses of dogs to habitual feeding of high fat versus high protein low CHO foods, relative to high CHO foods, is not known. Therefore, we compared fasting (0 hr) and 2‐0 hr delta values for BHB, NEFA, TG, glucose, BUN as markers of available energy for these foods in dogs.MethodsDogs housed in pairs, with daily group exercise in outdoor grassy runs. Dogs returned to the colony healthy after the study; no invasive procedures. Blood collections under approved protocols at 0 hours (immediately before a meal) and at 2 hours postprandial. Macronutrients (P/F/C; % energy) for the 3 foods: HiCHO (25/37/38); LoCHOprot (50/44/6); LoCHOfat (28/68/4). The LoCHOfat food further contained 22% of dietary fat energy as MCT. Prospective randomized crossover trial (2 groups, n = 18). HiCHO was the wash‐in food followed by LoCHOprot or LoCHOfat in randomized order (5 wk feeding each food). Foods analyzed according to AOAC methods. Energy substrates BHB, NEFA, TG, glucose and BUN measured by Cobas or enzymatic reaction. Individual diet differences by dependent samples t‐test, linear mixed modeling for overall diet effect. Significance at α = 0.05.ResultsAnalyzed ketogenic ratios of the foods: HiCHO (0.46), LoCHOprot (1.1), and LoCHOfat (1.7). At fasting, LoCHOprot and LoCHOfat elevated circulating BHB above HiCHO food with LoCHOfat BHB higher than LoCHOprot. Between 0‐2 hours postprandial, BHB decreased for HiCHO (‐23%) and increased more for LoCHOfat (+100%) than LoCHOprot (+33%). Fasting NEFA were higher in LoCHOprot than LoCHOfat, and not different otherwise. From 0‐2 hours postprandial all foods showed decreased NEFA: HiCHO (‐43%), LoCHOprot (‐57%), LoCHOfat (‐12%). Fasting glucose was not different between groups. From 0‐2 hours postprandial LoCHOprot (‐4%) and LoCHOfat (‐8%) showed decreased glucose while HiCHO was unchanged. Fasting TG levels were different between all foods with the LoCHOprot (‐45%) and LoCHOfat (‐37%) lower than HiCHO. From 0‐2 hours postprandial all dogs showed increased TG with all values different between groups: HiCHO (+135%), LoCHOprot (+356%), LoCHOfat (+591%). Fasting BUN was higher with LoCHOprot than either HiCHO (‐27%) or LoCHOfat (‐26%). From 0‐2 hours postprandial all dogs showed increased BUN with all changes different: HiCHO (+17%), LoCHOprot (+42%), LoCHOfat (+23%).ConclusionsThe LoCHOfat food increased postprandial availability of BHB, NEFA and TG energy while decreasing glucose energy. LoCHOprot primarily enhanced available energy from protein as shown by increased amino acid catabolism to BUN, with additional contributions from BHB, NEFA and TG. The HiCHO food presented only glucose and TG as energy postprandial. Together these data show that a moderate protein, high fat, low CHO food with added MCT can selectively apportion postprandial energy toward ketone and fats while decreasing availability of glucose.

Associations Among Dietary Fat Oxidation Responses to Overfeeding and Weight Gain in Obesity-Prone and Resistant Adults.

OBJECTIVE:We tested the hypothesis that three days of overfeeding (OF) decreases dietary fat oxidation and predicts longitudinal weight change in adults classified as obesity-prone (OP) and obesity-resistant (OR) based on self-identification, personal and family weight history. Changes in diurnal profiles of plasma metabolites and hormones were measured to probe mechanisms.METHODS:Adults identified as OP (n=22; BMI: 23.9 ± 2.4 kg/m2) and OR (n=30; BMI: 20.5 ± 2.2 kg/m2) completed 3 days of eucaloric (EU) feeding and 3 days of OF. On day three, 24-hr total and dietary fat oxidation were measured using room calorimetry and an oral 14C tracer. Plasma glucose, insulin, triglycerides (TG), and non-esterified fatty acid (NEFA) concentrations were frequently sampled over 24-hr. Body composition was measured annually for 4.0 ± 1.4 years in a sub-sample (n=19 OP and 23 OR).RESULTS:Dietary fat oxidation over 24-hr was not altered by OF versus EU (P=0.54). Weight gain in OP correlated with lower nocturnal NEFA concentrations during OF (r=−0.60, P=0.006) and impaired fuel selection over 24-hr (metabolic inflexibility, wake RQ-sleep RQ) (r=−0.48, P=0.04).CONCLUSIONS:Short-term OF did not alter dietary fat oxidation. Lower nocturnal NEFA availability and metabolic inflexibility to overfeeding may be factors contributing to weight gain.

Metabolic flexibility to lipid availability during exercise is enhanced in individuals with high insulin sensitivity.

Metabolic flexibility to lipid (MetFlex-lip) is the capacity to adapt lipid oxidation to lipid availability. Hypothetically, impaired MetFlex-lip in skeletal muscle induces accumulation of lipid metabolites that interfere with insulin signaling. Our aim was to compare MetFlex-lip during exercise in subjects with low (Low_IS) vs. high (High_IS) insulin sensitivity. Twenty healthy men were designated as Low_IS or High_IS on the basis of the median of the homeostatic model assessment of insulin resistance index. Groups had similar age, body mass index, and maximum oxygen uptake (V̇o2max). Subjects cycled at 50% V̇o2max until expending 650 kcal. Adaptation in lipid oxidation was calculated as the drop in respiratory quotient (RQ) at the end of exercise vs. the maximum RQ (ΔRQ). Lipid availability was calculated as the increase in circulating nonesterified fatty acids (NEFA) at the end of exercise vs. the minimum NEFA (ΔNEFA). ΔRQ as a function of ΔNEFA was used to determine MetFlex-lip. On average, RQ and circulating NEFA changed similarly in both groups. However, ΔRQ correlated with ΔNEFA in High_IS ( r = -0.83, P < 0.01) but not in Low_IS ( r = -0.25, P = 0.48) subjects. Thus the slope of the ΔRQ vs. ΔNEFA relationship was steeper in High_IS vs. Low_IS subjects (-0.139 ± 0.03 vs. -0.025 ± 0.03 RQ·mmol-1·l-1, respectively; P < 0.05), with similar intercepts. We conclude that in subjects with High_IS lipid-to-carbohydrate oxidation ratio adapts to the increased circulating NEFA availability during exercise. Such MetFlex-lip appears impaired in subjects with Low_IS. Whether a cause-effect relationship exists between impaired MetFlex-lip and low insulin sensitivity remains to be determined.

Substraatgebruik bij paarden tijdens inspanning - een vergelijking tussen de ‘gevaste’ en postprandiale status

Sporten in uitgevaste toestand heeft positieve effecten op het prestatievermogen van humane atleten. Bij paarden gaat trainen in gevaste toestand gepaard met een toegenomen mobilisatie van vrije vetzuren als energiebron. Er wordt verondersteld dat de hogere beschikbaarheid van vet als energiebron leidt tot een minder snelle depletie van spierglycogeen en een trager optreden van spierverzuring. Dit draagt in belangrijke mate bij tot het minder snel optreden van spiervermoeidheid. Omgekeerd zorgt de opname van een graanmaaltijd voor een uitgesproken plasma-insulinepiek en de onderdrukking van lipolyse. Gezien ruwvoer, de hoofdcomponent van het dieet van het paard, een lange passagetijd heeft doorheen de dikke darm, wordt een volledig uitgevaste status bij het paard normaal niet bereikt; dit in tegenstelling tot wat het geval is bij de mens. Het voeren van ruwvoer induceert echter geen uitgesproken plasma-insulinepiek en inhibeert daardoor geen lipolyse. Bovendien zorgt de darmflora in de dikke darm, waar het ruwvoer gefermenteerd wordt, voor een buffer van water en elektrolyten, alsook voor een continue bron van propionzuur. Dit propionzuur wordt verwerkt in de lever, waar het een precursor is voor de gluconeogenese. In tegenstelling tot wat bekend is bij menselijke atleten is er bij paarden nog heel wat te ontdekken wat betreft optimale diëtaire interventies voorafgaand aan competitie enerzijds en training anderzijds. Welke aanpak er ook gekozen wordt, ruwvoer van hoge kwaliteit hoort het sleutelingrediënt te zijn van elk paardendieet. De meeste paarden presteren even goed tot zelfs beter als ze op een dieet staan met een lager suikergehalte (dus minder of geen krachtvoer), op voorwaarde dat hoog kwalitatief ruwvoer wordt aangeboden (gras, voordroog of hooi) in combinatie met een vitaminen/ mineralensupplement. Andere alternatieven om niet-structurele koolhydraten te verlagen in het dieet van een paard met een hoge energiebehoefte is het gebruik van bijvoorbeeld vezelrijke krachtvoeders of gepilleteerde ruwvoerderbronnen, zoals luzernekorrels. Tot slot heeft het frequent voederen van meerdere kleine maaltijden per dag de voorkeur boven het voederen van twee “grote” maaltijden per dag.

Combined pharmacological activation of AMPK and PPARδ potentiates the effects of exercise in trained mice.

The combined activation of the cellular energy sensor AMP‐activated protein kinase (AMPK) and the nuclear transcription factor peroxisome proliferator‐activated receptor delta (PPAR δ) has been demonstrated to improve endurance and muscle function by mimicking the effects of exercise training. However, their combined pharmacological activation with exercise training has not been explored. Balb/c mice were trained on a treadmill and administered both the AMPK activator AICAR and the PPAR δ agonist GW0742 for 4 weeks. AICAR treatment potentiated endurance, but the combination of AICAR and GW0742 further potentiated endurance and increased all running parameters significantly relative to exercised and nonexercised groups (138–179% and 355% increase in running time, respectively). Despite the lack of change in basal whole‐body metabolism, a significant shift to fat as the main energy source with a decline in carbohydrate utilization was observed upon indirect calorimetry analysis at the period near exhaustion. Increased energy substrates before exercise, and elevated muscle nonesterified fatty acids (NEFA) and elevated muscle glycogen at exhaustion were observed together with increased PDK4 mRNA expression. Citrate synthase activity was elevated in AICAR‐treated groups, while PGC‐1α protein level tended to be increased in GW0742‐treated groups. At exhaustion, Pgc1a was robustly upregulated together with Pdk4, Cd36, and Lpl in the muscle. A robust upregulation of Pgc1a and a downregulation in Chrebp were observed in the liver. Our data show that combined pharmacological activation of AMPK and PPAR δ potentiates endurance in trained mice by transcriptional changes in muscle and liver, increased available energy substrates, delayed hypoglycemia through glycogen sparing accompanied by increased NEFA availability, and improved substrate shift from carbohydrate to fat.

Apolipoprotein CIII overexpression exacerbates diet-induced obesity due to adipose tissue higher exogenous lipid uptake and retention and lower lipolysis rates

BackgroundHypertriglyceridemia is a common type of dyslipidemia found in obesity. However, it is not established whether primary hyperlipidemia can predispose to obesity. Evidences have suggested that proteins primarily related to plasma lipoprotein transport, such as apolipoprotein (apo) CIII and E, may significantly affect the process of body fat accumulation. We have previously observed an increased adiposity in response to a high fat diet (HFD) in mice overexpressing apoCIII. Here, we examined the potential mechanisms involved in this exacerbated response of apoCIII mice to the HFD.MethodsWe measured body energy balance, tissue capacity to store exogenous lipids, lipogenesis and lipolysis rates in non-transgenic and apoCIII overexpressing mice fed a HFD during two months.ResultsFood intake, fat excretion and whole body CO2 production were similar in both groups. However, the adipose tissue mass (45 %) and leptin plasma levels (2-fold) were significantly greater in apoCIII mice. Lipogenesis rates were similar, while exogenous lipid retention was increased in perigonadal (2-fold) and brown adipose tissues (40 %) of apoCIII mice. In addition, adipocyte basal lipolysis (55 %) and in vivo lipolysis index (30 %) were significantly decreased in apoCIII mice. A fat tolerance test evidenced delayed plasma triglyceride clearance and greater transient availability of non-esterified fatty acids (NEFA) during the post-prandial state in the apoCIII mice plasma. Thus, apoCIII overexpression resulted in increased NEFA availability to adipose uptake and decreased adipocyte lipolysis, favoring lipid enlargement of adipose depots.ConclusionWe propose that plasma apoCIII levels represent a new risk factor for diet-induced obesity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12986-015-0058-6) contains supplementary material, which is available to authorized users.

Fat oxidation, hormonal and plasma metabolite kinetics during a submaximal incremental test in lean and obese adults.

This study aimed to compare fat oxidation, hormonal and plasma metabolite kinetics during exercise in lean (L) and obese (O) men. Sixteen L and 16 O men [Body Mass Index (BMI): 22.9±0.3 and 39.0±1.4 kg.m−2] performed a submaximal incremental test (Incr) on a cycle-ergometer. Fat oxidation rates (FORs) were determined using indirect calorimetry. A sinusoidal model, including 3 independent variables (dilatation, symmetry, translation), was used to describe fat oxidation kinetics and determine the intensity (Fatmax) eliciting maximal fat oxidation. Blood samples were drawn for the hormonal and plasma metabolite determination at each step of Incr. FORs (mg.FFM−1.min−1) were significantly higher from 20 to 30% of peak oxygen uptake () in O than in L and from 65 to 85% in L than in O (p≤0.05). FORs were similar in O and in L from 35 to 60% . Fatmax was 17% significantly lower in O than in L (p<0.01). Fat oxidation kinetics were characterized by similar translation, significantly lower dilatation and left-shift symmetry in O compared with L (p<0.05). During whole exercise, a blunted lipolysis was found in O [lower glycerol/fat mass (FM) in O than in L (p≤0.001)], likely associated with higher insulin concentrations in O than in L (p<0.01). Non-esterified fatty acids (NEFA) were significantly higher in O compared with L (p<0.05). Despite the blunted lipolysis, O presented higher NEFA availability, likely due to larger amounts of FM. Therefore, a lower Fatmax, a left-shifted and less dilated curve and a lower reliance on fat oxidation at high exercise intensities suggest that the difference in the fat oxidation kinetics is likely linked to impaired muscular capacity to oxidize NEFA in O. These results may have important implications for the appropriate exercise intensity prescription in training programs designed to optimize fat oxidation in O.

Appetite sensations and substrate metabolism at rest, during exercise, and recovery: impact of a high-calcium meal

The aim of this study was to investigate the effects of the calcium content of a high-carbohydrate, pre-exercise meal on substrate metabolism and appetite sensations before, during, and after exercise. Nine active males participated in 2 trials in a double-blind, randomised, crossover design. After consuming a high carbohydrate (1.5 g · kg(-1) of body mass) breakfast with a calcium content of either 3 (control trial) or 9 mg · kg(-1) of body mass (high milk-calcium (CAL)), participants ran at 60% peak oxygen uptake for 60 min. Following exercise, a recovery drink was consumed and responses were investigated for a further 90 min. Blood and expired gas were sampled throughout to determine circulating substrate and hormone concentrations and rates of substrate oxidation. Visual analogue scales were also administered to determine subjective appetite sensations. Neither whole-body lipid oxidation nor non-esterified fatty acid availability differed between trials. The area under the curve for the first hour following breakfast consumption was 16% (95% confidence interval: 0%-35%) greater for fullness and 10% (95% confidence interval: 2%-19%) greater for insulin in the CAL trial but these differences were transient and not apparent later in the trial. This study demonstrates that increasing the calcium content of a high carbohydrate meal transiently increases insulinemia and fullness but substrate metabolism is unaffected.

Effect of dietary fats with odd or even numbers of carbon atoms on metabolic response and muscle damage with exercise in Quarter Horse–type horses with type 1 polysaccharide storage myopathy

To evaluate effects of fats with odd and even numbers of carbon atoms on muscle metabolism in exercising horses with polysaccharide storage myopathy (PSSM). 8 horses with PSSM (6 females and 2 males; mean +/- SD age, 6.3 +/- 3.9 years). Isocaloric diets (grain, triheptanoin, corn oil, and high-fat, low-starch [HFLS] feed) were fed for 3 weeks each; horses performed daily treadmill exercise. Grain was fed to establish an exercise target, and HFLS feed was fed as a negative control diet. Daily plasma samples were obtained. For each diet, a 15-minute exercise test was performed, and gluteus medius muscle specimens and blood samples were obtained before and after exercise. Feeding triheptanoin, compared with the corn oil diet, resulted in exercise intolerance; higher plasma creatine kinase (CK) activity and concentrations of C3:0- and C7:0-acylcarnitine and insulin; and lower concentrations of nonesterified fatty acids (NEFA) and C16:0-, C18:1-, and C18:2-acylcarnitine, without changes in concentrations of plasma glucose or resting muscle substrates and metabolites. Feeding grain induced higher CK activity and insulin concentrations and lower NEFA concentrations than did corn oil or HFLS feed. Feeding grain induced higher glucose concentrations than did triheptanoin and corn oil. In muscle, feeding grain resulted in lower glucose-6-phosphate, higher citrate, and higher postexercise lactate concentrations than did the other diets. Triheptanoin had detrimental effects, reflecting decreased availability of NEFA, increased insulin stimulation of glycogen synthesis, and potential inhibition of lipid oxidation. Long-chain fats are the best dietetic for PSSM.

Dietary glycemic index influences lipid oxidation but not muscle or liver glycogen oxidation during exercise

The glycemic index (GI) of dietary carbohydrates influences glycogen storage in skeletal muscle and circulating nonesterified fatty acid (NEFA) concentrations. We hypothesized that diets differing only in GI would alter intramuscular lipid oxidation and glycogen usage in skeletal muscle and liver during subsequent exercise. Endurance-trained individuals (n = 9) cycled for 90 min at 70% Vo(2peak) and then consumed either high- or low-GI meals over the following 12 h. The following day after an overnight fast, the 90-min cycle was repeated. (1)H and (13)C magnetic resonance spectroscopy was used before and after exercise to assess intramuscular lipid and glycogen content of the vastus muscle group and liver. Blood and expired air samples were collected at 15-min intervals throughout exercise. NEFA availability was reduced during exercise in the high- compared with the low-GI trial (area under curve 44.5 +/- 6.0 vs. 38.4 +/- 7.30 mM/h, P < 0.05). Exercise elicited an approximately 55% greater reduction in intramyocellular triglyceride (IMCL) in the high- vs. low-GI trial (1.6 +/- 0.2 vs. 1.0 +/- 0.3 mmol/kg wet wt, P < 0.05). There was no difference in the exercise-induced reduction of the glycogen pool in skeletal muscle (76 +/- 8 vs. 68 +/- 5 mM) or in liver (65 +/- 8 vs. 71 +/- 4 mM) between the low- and high-GI trials, respectively. High-GI recovery diets reduce NEFA availability and increase reliance on IMCL during moderate-intensity exercise. Skeletal muscle and liver glycogen storage or usage are not affected by the GI of an acute recovery diet.

Peroxisome proliferator-activated receptor (PPAR) activation induces tissue-specific effects on fatty acid uptake and metabolism in vivo--a study using the novel PPARalpha/gamma agonist tesaglitazar.

Agonists of peroxisome proliferator-activated receptors (PPARs) have emerged as important pharmacological agents for improving insulin action. A major mechanism of action of PPAR agonists is thought to involve the alteration of the tissue distribution of nonesterified fatty acid (NEFA) uptake and utilization. To test this hypothesis directly, we examined the effect of the novel PPARalpha/gamma agonist tesaglitazar on whole-body insulin sensitivity and NEFA clearance into epididymal white adipose tissue (WAT), red gastrocnemius muscle, and liver in rats with dietary-induced insulin resistance. Wistar rats were fed a high-fat diet (59% of calories as fat) for 3 wk with or without treatment with tesaglitazar (1 micromol.kg(-1).d(-1), 7 d). NEFA clearance was measured using the partially metabolizable NEFA tracer, (3)H-R-bromopalmitate, administered under conditions of basal or elevated NEFA availability. Tesaglitazar improved the insulin sensitivity of high-fat-fed rats, indicated by an increase in the glucose infusion rate during hyperinsulinemic-euglycemic clamp (P < 0.01). This improvement in insulin action was associated with decreased diglyceride (P < 0.05) and long chain acyl coenzyme A (P < 0.05) in skeletal muscle. NEFA clearance into WAT of high-fat-fed rats was increased 52% by tesaglitazar under basal conditions (P < 0.001). In addition the PPARalpha/gamma agonist moderately increased hepatic and muscle NEFA utilization and reduced hepatic triglyceride accumulation (P < 0.05). This study shows that tesaglitazar is an effective insulin-sensitizing agent in a mild dietary model of insulin resistance. Furthermore, we provide the first direct in vivo evidence that an agonist of both PPARalpha and PPARgamma increases the ability of WAT, liver, and skeletal muscle to use fatty acids in association with its beneficial effects on insulin action in this model.

During exercise in the cold increased availability of plasma nonesterified fatty acids does not affect the pattern of substrate oxidation

Exercise in the cold was investigated to establish if the relative contribution of fat to energy expenditure is affected by the increased availability of circulating nonesterified fatty acids (NEFA). Seven men after an overnight fast cycled at approximately 70% of peak oxygen uptake for 60 minutes at an ambient temperature of 0.0°C ± 0.1°C. Fifteen minutes prior to exercise and then throughout the exercise, subjects were infused with either heparin (heparin) or saline (control). Immediately before exercise NEFA concentration (control, 0.27 ± 0.04 mmol · L −1; heparin 1.09 ± 0.13 mmol · l −1) was significantly higher ( P < .05) in the heparin trial. Pre-exercise concentration of plasma triacylglycerol (TG), blood glycerol, glucose, oxygen consumption (V̇ o 2) and respiratory exchange ratio (RER) were not significantly different between heparin and control trials. During exercise, plasma NEFA and blood glycerol concentrations were significantly higher ( P < .05) in the heparin trial, and levels of plasma TG and glucose were not different between trials. Over the exercise period rectal temperature, mean skin temperature, V̇ o 2, RER, and heart rate (HR) were not different between the 2 trials. Gross energy expenditure of cycling (control, 3.3 ± 0.1 MJ; heparin 3.3 ± 0.1 MJ), the oxidation rates of fat (control, 0.67 ± 0.05 g · min −1; heparin, 0.71 ± 0.06 g · min −1) and carbohydrate (CHO) (control, 1.68 ± 0.04 g·min −1; heparin, 1.62 ± 0.17 g · min −1) and the proportion of energy derived from fat (control, 43 ± 4%; heparin trial, 44 ± 9%) and CHO (control, 57 ± 4%; heparin trial, 56 ± 4%) were not different between the 2 trials. These findings suggest that despite increased availability of plasma NEFA, the pattern of substrate oxidation during exercise in cold temperatures does not change. This implies that uncoupling between the availability and oxidation of plasma NEFA may be a mechanism involved in the reduced oxidation of fat seen during cold exposure. Further research is needed on the utilization of intramuscular TG and circulating plasma TG-rich lipoproteins in the cold.

Glycerol and NEFA kinetics in long-term fasting king penguins: phase II versus phase III.

In spontaneously fasting birds such as penguins, below a body mass threshold corresponding to the phase II-phase III transition, a metabolic and hormonal shift occurs and feeding behaviour is stimulated ('refeeding signal'). The major aim of this study was to determine whether a decrease in non-esterified fatty acid (NEFA) release from adipose tissue could be a component of this signal. Lipolytic fluxes and primary triacylglycerol:fatty acid (TAG:FA) cycling were determined in vivo in breeding, fasting king penguins (Aptenodytes patagonicus) using continuous infusions of 2-[3H]glycerol and 1-[14C]palmitate under field conditions. In phase II (after approximately 8 days of fasting, large fat stores, body protein spared, N=8), the rate of appearance (R(a)) of glycerol and of NEFA were 5.7+/-0.8 and 10.5+/-0.4 micromol kg(-1) min(-1), respectively, and the percentage of primary TAG:FA cycling was 41+/-7%. In phase III (after approximately 25 days of fasting, fat stores reduced by fourfold, increased body protein catabolism, N=9), R(a) glycerol kg(-1) body mass remained unchanged, whereas R(a) glycerol kg(-1) fat mass and R(a) NEFA kg(-1) body mass were increased by 2.8-fold and 1.5-fold, respectively. Increased R(a) glycerol kg(-1) fat mass was possibly the result of a 3.5-fold increase in circulating glucagon, the increased R(a) NEFA kg(-1) body mass being attributable to decreased primary TAG:FA cycling. Thus, triggering of the refeeding signal that redirects the behavior of fasting, incubating penguins from incubation towards the search for food after entrance into phase III cannot be ascribed to a reduction in lipolytic fluxes and NEFA availability.

Blockade of fatty acid oxidation mimics phase II-phase III transition in a fasting bird, the king penguin.

This study tests the hypothesis that the metabolic and endocrine shift characterizing the phase II-phase III transition during prolonged fasting is related to a decrease in fatty acid (FA) oxidation. Changes in plasma concentrations of various metabolites and hormones and in lipolytic fluxes, as determined by continuous infusion of [2-(3)H]glycerol and [1-(14)C]palmitate, were examined in vivo in spontaneously fasting king penguins in the phase II status (large fat stores, protein sparing) before, during, and after treatment with mercaptoacetate (MA), an inhibitor of FA oxidation. MA induced a 7-fold decrease in plasma beta-hydroxybutyrate and a 2- to 2.5-fold increase in plasma nonesterified fatty acids (NEFA), glycerol, and triacylglycerols. MA also stimulated lipolytic fluxes, increasing the rate of appearance of NEFA and glycerol by 60-90%. This stimulation might be partly mediated by a doubling of circulating glucagon, with plasma insulin remaining unchanged. Plasma glucose level was unaffected by MA treatment. Plasma uric acid increased 4-fold, indicating a marked acceleration of body protein breakdown, possibly mediated by a 2.5-fold increase in circulating corticosterone. Strong similarities between these changes and those observed at the phase II-phase III transition in fasting penguins support the view that entrance into phase III, and especially the end of protein sparing, is related to decreased FA oxidation, rather than reduced NEFA availability. MA could be therefore a useful tool for understanding mechanisms underlying the phase II-phase III transition in spontaneously fasting birds and the associated stimulation of feeding behavior.

Effects of acipimox on the lipolysis rate in subcutaneous adipose tissue of obese subjects.

Acipimox is a hypolipidaemic agent reducing serum concentrations of triglycerides and non-esterified fatty acids. Acipimox may reduce triglyceride synthesis by decreasing non-esterified fatty acid availability from adipocytes, but this effect has yet to be demonstrated in vivo. Lipolysis after acipimox treatment was examined in subcutaneous adipose tissue of severely obese subjects with associated metabolic disorders. The microdialysis technique was performed in abdominal subcutaneous adipose tissue of eight hyperinsulinaemic subjects. After oral treatment with acipimox, glycerol concentration was determined as an index of lipolysis rate. Blood flow was assessed by the ethanol escape technique. The rates of release of glycerol from human adipose tissue maximally stimulated by norepinephrine were also investigated in the presence of acipimox. Eight weight- and age-matched subjects served as a control group. Under acipimox treatment, basal glycerol release decreased in subcutaneous adipose tissue, whereas no effect was observed on blood flow. In stimulated adipose tissue acipimox showed no effect. In the present study basal glycerol outflow from adipose tissue was inhibited by acipimox. The anti-lipolytic action of the agent may diminish elevated plasma concentrations of free fatty acids in subjects with severe obesity.

Sir David Cuthbertson Medal Lecture. Regulation of lipid metabolism in adipose tissue.

Adipose tissue is a major source of metabolic fuel. This metabolic fuel is stored in the form of triacylglycerol. Lipolysis of triacylglycerol yields non-esterified fatty acids and glycerol. In human subjects in vivo studies of the regulation of lipid metabolism in adipose tissue have been difficult because of the heterogeneous nature of the tissue and lack of a vascular pedicle. In the last decade the methodology of study of adipose tissue has improved with the advent of the anterior abdominal wall adipose tissue preparation technique and microdialysis. These techniques have demonstrated that lipid metabolism in adipose tissue is finely coordinated during feeding and fasting cycles, in order to provide metabolic fuel when required. Lipolysis takes place both in extracellular and intracellular space. The extracellular lipolysis is regulated by lipoprotein lipase and the intracellular lipolysis is regulated by hormone-sensitive lipase. In pathophysiological conditions such as trauma, sepsis and starvation profound changes are induced in the regulation of lipid metabolism. The increased mobilization of lipid fuel is brought about by the differential actions of various counter-regulatory hormones on adipose tissue blood flow and adipose tissue lipolysis through lipoprotein lipase and hormone-sensitive lipase, resulting in increased availability of non-esterified fatty acids as a source of fuel. In recent years, it has been demonstrated that adipose tissue produces various cytokines and these cytokines can have paracrine and endocrine effects. It would appear that adipose tissue has the ability to regulate lipid metabolism locally as well as at distant sites such as liver, muscle and brain. In future, it is likely that the mechanisms that lead to the secondary effects of lipid metabolism on atheroma, immunity and carcinogenesis will be demonstrated.

Lipolysis in skeletal muscle is rapidly regulated by low physiological doses of insulin.

Both patients with Type II (non-insulin-dependent) diabetes mellitus and normoglycaemic, insulin resistant subjects were shown to have an increased lipid content in skeletal muscle, which correlates negatively with insulin sensitivity. Recently, it was shown that during a hyperinsulinaemic euglycaemic clamp interstitial glycerol was reduced not only in adipose tissue but also in skeletal muscle. To assess whether lipolysis of muscular lipids is also regulated by low physiological concentrations of insulin, we used the microdialysis technique in combination with a 3-step hyperinsulinaemic glucose clamp. Nineteen lean, healthy subjects (12 m/7 f) underwent a glucose clamp with various doses of insulin (GC I = 0.1, GC II = 0.25 and GC III = 1.0 mU x kg(-1) x min(-1)). Two double lumen microdialysis catheters each were inserted in the paraumbilical subcutaneous adipose tissue and in skeletal muscle (tibialis anterior) to measure interstitial glycerol concentration (index of lipolysis) and ethanol outflow (index of tissue flow). During the different steps of the glucose clamp, glycerol in adipose tissue was reduced to 81 +/- 7 % (GC I), 55 +/- 8 % (GC II) and 25 +/- 5 % (GC III), respectively, of basal. In contrast, glycerol in skeletal muscle declined to 73 +/- 5 % (GC I) and to 57 +/- 6 % (GC II) but was not further reduced at GC III. Tissue flow was higher in the skeletal muscle and remained unchanged in both compartments throughout the experiment. This study confirms the presence of glycerol release in skeletal muscle. Lipolysis in skeletal muscle and adipose tissue are suppressed similarly by minute and physiological increases in insulin but differently by supraphysiological increases. Inadequate suppression of intramuscular lipolysis resulting in increased availability of non-esterified fatty acids, could represent a potential mechanism involved in the pathogenesis of impaired glucose disposal, i. e. insulin resistance, in muscle. [Diabetologia (1999) 42: 1171-1174]

Regulation of glucose production by NEFA and gluconeogenic precursors during chronic glucagon infusion.

We previously reported that simulation of the chronic hyperglucagonemia seen during infection was unable to recreate the infection-induced increase in hepatic glucose production. However, chronic hyperglucagonemia was accompanied by a fall in the arterial levels of gluconeogenic precursors as opposed to a rise as is seen during infection. Thus our aim was to determine whether an infusion of gluconeogenic precursors could increase hepatic glucose production in a setting of hyperglucagonemia. Studies were done in 11 conscious chronically catheterized dogs in which sampling (artery and portal and hepatic veins) and infusion catheters (splenic vein) were implanted 17 days before study. Forty-eight hours before infusion of gluconeogenic (GNG) precursors, a sterile fibrinogen clot was placed into the peritoneal cavity. Glucagon was infused over the subsequent 48-h period to simulate the increased glucagon levels (approximately 500 pg/ml) seen during infection. On the day of the experiment, somatostatin was infused peripherally, and basal insulin and simulated glucagon were infused intraportally. After a basal period, a two-step increase in lactate and alanine was initiated (120 min/step; n = 5). Lactate (Delta479 +/- 25 and Delta1, 780 +/- 85 microM; expressed as change from basal in periods I and II, respectively) and alanine (Delta94 +/- 13 and Delta287 +/- 44 microM) levels were increased. Despite increases in net hepatic GNG precursor uptake (Delta0.7 +/- 0.3 and Delta1.1 +/- 0.4 mg glucose . kg-1 . min-1), net hepatic glucose output did not increase. Because nonesterified fatty acid (NEFA) levels fell, in a second series of studies, the fall in NEFA was eliminated. Intralipid and heparin were infused during the two-step substrate infusion to maintain the NEFA levels constant in period I and increase NEFA availability in period II (Delta -29 +/- 29 and Delta689 +/- 186 microM; n = 6). In the presence of similar increases in net hepatic GNG precursor uptake and despite increases in arterial glucose levels (Delta17 +/- 5 and Delta38 +/- 12 mg/dl), net hepatic glucose output increased (Delta0.6 +/- 0.1 and Delta0.7 +/- 0.2 mg . kg-1 . min-1). In summary, a chronic increase in glucagon, when combined with an acute increase in gluconeogenic precursor and maintenance of NEFA supply, increases hepatic glucose output as is seen during infection.

Insulin kinetics, insulin action, and muscle morphology in lean or slightly overweight persons with impaired glucose tolerance

Glucose intolerance is influenced by body fat mass, as well as muscle fiber composition. To examine the relation between the metabolic profile and muscle morphology in this condition, we performed muscle biopsies and hyperglycemic clamps to determine insulin secretion and clearance, and the insulin effects on glucose disposal and nonesterified fatty acids (NEFA) in 45 glucose intolerant persons (body mass index [BMI], 27.8 ± 3.0 kg/m 2) and 45 normoglycemic controls (BMI, 25.8 ± 2.7 kg/m 2) ( P = .001). After adjustment for BMI, glucose-intolerant subjects had lower first-phase insulin release (726 v 954 pmol/L, P = .04). Glucose-intolerant subjects and controls differed in fasting insulin, insulin clearance, and insulin sensitivity to glucose disposal before, but not after, standardizing for BMI. During the clamp, glucose-intolerant subjects had less NEFA suppression and elevated levels of NEFA compared with controls (85% ± 9% v 90% ± 6%, P = .02; and 70 ± 42 μmol/L v 45 ± 28 μmol/L, P = .01). Glucose-intolerant subjects also had a higher percentage of insulin-insensitive, type 2b muscle fibers, which are not adapted for fat oxidation (7% ± 9% v 9% ± 9%, P = .003). BMI was not associated with NEFA suppression or the percentage of type 2b muscle fibers in either group. In conclusion, glucose-intolerant persons have impaired first-phase insulin release, an elevated percentage of type 2b muscle fibers, and increased NEFA availability. Reduced insulin clearance, hyperinsulinemia, and insulin resistance were associated with small increments in BMI.