High Plasma Free Fatty Acids Decrease Splanchnic Glucose Uptake in Patients with Non-Insulin-Dependent Diabetes Mellitus

Endocrine Journal

MASAHIKO IKEDA²  YOSHIMITSU YAMASAKI²  TADAHIRO TOMITA²  RYOHEI TOHDO¹  MUNEHIDE MATSUHISA²  MASARU KATSURA¹  MASATSUCU HORI²  MINORU KUBOTA³  YUICHI SHIBA²  ITSURO NAKAHARA² 

[1] Osaka National Hospital;First Department of Medicine, Osaka University School of Medicine;Department of Sociology, Kwansei Gakuin University

关键词: Free fatty acid;    Insulin resistance;    Splanchnic glucose uptake;    Peripheral glucose uptake;   

DOI  :  10.1507/endocrj.45.165

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(40)Cited-By(6)It has been proposed that high plasma free fatty acid (FFA) levels observed in patients with non-insulin dependent diabetes mellitus (NIDDM) contribute to the development of their insulin resistance. We examined patients with NIDDM to find whether maintaining plasma FFA levels in the fasting range with a euglycemic hyperinsulinemic clamp combined with an oral glucose load (clamp OGL) would affect insulin-mediated peripheral glucose uptake (PGU) and splanchnic glucose uptake (SGU). Nine NIDDM subjects (age, 55±3 years; duration of diabetes, 11±2 years; body mass index, 21.0 ±0.4kg/m2; hemoglobin A1c, 9.0±0.3%; fasting plasma glucose, 9.4±3.0mmol/l, means±SEM) were hospitalized and treated with diet, oral hypoglycemic agents or insulin for at least 2 weeks to maintain fasting plasma glucose <8mmol/l. All the patients were subjected to two different protocols in a random order. On one protocol, under the hyperinsulinemic condition, FFAs were maintained at the their fasting levels (1.19±0.08) by triglyceride emulsion infusion (Lipid infusion study, L), and on the other protocol, FFAs were made to fall (0.26±0.06mmol/l) with saline instead of triglyceride emulsion infusion (Saline infusion study, S). During euglycemic (L, 5.4±0.2; S, 5.1±0.2mmol/l) hyperinsulinemic (L, 1377±108; S, 1328±67pmol/l) clamp, high FFA levels significantly reduced PGU (L, 26.7±3.6; S, 32.1±3.4μmokg-1•min-1, P<0.05) and SGU (L, 12.1±4.2; S, 27.5±5.6%, P<0.05). In conclusion, high FFA levels in patients with NIDDM impaired insulin-mediated glucose uptake in the splanchnic as well as peripheral tissues.

【 授权许可】

Unknown