Volume 47, Number 7, 1149-1156, DOI: 10.1007/s00125-004-1443-2

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European Association for the Study of Diabetes

Non-esterified fatty acids impair insulin-mediated glucose uptake and disposition in the liver

P. Iozzo, R. Lautamaki, F. Geisler, K. A. Virtanen, V. Oikonen, M. Haaparanta, H. Yki-Jarvinen, E. Ferrannini, J. Knuuti and P. Nuutila

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Abstract

Aims/hypothesis  

We investigated the effect of elevated circulating NEFA on insulin-mediated hepatic glucose uptake (HGU) and whole-body glucose disposal (M) in eight healthy male subjects.

Methods  

Studies were performed using positron emission tomography (PET) and [18F]-2-fluoro-2-deoxyglucose ([18F]FDG) during euglycaemic hyperinsulinaemia (0–120 min) and an Intralipid/heparin infusion (IL/Hep; –90–120 min). On a different day, similar measurements were taken during euglycaemic hyperinsulinaemia and saline infusion (SAL). Graphical and compartmental analyses were used to model liver data.

Results  

Circulating NEFA increased approximately three-fold during IL/Hep, and declined by 81±7% in the SAL study (ple0.01). Both M (–28±7%) and HGU (–25±9%) were significantly lowered by NEFA elevation (p=0.004 and p=0.035 respectively). In the whole data set, the decreases in M and HGU were positively correlated (r=0.78, p=0.038). No evidence of [18F]FDG outflow was detected during the scanning time. HGU was correlated with the phosphorylation rate parameter (r=0.71, p=0.003) as derived by compartmental modelling.

Conclusions/interpretation  

In healthy men, NEFA impair insulin-mediated HGU and whole-body glucose uptake to a similar extent. Our data suggest that multiple intracellular NEFA targets may concur to down-regulate glucose uptake by the liver.

Keywords  Glucose uptake - Insulin - Intralipid - Liver - NEFA

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