TY - JOUR

T1 - Heterogeneity in limb fatty acid kinetics in type 2 diabetes

AU - Sacchetti, M

AU - Olsen, D B

AU - Saltin, B

AU - Van Hall, Gerrit

N1 - Keywords: Arm; Biological Transport; Blood Flow Velocity; Body Composition; Body Mass Index; Diabetes Mellitus, Type 2; Fatty Acids, Nonesterified; Femoral Artery; Femoral Vein; Humans; Leg; Male; Middle Aged; Palmitic Acid; Reference Values

PY - 2005

Y1 - 2005

N2 - AIMS/HYPOTHESIS: In order to test the hypothesis that disturbances in skeletal muscle fatty acid metabolism with type 2 diabetes are not equally present in the upper and lower limbs, we studied fatty acid kinetics simultaneously across the arm and leg of type 2 diabetic patients (n=6) and matched control subjects (n=7) for 5 h under baseline conditions and during a 4-h hyperinsulinaemic-euglycaemic clamp. METHODS: Limb fatty acid kinetics was determined by means of continuous [U-(13)C]palmitate infusion and measurement of arteriovenous differences. RESULTS: The systemic palmitate rate of appearance was 3.6+/-0.4 and 2.7+/-0.3 micromol.kg lean body mass(-1).min(-1) and decreased during the clamp by 26% (p=0.04) and 43% (p<0.01) in the diabetic patients and in the control subjects respectively. At baseline, palmitate uptake across the arm was similar in the two groups, whereas leg palmitate uptake was lower than in the arm in the diabetic patients. During the clamp, palmitate uptake decreased in the arm (-48%, p=0.02) and the leg (-38%, p=0.04) of the control subjects, whereas it decreased in the arm (-30%, p=0.04) but not in the leg of the diabetic patients. Similarly, during the clamp palmitate release was substantially suppressed in the arm (-47%, p<0.01) and the leg of the control subjects (-45%, p<0.01), but only in the arm of the diabetic patients (-45%, p<0.01). CONCLUSIONS/INTERPRETATION: The present data indicate that type 2 diabetes is characterised by heterogeneity in the dysregulation of skeletal muscle fatty acid metabolism, with only the leg, but not the arm, showing an impairment of fatty acid kinetics at baseline and during a hyperinsulinaemic-euglycaemic clamp causing a physiological increase in insulin concentration.

AB - AIMS/HYPOTHESIS: In order to test the hypothesis that disturbances in skeletal muscle fatty acid metabolism with type 2 diabetes are not equally present in the upper and lower limbs, we studied fatty acid kinetics simultaneously across the arm and leg of type 2 diabetic patients (n=6) and matched control subjects (n=7) for 5 h under baseline conditions and during a 4-h hyperinsulinaemic-euglycaemic clamp. METHODS: Limb fatty acid kinetics was determined by means of continuous [U-(13)C]palmitate infusion and measurement of arteriovenous differences. RESULTS: The systemic palmitate rate of appearance was 3.6+/-0.4 and 2.7+/-0.3 micromol.kg lean body mass(-1).min(-1) and decreased during the clamp by 26% (p=0.04) and 43% (p<0.01) in the diabetic patients and in the control subjects respectively. At baseline, palmitate uptake across the arm was similar in the two groups, whereas leg palmitate uptake was lower than in the arm in the diabetic patients. During the clamp, palmitate uptake decreased in the arm (-48%, p=0.02) and the leg (-38%, p=0.04) of the control subjects, whereas it decreased in the arm (-30%, p=0.04) but not in the leg of the diabetic patients. Similarly, during the clamp palmitate release was substantially suppressed in the arm (-47%, p<0.01) and the leg of the control subjects (-45%, p<0.01), but only in the arm of the diabetic patients (-45%, p<0.01). CONCLUSIONS/INTERPRETATION: The present data indicate that type 2 diabetes is characterised by heterogeneity in the dysregulation of skeletal muscle fatty acid metabolism, with only the leg, but not the arm, showing an impairment of fatty acid kinetics at baseline and during a hyperinsulinaemic-euglycaemic clamp causing a physiological increase in insulin concentration.

U2 - 10.1007/s00125-005-1727-1

DO - 10.1007/s00125-005-1727-1

M3 - Journal article

C2 - 15830181

VL - 48

SP - 938

EP - 945

JO - Diabetologia

JF - Diabetologia

SN - 0012-186X

IS - 5

ER -