Metabolic effects of suppression of nonesterified fatty acid levels with acipimox in obese NIDDM subjects.

Abstract

NEFAs characteristically are elevated in obese NIDDM patients in both the basal state and after insulin. This elevation might aggravate glycemic control both by decreasing peripheral glucose disposal (glucose-fatty acid cycle), and by increasing HGO. Thus, lowering plasma NEFA levels might improve carbohydrate metabolism. We therefore measured HGO and fuel use (by indirect calorimetry) both in the basal state and during the last 30 min of a hyperinsulinemic clamp (0.025U.kg-1.h-1) in 8 obese NIDDM patients (BMI 34.8 +/- 1.0 kg/m2) after complete overnight suppression of plasma NEFA levels with acipimox, a new nicotinic acid analogue. After acipimox, mean basal plasma NEFA and glycerol levels were lower than control values (0.11 +/- 0.02 vs. 0.65 +/- 0.04 mM, P < 0.001; and 16 +/- 3 vs. 68 +/- 7 microM, P = 0.004, respectively) and were accompanied by a fall in lipid oxidation (acipimox vs. placebo: 16.1 +/- 1.2 vs. 38.8 +/- 2.4 mg.m-2 x min-1; P < 0.001) and a rise in glucose oxidation (91.1 +/- 6.2 vs. 54.1 +/- 9.0 mg.m-2 x min-1; P = 0.002). Basal HGO and fasting plasma glucose levels were lower (94.1 +/- 9.2 vs. 118.5 +/- 9.5 mg.m-2 x min-1, P = 0.01; and 8.3 +/- 1.2 vs. 9.8 +/- 1.2 mM; P < 0.001), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: G R Fulcher, M Walker, C Catalano, L Agius, K G Alberti
• Journal: Diabetes (Diabetes) Vol. 41 Issue 11 Pg. 1400-8 (Nov 1992) ISSN: 0012-1797 [Print] United States
• PMID: 1397716 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)

Chemical References

• Blood Glucose
• Fatty Acids, Nonesterified
• Hydroxybutyrates
• Hypolipidemic Agents
• Insulin
• Lactates
• Pyrazines
• Pyruvates
• Triglycerides
• Cholesterol
• acipimox
• Alanine
• Glycerol
• 3-Hydroxybutyric Acid

Topics

• 3-Hydroxybutyric Acid
• Alanine (blood)
• Blood Glucose (metabolism)
• Cholesterol (blood)
• Diabetes Mellitus (blood)
• Diabetes Mellitus, Type 2 (blood)
• Fatty Acids, Nonesterified (blood)
• Female
• Glucose Clamp Technique
• Glycerol (blood)
• Humans
• Hydroxybutyrates (blood)
• Hypolipidemic Agents (pharmacology)
• Insulin (blood)
• Lactates (blood)
• Male
• Middle Aged
• Obesity
• Pyrazines (pharmacology)
• Pyruvates (blood)
• Triglycerides (blood)