Vessby B
Department of Public Health and Caring Sciences/Geriatrics, University of Uppsala, Sweden.
Br J Nutr. 2000 Mar;83 Suppl 1:S91-6. doi: 10.1017/s000711450000101x.
A high intake of fat may increase the risk of obesity. Obesity, especially abdominal obesity, is an important determinant of the risk of developing insulin resistance and non-insulin-dependent diabetes mellitus. It is suggested that a high proportion of fat in the diet is associated with impaired insulin sensitivity and an increased risk of developing diabetes, independent of obesity and body fat localization, and that this risk may be influenced by the type of fatty acids in the diet. Cross-sectional studies show significant relationships between the serum lipid fatty acid composition, which at least partly mirrors the quality of the fatty acids in the diet, and insulin sensitivity. Insulin resistance, and disorders characterized by insulin resistance, are associated with a specific fatty acid pattern of the serum lipids with increased proportions of palmitic (16:0) and palmitoleic acids (16:1 n-7) and reduced levels of linoleic acid (18:2 n-6). The metabolism of linoleic acid seems to be disturbed with increased proportions of dihomo-gamma linolenic acid (20:3 n-6) and a reduced activity of the delta 5 desaturase, while the activities of the delta 9 and delta 6 desaturases appear to be increased. The skeletal muscle is the main determinant of insulin sensitivity. Several studies have shown that the fatty acid composition of the phosholipids of the skeletal muscle cell membranes is closely related to insulin sensitivity. An increased saturation of the membrane fatty acids and a reduced activity of delta 5 desaturase have been associated with insulin resistance. There are several possible mechanisms which could explain this relationship. The fatty acid composition of the lipids in serum and muscle is influenced by diet, but also by the degree of physical activity, genetic disposition, and possibly fetal undernutrition. However, controlled dietary intervention studies in humans investigating the effects of different types of fatty acids on insulin sensitivity have so far been negative.
高脂肪摄入可能会增加肥胖风险。肥胖，尤其是腹部肥胖，是发生胰岛素抵抗和非胰岛素依赖型糖尿病风险的重要决定因素。有人认为，饮食中高比例的脂肪与胰岛素敏感性受损以及患糖尿病风险增加有关，这与肥胖和体脂分布无关，而且这种风险可能受饮食中脂肪酸类型的影响。横断面研究表明，血清脂质脂肪酸组成（至少部分反映饮食中脂肪酸质量）与胰岛素敏感性之间存在显著关系。胰岛素抵抗以及以胰岛素抵抗为特征的疾病，与血清脂质的特定脂肪酸模式相关，即棕榈酸（16:0）和棕榈油酸（16:1 n - 7）比例增加，亚油酸（18:2 n - 6）水平降低。亚油酸的代谢似乎受到干扰，二高 - γ - 亚麻酸（20:3 n - 6）比例增加，δ5 去饱和酶活性降低，而 δ9 和 δ6 去饱和酶的活性似乎增加。骨骼肌是胰岛素敏感性的主要决定因素。多项研究表明，骨骼肌细胞膜磷脂的脂肪酸组成与胰岛素敏感性密切相关。膜脂肪酸饱和度增加和 δ5 去饱和酶活性降低与胰岛素抵抗有关。有几种可能的机制可以解释这种关系。血清和肌肉中脂质的脂肪酸组成受饮食影响，但也受身体活动程度、遗传倾向以及可能的胎儿营养不良影响。然而，迄今为止，在人体中进行的研究不同类型脂肪酸对胰岛素敏感性影响的对照饮食干预研究结果均为阴性。
