Gormsen Lars C, Nellemann Birgitte, Sørensen Lars P, Jensen Michael D, Christiansen Jens S, Nielsen Søren
Dept. of Nuclear Medicine, Aarhus Univ. Hospital, DK-8000 Aarhus C, Denmark.
Am J Physiol Endocrinol Metab. 2009 Jan;296(1):E165-73. doi: 10.1152/ajpendo.90675.2008. Epub 2008 Nov 4.
Upper body obese (UBO) subjects have greater cardiovascular disease risk than lower body obese (LBO) or lean subjects. Obesity is also associated with hypertriglyceridemia that may involve greater production and impaired removal of very-low-density lipoprotein (VLDL)-triglycerides (TG). In these studies, we assessed the impact of body composition on basal VLDL-TG production, VLDL-TG oxidation, and VLDL-TG storage. VLDL-TG kinetics were assessed in 10 UBO, 10 LBO, and 10 lean women using a bolus injection of [1-(14)C]VLDL-TG. VLDL-TG oxidation was measured by (14)CO(2) production (hyamine trapping) and VLDL-TG adipose tissue storage by fat biopsies. Insulin sensititvity was assessed by the hyperinsulinemic-euglycemic clamp technique and body composition by dual X-ray absorptiometry in combination with computed tomography. Hepatic VLDL-TG production was significantly greater in UBO than in lean women [(mumol/min) UBO: 64.8 (SD 40.0) vs. LBO: 42.5 (SD 25.6) vs. lean: 31.8 (SD 13.3), P = 0.04], whereas VLDL-TG oxidation was similar in the three groups and averaged 20% of resting energy expenditure [(mumol/min) UBO: 38.3 (SD 26.5) vs. LBO: 23.5 (SD 13.5) vs. lean: 21.1 (SD 9.7), P = 0.09]. In UBO women, more VLDL-TG was deposited in upper body subcutaneous fat [VLDL-TG redeposition in abdominal adipose tissue (mumol/min): UBO: 5.0 (SD 2.9) vs. LBO: 4.0 (SD 3.2) vs. lean: 1.3 (SD 1.0), ANOVA P = 0.01]; in LBO women, more VLDL-TG was deposited in femoral fat [VLDL-TG redeposition in femoral adipose tissue (mumol/min): UBO: 5.1 (SD 3.1) vs. LBO: 5.8 (SD 4.3) vs. lean: 2.3 (SD 1.5), ANOVA P = 0.04]. Only a small proportion of VLDL-TG (8-16%) was partitioned into redeposition in either group. We found that elevated VLDL-TG production without concomitant increased clearance via oxidation and adipose tissue redeposition contributes to hypertriglyceridemia in UBO women.
上半身肥胖(UBO)受试者患心血管疾病的风险高于下半身肥胖(LBO)或瘦体型受试者。肥胖还与高甘油三酯血症相关,这可能涉及极低密度脂蛋白(VLDL)-甘油三酯(TG)的生成增加和清除受损。在这些研究中,我们评估了身体组成对基础VLDL-TG生成、VLDL-TG氧化和VLDL-TG储存的影响。使用[1-(14)C]VLDL-TG静脉推注法,对10名UBO女性、10名LBO女性和10名瘦体型女性的VLDL-TG动力学进行了评估。通过(14)CO(2)生成(氢氧化钾捕获法)测量VLDL-TG氧化,通过脂肪活检测量VLDL-TG在脂肪组织中的储存。采用高胰岛素-正常血糖钳夹技术评估胰岛素敏感性,采用双能X线吸收法结合计算机断层扫描评估身体组成。UBO女性的肝脏VLDL-TG生成显著高于瘦体型女性[(微摩尔/分钟)UBO:64.8(标准差40.0),LBO:42.5(标准差25.6) vs. 瘦体型:31.8(标准差13.3),P = 0.04],而三组的VLDL-TG氧化相似,平均占静息能量消耗的20%[(微摩尔/分钟)UBO:38.3(标准差26.5),LBO:23.5(标准差13.5) vs. 瘦体型:21.1(标准差9.7),P = 0.09]。在UBO女性中,更多VLDL-TG沉积在上半身皮下脂肪中[VLDL-TG在腹部脂肪组织中的再沉积(微摩尔/分钟):UBO:5.0(标准差2.9),LBO:4.0(标准差3.2) vs. 瘦体型:1.3(标准差1.0),方差分析P = 0.01];在LBO女性中,更多VLDL-TG沉积在股部脂肪中[VLDL-TG在股部脂肪组织中的再沉积(微摩尔/分钟):UBO:5.1(标准差3.1),LBO:5.8(标准差4.3) vs. 瘦体型:2.3(标准差1.5),方差分析P = 0.04]。两组中只有一小部分VLDL-TG(8 - 16%)被分配到再沉积中。我们发现,UBO女性中VLDL-TG生成升高,但未伴随通过氧化和脂肪组织再沉积清除的相应增加,这导致了高甘油三酯血症。