Kraegen E W, Clark P W, Jenkins A B, Daley E A, Chisholm D J, Storlien L H
Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, New South Wales, Australia.
Diabetes. 1991 Nov;40(11):1397-403. doi: 10.2337/diab.40.11.1397.
Muscle and hepatic insulin resistance are two major defects of non-insulin-dependent diabetes mellitus. Dietary factors may be important in the etiology of insulin resistance. We studied progressive changes in the development of high-fat-diet-induced insulin resistance in tissues of the adult male Wistar rat. In vivo insulin action was compared 3 days and 3 wk after isocaloric synthetic high-fat or high-starch feeding (59 and 10% cal as fat, respectively). Basal and insulin-stimulated glucose metabolism were assessed in the conscious 5- to 7-h fasted state with the euglycemic clamp (600 pM insulin) with a [3-3H]-glucose infusion. Fat feeding significantly reduced suppressibility of hepatic glucose output by insulin after both 3 days and 3 wk of diet (P less than 0.01). However, a significant impairment of insulin-mediated peripheral glucose disposal was only present after 3 wk of diet. Further in vivo [3H]-2-deoxyglucose uptake studies supported this finding and demonstrated adipose but not muscle insulin resistance after 3 days of high-fat feeding. Muscle triglyceride accumulation due to fat feeding was not significant at 3 days but had doubled by 3 wk in red muscle (P less than 0.001) compared with starch-fed controls. By 3 wk, high-fat-fed animals had developed significant glucose intolerance. We conclude that fat feeding induces insulin resistance in liver and adipose tissue before skeletal muscle with early metabolic changes favoring an oversupply of energy substrate to skeletal muscle relative to metabolic needs. This may generate later muscle insulin resistance.
肌肉和肝脏胰岛素抵抗是非胰岛素依赖型糖尿病的两个主要缺陷。饮食因素在胰岛素抵抗的病因学中可能很重要。我们研究了成年雄性Wistar大鼠组织中高脂饮食诱导的胰岛素抵抗发展过程中的渐进性变化。在给予等热量的合成高脂或高淀粉饮食(分别含59%和10%的热量为脂肪)3天和3周后,比较体内胰岛素作用。在有意识的禁食5至7小时状态下,通过正常血糖钳夹技术(600 pM胰岛素)并输注[3-³H] -葡萄糖来评估基础和胰岛素刺激的葡萄糖代谢。饮食3天和3周后,脂肪喂养均显著降低了胰岛素对肝脏葡萄糖输出的抑制作用(P < 0.01)。然而,仅在饮食3周后才出现胰岛素介导的外周葡萄糖处置的显著受损。进一步的体内[³H] -2-脱氧葡萄糖摄取研究支持了这一发现,并表明高脂喂养3天后存在脂肪而非肌肉的胰岛素抵抗。脂肪喂养导致的肌肉甘油三酯积累在3天时不显著,但与淀粉喂养的对照组相比,3周时红色肌肉中的积累增加了一倍(P < 0.001)。到3周时,高脂喂养的动物出现了明显的葡萄糖不耐受。我们得出结论,脂肪喂养在骨骼肌之前先在肝脏和脂肪组织中诱导胰岛素抵抗,早期代谢变化有利于相对于代谢需求向骨骼肌过度供应能量底物。这可能会导致后期肌肉胰岛素抵抗。