Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA.
Obesity (Silver Spring). 2024 Dec;32(12):2334-2344. doi: 10.1002/oby.24156.
Circulating lipids are linked with insulin resistance and increased cardiovascular disease risk. We previously reported that dihydroceramides, a specific type of sphingolipid, are elevated in insulin-resistant individuals; however, little is known regarding whether insulin-sensitizing lifestyle interventions can improve profiles of sphingolipids and other lipid species.
A total of 21 individuals with obesity participated in a 3-month lifestyle intervention of combined weight loss and exercise training. Insulin sensitivity was assessed by hyperinsulinemic-euglycemic clamps, and serum lipidomics was conducted.
Following the intervention, BMI was significantly reduced by 10%; VOpeak and insulin sensitivity increased by 12% and 57%, respectively; and total serum triacylglycerol (TAG), diacylglycerol, dihydroceramides, sphingosine-1-phosphate, and sphinganine-1-phosphate were significantly reduced, as were specific species of dihydroceramides (C18:0 and C24:1). Individuals with higher preintervention TAG concentrations had significant decreases in serum lipids, which were not significantly changed in individuals with lower preintervention TAG.
These data show that serum sphingolipid species previously linked to insulin resistance in humans can be reduced with insulin-sensitizing lifestyle interventions. Furthermore, individuals with elevated serum TAG may significantly benefit from lifestyle interventions that increase insulin sensitivity due to a greater decrease in serum lipids related to insulin resistance.
循环脂质与胰岛素抵抗和增加心血管疾病风险有关。我们之前报告称，二氢神经酰胺是一种特定类型的神经鞘脂，在胰岛素抵抗个体中升高；然而，对于胰岛素增敏生活方式干预是否可以改善神经鞘脂和其他脂质种类的状况，知之甚少。
共有 21 名肥胖者参与了为期 3 个月的联合减肥和运动训练的生活方式干预。通过高胰岛素正葡萄糖钳夹评估胰岛素敏感性，并进行血清脂质组学检测。
干预后，BMI 显著降低 10%；VOpeak 和胰岛素敏感性分别增加 12%和 57%；总血清三酰甘油（TAG）、二酰甘油、二氢神经酰胺、1-磷酸鞘氨醇和 1-氨基庚酸-1-磷酸显著降低，特定的二氢神经酰胺（C18:0 和 C24:1）也显著降低。干预前 TAG 浓度较高的个体血清脂质显著降低，而干预前 TAG 浓度较低的个体血清脂质没有显著变化。
这些数据表明，与人类胰岛素抵抗相关的血清神经鞘脂种类可以通过胰岛素增敏的生活方式干预来降低。此外，由于与胰岛素抵抗相关的血清脂质降低幅度更大，血清 TAG 升高的个体可能会从增加胰岛素敏感性的生活方式干预中显著获益。
