胰岛素敏感性与骨骼肌磷脂脂肪酸组成之间的关系。

The relation between insulin sensitivity and the fatty-acid composition of skeletal-muscle phospholipids.

作者信息

Borkman M, Storlien L H, Pan D A, Jenkins A B, Chisholm D J, Campbell L V

机构信息

Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, New South Wales, Australia.

出版信息

N Engl J Med. 1993 Jan 28;328(4):238-44. doi: 10.1056/NEJM199301283280404.

DOI:10.1056/NEJM199301283280404

PMID:8418404

Abstract

BACKGROUND

Insulin resistance and hyperinsulinemia are features of obesity, non-insulin-dependent diabetes mellitus, and other disorders. Skeletal muscle is a major site of insulin action, and insulin sensitivity may be related to the fatty-acid composition of the phospholipids within the muscle membranes involved in the action of insulin.

METHODS

We determined the relation between the fatty-acid composition of skeletal-muscle phospholipids and insulin sensitivity in two groups of subjects. In one study, we obtained samples of the rectus abdominis muscle from 27 patients undergoing coronary artery surgery; fasting serum insulin levels provided an index of insulin sensitivity. In the second study, a biopsy of the vastus lateralis muscle was performed in 13 normal men, and insulin sensitivity was assessed by euglycemic-clamp studies.

RESULTS

In the patients undergoing surgery, the fasting serum insulin concentration (a measure of insulin resistance) was negatively correlated with the percentage of individual long-chain polyunsaturated fatty acids in the phospholipid fraction of muscle, particularly arachidonic acid (r = -0.63, P < 0.001); the total percentage of C20-22 polyunsaturated fatty acids (r = -0.68, P < 0.001); the average degree of fatty-acid unsaturation (r = -0.61, P < 0.001); and the ratio of the percentage of C20:4 n-6 fatty acids to the percentage of C20:3 n-6 fatty acids (r = -0.55, P < 0.01), an index of fatty-acid desaturase activity. In the normal men, insulin sensitivity was positively correlated with the percentage of arachidonic acid in muscle (r = 0.76, P < 0.01), the total percentage of C20-22 polyunsaturated fatty acids (r = 0.76, P < 0.01), the average degree of fatty-acid unsaturation (r = 0.62, P < 0.05), and the ratio of C20:4 n-6 to C20:3 n-6 (rho = 0.76, P = 0.007).

CONCLUSIONS

Decreased insulin sensitivity is associated with decreased concentrations of polyunsaturated fatty acids in skeletal-muscle phospholipids, raising the possibility that changes in the fatty-acid composition of muscles modulate the action of insulin.

摘要

背景

胰岛素抵抗和高胰岛素血症是肥胖症、非胰岛素依赖型糖尿病及其他病症的特征。骨骼肌是胰岛素作用的主要部位，胰岛素敏感性可能与参与胰岛素作用的肌膜内磷脂的脂肪酸组成有关。

方法

我们在两组受试者中确定了骨骼肌磷脂的脂肪酸组成与胰岛素敏感性之间的关系。在一项研究中，我们从27例接受冠状动脉手术的患者身上获取了腹直肌样本；空腹血清胰岛素水平提供了胰岛素敏感性指标。在第二项研究中，对13名正常男性进行了股外侧肌活检，并通过正常血糖钳夹研究评估胰岛素敏感性。

结果

在接受手术的患者中，空腹血清胰岛素浓度（胰岛素抵抗的一项指标）与肌肉磷脂部分中单个长链多不饱和脂肪酸的百分比呈负相关，尤其是花生四烯酸（r = -0.63，P < 0.001）；C20 - 22多不饱和脂肪酸的总百分比（r = -0.68，P < 0.001）；脂肪酸不饱和度的平均程度（r = -0.61，P < 0.001）；以及C20:4 n - 6脂肪酸百分比与C20:3 n - 6脂肪酸百分比的比值（r = -0.55，P < 0.01），这是脂肪酸去饱和酶活性指标。在正常男性中，胰岛素敏感性与肌肉中花生四烯酸的百分比呈正相关（r = 0.76，P < 0.01），C20 - 22多不饱和脂肪酸的总百分比（r = 0.76，P < 0.01），脂肪酸不饱和度的平均程度（r = 0.62，P < 0.05），以及C20:4 n - 6与C20:3 n - 6的比值（rho = 0.76，P = 0.007）。