Operation of the “Glucose‐Fatty Acid Cycle” during Experimental Elevations of Plasma Free Fatty Acid Levels in Man

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Abstract
In order to determine whether increased plasma free fatty acid (FFA) levels inhibit glucose utilization in man, glucose metabolism was studied in 8 normal subjects both under basal conditions and during experimental elevations of plasma FFA concentrations induced by the administration of high fat meals and heparin. A primed constant infusion of 1‐14C‐glucose was used to measure the rate of turnover, the fractional removal rate and the rate of oxidation of plasma glucose under both experimental conditions. Elevations of FFA levels (+117%) were accompanied by a 9% reduction in both the fractional removal rate of glucose and the hepatic glucose production so that glycaemia remained unchanged. The % glucose converted to CO2 and the % CO2 derived from plasma glucose decreased respectively by 13.5% and 21.7%, while unlabelled CO2 production remained unchanged. This reduction in glucose utilization occurred despite a significant rise in insulin concentration indicating that high FFA levels reduce sensitivity to insulin. The tissue implicated in the inhibitory effect of FFA on overall glucose utilization cannot be determined from these experiments but it is suggested that muscle participated in these metabolic changes. These data provide further arguments supporting the view that plasma FFA participate in the regulation of glucose metabolism in man.