Sex Difference in Serum-Free Fatty Acid Levels in Diabetic Subjects

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Abstract
Fasting serum-free fatty acid (FFA) and blood glucose levels were measured in 57 healthy subjects and in 80 untreated diabetic subjects. The response of the serum-FFA level to the rapid intravenous injection of glucose (1.0 g/kg0.7) was examined in 33 healthy subjects and in 57 untreated diabetic subjects. The effect of treatment of diabetes with Lente insulin, sulfonylureas and phenformin (phenethyl biguanide) upon the serum-FFA levels and responsiveness was examined in 16, 4 and 7 subjects, respectively. A distinct sex difference was observed in both the fasting serum-FFA level and its responsiveness to glucose. In healthy men the fasting serum-FFA level was lower, and its response to glucose less, than in healthy women. In diabetic men the fasting serum-FFA level did not increase as the fasting blood glucose level increased, and was only slightly elevated even when severe fasting hyperglycemia was present. In diabetic women the fasting serum-FFA level did increase as the fasting blood glucose level increased, and was nearly double that of the men when severe hyperglycemia was present. In diabetic men the response of the serum-FFA level to glucose became progressively less with increasing hyperglycemia, so that almost no response occurred when severe hyperglycemia was present. In diabetic women the response was independent of the fasting blood glucose level, being about half normal throughout the entire group. These sex differences appeared not to be due to such factors as age, obesity or gonadal activity. Therapy of the diabetes with depot insulin and with sulfonylureas caused the elevated fasting serum FFA in the female subjects to return to near the normal range. Phenformin had no effect upon the fasting serum-FFA level. None of the conventional hypoglycemic agents caused any improvement in the impaired responsiveness of the serum-FFA level to glucose. This defect was corrected when soluble insulin was given with the injected glucose.

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