Suppression of non-esterified fatty acids to treat type A insulin resistance syndrome.
A patient with type A insulin-resistance syndrome resistance presented with severe hypertriglyceridaemia and diabetes. Fasting insulin and non-esterified fatty acids (NEFA) were very high (41 mU/L and 3.3 mmol/L). A low-fat diet failed to correct hyperlipidaemia and diabetes. Sustained suppression of NEFA with slow-release acipimox for 8 weeks resulted in substantial reduction of serum fasting NEFA (0.31 mmol/L). Glucose tolerance became normal and insulin sensitivity increased from 7% to 32%. The glucose fatty-acid cycle may operate in patients with severe insulin resistance and hyperlipidaemia: high serum NEFA aggravates insulin resistance and hyperglycaemia by inhibiting glucose uptake and utilisation.
Kumar
S
S
University Department of Medicine, Royal Infirmary, Manchester, UK.
Durrington
P N
PN
Bhatnagar
D
D
Laing
I
I
D000052:Acanthosis Nigricans / Q000188:drug therapy*; D000328:Adult; D003692:Delayed-Action Preparations; D003920:Diabetes Mellitus / Q000628:therapy; D005230:Fatty Acids, Nonesterified / Q000037:antagonists & inhibitors* / Q000097:blood; D005260:Female; D006628:Hirsutism / Q000188:drug therapy*; D006801:Humans; D015228:Hypertriglyceridemia / Q000628:therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D013577:Syndrome
D003692:Delayed-Action Preparations; D005230:Fatty Acids, Nonesterified; D000960:Hypolipidemic Agents