title: The impairment in endothelial function induced by non-esterified fatty acids can be reversed by insulin.
abstract: Dyslipidaemia, with elevations of circulating triacylglycerols (triglycerides) and non-esterified (free) fatty acids, and hyperinsulinaemia are often found in the same subjects, the so-called 'insulin resistance syndrome'. The present study aims to investigate how elevated levels of non-esterified fatty acids, hyperinsulinaemia and the combination of these factors affects endothelium-dependent vasodilatation (EDV). Ten volunteers were examined on two occasions. Intralipid (plus heparin) or saline (0.9% NaCl) was infused for 4 h. During the final 2 h, euglycaemic hyperinsulinaemia (80+/-4 m-units/l) was imposed. EDV and endothelium-independent vasodilatation were evaluated in the forearm by local intra-arterial infusion of methacholine or sodium nitroprusside at baseline and after 2 and 4 h. Forearm blood flow was measured by venous occlusion plethysmography. Lipid oxidation was determined by measuring plasma malondialdehyde levels. Infusion of Intralipid plus heparin increased the concentration of non-esterified fatty acids to 2.6+/-1.2 mmol/l and decreased EDV from 27.6+/-8.7 to 21.0+/-5.7 ml x min(-1) x 100 ml(-1) tissue (P < 0.01). This effect was completely reversed by hyperinsulinaemia (P < 0.01). Hyperinsulinaemia alone increased EDV (to 30.4+/-9.5 ml x min(-1) x 100 ml(-1) tissue; P < 0.01), while endothelium-independent vasodilatation was unaltered by the interventions. Infusion of Intralipid plus heparin increased malondialdehyde levels from 0.67+/-0.22 to 1.2+/-0.37 micromol/l (P < 0.001), while hyperinsulinaemiadid not change the malondialdehyde level. In conclusion, an acute increase in serum levels of non-esterified fatty acids increased lipid oxidation and decreased EDV. The effect on EDV of non-esterified fatty acids could be reversed by hyperinsulinaemia.
authors.affiliation: Department of Internal Medicine, University Hospital of Uppsala, Sweden. lars.lind@medsci.uu.se
authors.forename: L
authors.initials: L
authors.lastname: Lind
authors.forename: A
authors.initials: A
authors.lastname: Fugmann
authors.forename: S
authors.initials: S
authors.lastname: Branth
authors.forename: B
authors.initials: B
authors.lastname: Vessby
authors.forename: J
authors.initials: J
authors.lastname: Millgård
authors.forename: C
authors.initials: C
authors.lastname: Berne
authors.forename: H
authors.initials: H
authors.lastname: Lithell
mesh_terms: D000328:Adult; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology; D005230:Fatty Acids, Nonesterified / Q000097:blood / Q000502:physiology*; D005260:Female; D005542:Forearm / Q000098:blood supply; D015309:Glucose Clamp Technique; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000503:physiopathology*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology; D014280:Triglycerides / Q000097:blood; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D005217:Fat Emulsions, Intravenous; D005230:Fatty Acids, Nonesterified; D014280:Triglycerides; D014665:Vasodilator Agents; D008315:Malondialdehyde