Researchers at the University of Gothenburg, Sweden, have reported that free fatty acids (FFAs) in the blood trigger the release of insulin even at normal blood sugar levels, without an evident uncompensated insulin resistance in fat cells.
Moreover, the researchers demonstrated the link to obesity: the amount of FFA largely depends on how many extra pounds of adipose tissue a person has, but also on how the body adapts to increased adiposity.
The study
The findings appeared in the article, “Hyperinsulinemia and insulin resistance in the obese may develop as part of a homeostatic response to elevated free fatty acids: A mechanistic case-control and a population-based cohort study,” published in EBioMedicine.
“Interestingly, obese non-diabetics had high levels of free fatty acids and blood insulin, and those levels were similar to or higher than the levels we could measure in the blood of participants with obesity and type 2 diabetes,” Emanuel Fryk explained. He is a resident physician specializing in general medicine and a doctoral student at University of Gothenburg Sahlgrenska Academy. Fryk is one of the first authors of the study.
Around the world, extensive research is being conducted to clarify exactly what happens in the body as type 2 diabetes progresses and why obesity is such a big risk factor for the disease.
For nearly 50 years, diabetes researchers have been discussing their version of the chicken-or-egg dilemma: Which comes first, insulin resistance or elevated insulin levels?
The dominant hypothesis has long been that the pancreas increases the production of insulin because cells have already become resistant to insulin and then blood sugar rises. Nonetheless, the results now published in the journal EBioMedicine support the opposite idea: that insulin rises first. The study indicates that high levels of FFA in the blood after an overnight fast increase insulin production in the morning. FFAs have long been part of the main research equation for type 2 diabetes, but it is now proposed that they play another role too: a role in the progression of the disease.
The findings
For the study, the researchers compared metabolism in adipose (fat-storing) tissue among 27 carefully selected research subjects (9 of normal weight, 9 with obesity and normal blood sugar levels, and 9 with obesity and progressive type 2 diabetes). Over several days, they underwent extensive examinations in which samples were taken under various conditions. The researchers analyzed the metabolism and gene expression in the participants’ subcutaneous fat and the levels of blood sugar, insulin and FFA in the blood.
People with obesity but not diabetes were shown to have the same normal blood sugar levels as healthy people of normal weight. In collaboration with researchers at Uppsala University, the same pattern was observed in a population study based on blood samples taken from 500 people after an overnight fast. “The fact that we observed an association between free fatty acids and insulin there also suggests that fatty acids are linked to insulin release and contribute to the increase of insulin production on an empty stomach, when blood sugar has not risen,” Fryk added. He, however, notes that the finding needs to be confirmed with further research.
Free fatty acids are found naturally in the bloodstream and, like glycerol, are a byproduct of the body’s fat metabolism. In the subjects, the amount of glycerol released was found to be roughly the same per kilogram of body fat, regardless of whether they were of normal weight, only obese, or also had type 2 diabetes.
The future
“Our hypothesis is that free fatty acids increase in the blood because adipose tissue can no longer store excess energy. We believe that, in that case, it could be an early sign of type 2 diabetes,” Fryk said. “If our findings are confirmed when other research methods are used, there may be a possibility that some specific fatty acids become biomarkers. However, it’s just the beginning of a long way. There are many factors that contribute to the progression of type 2 diabetes, but it is our lifestyle that has, in absolute terms, the greatest impact in most people. Our study provides another argument supporting that the most important thing you can do to slow the progression of diabetes is to change your lifestyle early in the disease onset, before your blood glucose increases.”
Link: https://www.sochob.cl/web1/los-acidos-grasos-libres-desencadenan-la-liberacion-de-insulina-incluso-a-un-nivel-normal-de-azucar-en-sangre/
Date: March 17th, 2021
Source: http://www.bariatricnews.net
Reference: Fryk E, Olausson J, Mossberg K, et al. Hyperinsulinemia and insulin resistance in the obese may develop as part of a homeostatic response to elevated free fatty acids: A mechanistic case-control and a population-based cohort study. EBioMedicine. 2021 Mar 6:103264.
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