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Original Article
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Volume 328:238-244 January 28, 1993 Number 4
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The Relation between Insulin Sensitivity and the Fatty-Acid Composition of Skeletal-Muscle Phospholipids
Mark Borkman, Leonard H. Storlien, David A. Pan, Arthur B. Jenkins, Donald J. Chisholm, and Lesley V. Campbell

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ABSTRACT

Background Insulin resistance and hyperinsulinemia are features of obesity, non-insulin-dependent diabetes mellitus, and other disorders. Skeletal muscle is a major site of insulin action, and insulin sensitivity may be related to the fatty-acid composition of the phospholipids within the muscle membranes involved in the action of insulin.

Methods We determined the relation between the fatty-acid composition of skeletal-muscle phospholipids and insulin sensitivity in two groups of subjects. In one study, we obtained samples of the rectus abdominis muscle from 27 patients undergoing coronary artery surgery; fasting serum insulin levels provided an index of insulin sensitivity. In the second study, a biopsy of the vastus lateralis muscle was performed in 13 normal men, and insulin sensitivity was assessed by euglycemic-clamp studies.

Results In the patients undergoing surgery, the fasting serum insulin concentration (a measure of insulin resistance) was negatively correlated with the percentage of individual long-chain polyunsaturated fatty acids in the phospholipid fraction of muscle, particularly arachidonic acid (r = -0.63, P<0.001); the total percentage of C20-22 polyunsaturated fatty acids (r = -0.68, P<0.001); the average degree of fatty-acid unsaturation (r = -0.61, P<0.001); and the ratio of the percentage of C20:4 n-6 fatty acids to the percentage of C20:3 n-6 fatty acids (r = -0.55, P<0.01), an index of fatty-acid desaturase activity. In the normal men, insulin sensitivity was positively correlated with the percentage of arachidonic acid in muscle (r = 0.76, P<0.01), the total percentage of C20-22 polyunsaturated fatty acids (r = 0.76, P<0.01), the average degree of fatty-acid unsaturation (r = 0.62, P<0.05), and the ratio of C20:4 n-6 to C20:3 n-6 (rho = 0.78, P = 0.007).

Conclusions Decreased insulin sensitivity is associated with decreased concentrations of polyunsaturated fatty acids in skeletal-muscle phospholipids, raising the possibility that changes in the fatty-acid composition of muscles modulate the action of insulin.


Source Information

From the Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, New South Wales, Australia.

Address reprint requests to Dr. Storlien at the Department of Medicine (Endocrinology), University of Sydney, NSW 2006, Australia.

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