Background Insulin resistance and hyperinsulinemia are featuresof obesity, non-insulin-dependent diabetes mellitus, and otherdisorders. Skeletal muscle is a major site of insulin action,and insulin sensitivity may be related to the fatty-acid compositionof the phospholipids within the muscle membranes involved inthe action of insulin.
Methods We determined the relation between the fatty-acid compositionof skeletal-muscle phospholipids and insulin sensitivity intwo groups of subjects. In one study, we obtained samples ofthe rectus abdominis muscle from 27 patients undergoing coronaryartery surgery; fasting serum insulin levels provided an indexof insulin sensitivity. In the second study, a biopsy of thevastus lateralis muscle was performed in 13 normal men, andinsulin sensitivity was assessed by euglycemic-clamp studies.
Results In the patients undergoing surgery, the fasting seruminsulin concentration (a measure of insulin resistance) wasnegatively correlated with the percentage of individual long-chainpolyunsaturated fatty acids in the phospholipid fraction ofmuscle, 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 ofC20:4 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 correlatedwith the percentage of arachidonic acid in muscle (r = 0.76,P<0.01), the total percentage of C20-22 polyunsaturated fattyacids (r = 0.76, P<0.01), the average degree of fatty-acidunsaturation (r = 0.62, P<0.05), and the ratio of C20:4 n-6to C20:3 n-6 (rho = 0.78, P = 0.007).
Conclusions Decreased insulin sensitivity is associated withdecreased concentrations of polyunsaturated fatty acids in skeletal-musclephospholipids, raising the possibility that changes in the fatty-acidcomposition 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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