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1 Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110; and 2 University College London Medical School, Whittington Hospital, London N19 3UA, United Kingdom
We evaluated whole body and regional adipose
tissue lipid kinetics and norepinephrine (NE) spillover during brief
fasting in six lean [body mass index (BMI) 21 ± 1
kg/m2] and six upper-body obese (UBO; BMI 36 ± 1
kg/m2) women. At 14 h of fasting, abdominal adipose tissue
glycerol and free fatty acid (FFA) release rates were lower
(P = 0.07), but whole body glycerol and FFA rates of
appearance (Ra) were greater (P < 0.05) in
obese than in lean subjects. At 22 h of fasting, glycerol and FFA
Ra increased less in obese (19.8 ± 7.0 and
87.1 ± 30.3 µmol/min, respectively) than in lean (44.2 ± 6.6 and 137.4 ± 30.4 µmol/min, respectively; P < 0.05)
women. The percent increase in glycerol Ra correlated
closely with the percent decline in plasma insulin in both groups
(r2 = 0.85; P < 0.05). Whole body NE
spillover declined in lean (P < 0.05) but not obese
subjects with continued fasting, whereas regional adipose tissue NE
spillover did not change in either group. We conclude that, compared
with lean women, in UBO women 1) basal adipose tissue
lipolysis is lower, but whole body lipid kinetics is higher
because of their greater fat mass; 2) the increase in
lipolysis during fasting is blunted because of an attenuated decline in
circulating insulin; and 3) downregulation of whole body
sympathetic nervous system activity is impaired during fasting.
lipid metabolism; sympathetic nervous system; stable isotopes; starvation; adipose tissue
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