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Am J Physiol Endocrinol Metab 287: E558-E565, 2004. First published May 27, 2004; doi:10.1152/ajpendo.00464.2003
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Intramyocellular lipid content in type 2 diabetes patients compared with overweight sedentary men and highly trained endurance athletes

Luc J. C. van Loon,1,2 René Koopman,2 Ralph Manders,2 Walter van der Weegen,1 Gerrit P. van Kranenburg,1 and Hans A. Keizer1

1Department of Movement Sciences and 2Department of Human Biology, Nutrition Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, The Netherlands

Submitted 15 October 2003 ; accepted in final form 19 May 2004

Recent evidence suggests that intramyocellular lipid (IMCL) accretion is associated with obesity and the development of insulin resistance and/or type 2 diabetes. However, trained endurance athletes are markedly insulin sensitive, despite an elevated mixed muscle lipid content. In an effort to explain this metabolic paradox, we compared muscle fiber type-specific IMCL storage between populations known to have elevated IMCL deposits. Immunofluorescence microscopy was performed on muscle biopsies obtained from eight highly trained endurance athletes, eight type 2 diabetes patients, and eight overweight, sedentary men after an overnight fast. Mixed muscle lipid content was substantially greater in the endurance athletes (4.0 ± 0.4% area lipid stained) compared with the diabetes patients and the overweight men (2.3 ± 0.4 and 2.2 ± 0.5%, respectively). More than 40% of the greater mixed muscle lipid content was attributed to a higher proportion type I muscle fibers (62 ± 8 vs. 38 ± 3 and 33 ± 7%, respectively), which contained 2.8 ± 0.3-fold more lipid than the type II fibers. The remaining difference was explained by a significantly greater IMCL content in the type I muscle fibers of the trained athletes. Differences in IMCL content between groups or fiber types were accounted for by differences in lipid droplet density, not lipid droplet size. IMCL distribution showed an exponential increase in lipid content from the central region toward the sarcolemma, which was similar between groups and fiber types. In conclusion, IMCL contents can be substantially greater in trained endurance athletes compared with overweight and/or type 2 diabetes patients. Because structural characteristics and intramyocellular distribution of lipid aggregates seem to be similar between groups, we conclude that elevated IMCL deposits are unlikely to be directly responsible for inducing insulin resistance.

intramuscular triacylglycerol; intramuscular fat; endurance training; insulin resistance



Address for reprint requests and other correspondence: L. J. C. van Loon, Dept. of Human Biology, Nutrition Research Institute Maastricht, Maastricht Univ., PO Box 616, 6200 MD Maastricht, The Netherlands (E-mail L.vanLoon{at}HB.Unimaas.nl).




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