Relation of adipose tissue to metabolic flexibility

Lauren M. Sparks, Barbara Ukropcova, Jana Smith, Magdalena Pasarica, David Hymel, Hui Xie, George A. Bray, John M. Miles, Steven R. Smith

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Metabolic flexibility is the capacity for skeletal muscle to shift reliance between lipids and glucose during fasting or in response to insulin. We hypothesized that body fat, adipose tissue characteristics, e.g. larger adipocytes, presence of inflammatory gene markers and impaired suppression of non-esterified fatty acids (NEFAs) during insulin infusion might be related to metabolic flexibility. We measured changes in respiratory quotient (ΔRQ) before and during euglycemic-hyperinsulinemic clamp in healthy young males. Body fat by DXA, laboratory measurements, abdominal subcutaneous adipose tissue biopsies and fat cell size (FCS) were obtained after an overnight fast. Gene expression for 17 adipose tissue genes related to lipid synthesis, uptake, oxidation and storage, lipolysis and inflammation were measured. Reduced metabolic flexibility was associated with higher body fat, larger FCS and impaired insulin suppression of NEFAs. Metabolic flexibility was associated with higher serum adiponectin levels. Lower adipose tissue gene expression for inflammation markers was associated with greater NEFA suppression by insulin and metabolic flexibility. Combined, these results indicate that body fat, larger adipocytes, failure of insulin to suppress NEFAs, decreased adiponectin levels and inflammation markers in adipose tissue are associated with decreased insulin-stimulated glucose uptake and oxidation, which is an important component of reduced metabolic flexibility.

Original languageEnglish (US)
Pages (from-to)32-43
Number of pages12
JournalDiabetes Research and Clinical Practice
Issue number1
StatePublished - Jan 2009


  • Adiponectin
  • Adipose tissue
  • Euglycemic-hyperinsulinemic clamp
  • Fat cell size
  • Inflammatory markers
  • Metabolic flexibility
  • Non-esterified free fatty acids

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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