Impact of Free Fatty Acids on Vascular Insulin Responses Across the Arterial Tree: A Randomized Crossover Study
Authors' conclusion
Clinically relevant elevation of plasma FFA concentrations induces pan-arterial insulin resistance, the vascular insulin resistance outcomes are interconnected, and insulin-mediated muscle microvascular perfusion associates with cardiovascular disease predictors. Our data provide biologic plausibility whereby a causative relationship between FFAs and cardiovascular disease could exist, and suggest that further attention to interventions that block FFA-mediated vascular insulin resistance may be warranted.
Study context
- Population
- Healthy lean adults
- Comparison
- Lipid infusion vs matched-volume saline infusion, with euglycemic insulin clamp
Methodological detailseuglycemic insulin clamp
- Euglycemic insulin clamp
Primary result
As reported in the abstract
Vascular insulin responses across the arterial tree · before and after insulin clamp
- Insulin enhanced flow-mediated dilation (FMD), augmentation index (AIx), reflection magnitude, and cardiac and skeletal muscle microvascular perfusion
- Elevated plasma FFA suppressed subendocardial viability ratio (SEVR)
- Elevated FFA blunted insulin-induced increases in FMD and cardiac and skeletal muscle microvascular blood volume
- Elevated FFA lowered insulin's ability to reduce AIx and reflection magnitude
Further findings
Association of insulin-mediated muscle microvascular perfusion with other vascular responses
- In multivariate regression, insulin-mediated muscle microvascular perfusion was independently associated with insulin-mediated FMD and carotid femoral pulse wave velocity (cfPWV)
Original publication
Impact of Free Fatty Acids on Vascular Insulin Responses Across the Arterial Tree: A Randomized Crossover Study. J Clin Endocrinol Metab. Published 10 November 2023. doi:10.
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