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August 24, 1964, Vol 189, No. 8 >
CLINICAL SCIENCE | August 24, 1964

Energy Metabolism in Human Obesity: Title and subTitle BreakPlasma Free Fatty Acid, Glucose, and Glycerol Response to Epinephrine

Marshall Goldberg, MD; Edgar S. Gordon, MD
[+] Author Affiliations

Madison, Wis

From the Department of Medicine of the University of Wisconsin.


JAMA. 1964;189(8):616-623. doi:10.1001/jama.1964.03070080022005
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References

ABNORMALLY HIGH fasting levels of plasma free fatty acids (FFA) and decreased responsiveness of this lipid fraction to various lipolytic stimuli in obese humans and animals have now been documented by several investigators.1-5 Whether such alterations in FFA metabolism relate to obesity as cause or effect, however, remains speculative.

We have previously reported the failure of the plasma FFA to rise significantly during periods of prolonged fasting in certain patients with longstanding, therapeutically resistant obesity.1 In contrast, a normal FFA response to fasting has been observed in patients whose obesity seems clearly the result of compulsive overeating.

In the present investigation, the plasma FFA response to the more potent lipid-mobilizing action of epinephrine is compared in obese subjects and normal weight controls in two separate experiments: an initial study in which plasma FFA and glucose levels were determined before and 30 minutes after epinephrine administration, and a subsequent

REFERENCES

1 +
Gordon, E.S.:  Non-Esterified Fatty Acids in Blood of Obese and Lean Subjects , Amer J Clin Nutr 8:740, 1960;.
2 +
Opie, L.H., and Walfish, P.G.:  Plasma Free Fatty Acid Concentration in Obesity , New Eng J Med 268:757, 1963;.
3 +
Dole, V.P.:  Relationship Between Non-Esterified Fatty Acids in Plasma and Metabolism of Glucose , J Clin Invest 35:150, 1956;.
4 +
Gordon, E.S., et al:  Abnormal Energy Metabolism in Obesity , Trans Assoc Amer Physicians 75:118, 1962;.
5 +
Marshall, N.B., and Engel, F.L.:  Influence of Epinephrine and Fasting on Adipose Tissue Content and Release of Free Fatty Acids in Obese-Hyperglycemic and Lean Mice , J Lipid Res 1:339, 1960;.
6 +
Hagen, J.H., and Hagen, P.B.:  Enzymatic Method for Measurement of Glycerol in Blood , Canad J Biochem Physiol 40:1129, 1962;.
7 +
Bierman, E.L.: Direct Measurement of Plasma Triglycerides , publication 236, US Army Medical Research & Nutrition Laboratory Report, (July 1) , 1959;.
8 +
Sherman, L.; Goldberg, M.; and Larson, F.: Achilles Reflex:  Diagnostic Test of Thyroid Dysfunction , Lancet 1:243, 1963;.
9 +
Tolbert, B.M.; Kirk, M.; and Baker, E.M.:  Continuous C14O2 and CO2 Excretion Studies in Experimental Animals , Amer J Physiol 185:269, 1956;.
10 +
Gordon, E.S., and Goldberg, M.:  Carbon-14 Studies of Energy Metabolism in Various Thyroid States , Metabolism , to be published.
11 +
Gordon, E.S.; Reichard, G.; and Goldberg, M.: Unpublished data.
12 +
Pollycove, M.:  Glucose Kinetics and Oxidation and Effects of Insulin Tolbutamide and DBI in Normal Human Subjects , J Nucl Med 3:206, 1962;.
13 +
Bogdonoff, M.D., et al:  Fat Mobilization in Man , Ann Intern Med 55:328, 1961;.
14 +
Mueller, P.S., and Evans, W.H.:  Responses of Plasma Glycerol Concentrations to Epinephrine, Norepinephrine, Glucose, Insulin and Prolonged Fasting in Man , J Lab Clin Med 61:953, 1963;.
15 +
Mayer, J.:  Obese-Hyperglycemic Syndrome of Mice as Example of "Metabolic" Obesity , Amer J Clin Nutr 8: 712, 1960;.
16 +
Gordon, E.S.; Goldberg, M.; and Chosy, J.:  New Concept in Treatment of Obesity , JAMA 186:50, 1963;.
17 +
Laszlo, J.; Klein, R.F.; and Bogdonoff, M.D.:  Prolonged Starvation in Obese Patients: In Vitro and In Vivo Effects , Clin Res 9:183, 1961;.
18 +
Keys, A., and Brozek, J.:  Body Fat in Man , Physiol Rev 33:245, 1953;.
19 +
Astwood, E.B.:  Presidential Address: Heritage of Corpulence , Endocrinology 71:337, 1962;.
20 +
Kekwick, A.; Pawan, G.L.S.; and Chalmers, T.M.:  Resistance to Ketosis in Obese Subjects , Lancet 2:1157, 1959;.
21 +
Lardy, H.A.; Lee, Y.P.; and Takemori, A.:  Enzyme Responses to Thyroid Hormones , Ann NY Acad Sci 86:506, 1960;.
22 +
Debons, A.F., and Schwartz, I.L.:  Dependence of Lipolytic Action of Epinephrine In Vitro Upon Thyroid Hormone , J Lipid Res 2:86, 1961;.
23 +
Rich, C.; Bierman, E.L.; and Schwartz, I.L.:  Plasma Nonesterified Fatty Acids in Hyperthyroid States , J Clin Invest 38:275, 1959;.
24 +
Randle, P.J., et al:  Glucose-Free Fatty Acid Cycle , Lancet 1:785, 1963;.
25 +
Berkowitz, D.:  Metabolic Changes Associated With Obesity Before and After Weight Reduction , JAMA 187: 399, 1964;.

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1 +
Gordon, E.S.:  Non-Esterified Fatty Acids in Blood of Obese and Lean Subjects , Amer J Clin Nutr 8:740, 1960;.
2 +
Opie, L.H., and Walfish, P.G.:  Plasma Free Fatty Acid Concentration in Obesity , New Eng J Med 268:757, 1963;.
3 +
Dole, V.P.:  Relationship Between Non-Esterified Fatty Acids in Plasma and Metabolism of Glucose , J Clin Invest 35:150, 1956;.
4 +
Gordon, E.S., et al:  Abnormal Energy Metabolism in Obesity , Trans Assoc Amer Physicians 75:118, 1962;.
5 +
Marshall, N.B., and Engel, F.L.:  Influence of Epinephrine and Fasting on Adipose Tissue Content and Release of Free Fatty Acids in Obese-Hyperglycemic and Lean Mice , J Lipid Res 1:339, 1960;.
6 +
Hagen, J.H., and Hagen, P.B.:  Enzymatic Method for Measurement of Glycerol in Blood , Canad J Biochem Physiol 40:1129, 1962;.
7 +
Bierman, E.L.: Direct Measurement of Plasma Triglycerides , publication 236, US Army Medical Research & Nutrition Laboratory Report, (July 1) , 1959;.
8 +
Sherman, L.; Goldberg, M.; and Larson, F.: Achilles Reflex:  Diagnostic Test of Thyroid Dysfunction , Lancet 1:243, 1963;.
9 +
Tolbert, B.M.; Kirk, M.; and Baker, E.M.:  Continuous C14O2 and CO2 Excretion Studies in Experimental Animals , Amer J Physiol 185:269, 1956;.
10 +
Gordon, E.S., and Goldberg, M.:  Carbon-14 Studies of Energy Metabolism in Various Thyroid States , Metabolism , to be published.
11 +
Gordon, E.S.; Reichard, G.; and Goldberg, M.: Unpublished data.
12 +
Pollycove, M.:  Glucose Kinetics and Oxidation and Effects of Insulin Tolbutamide and DBI in Normal Human Subjects , J Nucl Med 3:206, 1962;.
13 +
Bogdonoff, M.D., et al:  Fat Mobilization in Man , Ann Intern Med 55:328, 1961;.
14 +
Mueller, P.S., and Evans, W.H.:  Responses of Plasma Glycerol Concentrations to Epinephrine, Norepinephrine, Glucose, Insulin and Prolonged Fasting in Man , J Lab Clin Med 61:953, 1963;.
15 +
Mayer, J.:  Obese-Hyperglycemic Syndrome of Mice as Example of "Metabolic" Obesity , Amer J Clin Nutr 8: 712, 1960;.
16 +
Gordon, E.S.; Goldberg, M.; and Chosy, J.:  New Concept in Treatment of Obesity , JAMA 186:50, 1963;.
17 +
Laszlo, J.; Klein, R.F.; and Bogdonoff, M.D.:  Prolonged Starvation in Obese Patients: In Vitro and In Vivo Effects , Clin Res 9:183, 1961;.
18 +
Keys, A., and Brozek, J.:  Body Fat in Man , Physiol Rev 33:245, 1953;.
19 +
Astwood, E.B.:  Presidential Address: Heritage of Corpulence , Endocrinology 71:337, 1962;.
20 +
Kekwick, A.; Pawan, G.L.S.; and Chalmers, T.M.:  Resistance to Ketosis in Obese Subjects , Lancet 2:1157, 1959;.
21 +
Lardy, H.A.; Lee, Y.P.; and Takemori, A.:  Enzyme Responses to Thyroid Hormones , Ann NY Acad Sci 86:506, 1960;.
22 +
Debons, A.F., and Schwartz, I.L.:  Dependence of Lipolytic Action of Epinephrine In Vitro Upon Thyroid Hormone , J Lipid Res 2:86, 1961;.
23 +
Rich, C.; Bierman, E.L.; and Schwartz, I.L.:  Plasma Nonesterified Fatty Acids in Hyperthyroid States , J Clin Invest 38:275, 1959;.
24 +
Randle, P.J., et al:  Glucose-Free Fatty Acid Cycle , Lancet 1:785, 1963;.
25 +
Berkowitz, D.:  Metabolic Changes Associated With Obesity Before and After Weight Reduction , JAMA 187: 399, 1964;.

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