The relation between carbohydrate extraction by the forearm and arterial free fatty acid concentration in man: I. Forearm work with nicotinic acid infusion

Pyridine nucleotides in glucose metabolism and diabetes: a review

Nicotinamide adenine dinucleotide (NAD) and its derivatives NADH, NADP and NADPH have regulatory functions in the generation of triose phosphates and pyruvate from glucose. In many studies of the influence of the diabetic state on relationships between pyridine nucleotide and glucose metabolism, the focus has been on the sorbitol pathway. Less attention has been paid to other aspects of the role of pyridine nucleotides in pyruvate formation from glucose, in particular the effects of the NAD precursors nicotinamide and nicotinic acid on glucose metabolism. This paper reviews current knowledge of the involvement of pyridine nucleotides and their precursors in glucose catabolism in the normal and diabetic state. Reference is also made to the following three current hypotheses for mechanisms underlying diabetic microangiopathy: 1. Chronic glucose overutilization, caused by hyperglycemia, in tissues which lack insulin receptors and therefore are freely permeable to glucose. 2. Enhancement of sorbitol pathway activity with an ensuing decrease in the ratio of NAD/NADH. 3. Enhanced utilization of both glucose and pyridine nucleotides in formation of triose phosphates and pyruvate. Therapy with NAD precursors like nicotinamide might have corrective effects on these proposed biochemical aberrations, thereby retarding progression of microangiopathy.

The effects of induced alkalosis on the metabolic response to prolonged exercise in humans

To examine the effects of alkalosis on the metabolic response to prolonged exercise, seven healthy males cycled for 1 h at approximately 70% of maximum oxygen uptake on two occasions, 1-week apart. Starting 3 h prior to exercise, subjects consumed either CaCO3 (placebo) or NaHCO3 (0.3 g.kg-1 body mass) over a 2-h period. Arterialised-venous blood samples were drawn before and during exercise for the determination of acid-base status and blood metabolites (lactate, glucose, glycerol and plasma free fatty acids). Expired gas was collected during exercise for determination of oxygen uptake (VO2) and respiratory exchange ratio to estimate fuel oxidation rates. Ratings of perceived exertion (RPE) and heart rates were also recorded. A significant (P < 0.01) alkalosis was observed at all times following bicarbonate ingestion. Blood lactate was significantly (P < 0.05) higher at all sample times throughout exercise following bicarbonate ingestion. Blood lactate concentration [mean (SEM)] reached peak values of 2.90 (0.16) and 4.24 (0.45) mmol.l-1 following 20 min of exercise following placebo and bicarbonate, respectively. No differences between treatments were noted at any time for the other metabolites. VO2 and RPE were significantly higher (P < 0.01) with the bicarbonate trial. At a constant power output increases in VO2 are generally associated with increases in fat oxidation, however, no evidence for an altered fuel oxidation was obtained in the present study. The differences in blood lactate indicate that induced alkalosis increased lactate efflux from muscle, but it cannot be confirmed whether this represents an increased rate of glycolysis within the muscle.

Acclimatization to 4,300-m altitude decreases reliance on fat as a substrate

We tested the hypothesis that exposure to altitude decreases reliance on free fatty acids (FFA) as substrates and increases dependency on blood glucose. Therefore, the effects of exercise, hypobaric hypoxia, and altitude acclimatization on FFA, glycerol and net glucose uptake and release [= 2(leg blood flow)(arteriovenous concentration)] and on fatty acid (FA) consumption by the legs (= 3 x glycerol release + FFA uptake) were measured. Because sympathetic responses have been implicated, we utilized nonspecific beta-blockade and observed responses to exercise, altitude, and altitude acclimatization. We studied six healthy beta-blocked men (beta) and five matched controls (C) during rest and cycle ergometry exercise (88 W) at 49% of sea-level (SL) peak O2 uptake at the same absolute power output on acute altitude exposure (A1; barometric pressure = 430 Torr) and after 3 wk of chronic altitude exposure to 4,300 m (A2). During exercise at SL, FA consumption rates increased (P < 0.05). On arrival at 4,300 m, resting leg FFA uptake and FA consumption rates were not significantly different from those at SL. However, after acclimatization to altitude, at rest leg FA consumption decreased to essentially zero in both C and beta groups. During exercise to altitude after acclimatization, leg FA consumption increased significantly, but values were less than at SL or A1 (P < 0.05), whereas glucose uptake increased relative to SL values. Furthermore, beta-blockade significantly increased glucose uptake relative to control. We conclude that 1) chronic altitude exposure decreases leg FA consumption during rest and exercise; 2) relative to SL FFA uptake decreases while glucose uptake increases during exercise at altitude; and 3) beta-blockade potentiates these effects.

Effects of nicotinic acid on glucose tolerance and glucose incorporation into adipose tissue in hypertriglyceridaemia

Nicotinic acid 4 g daily was given to 28 weight-stable hypertriglyceridaemic patients. The aim was to study its effects on serum lipoprotein lipid levels, intravenous glucose tolerance (k-values) and glucose incorporation into subcutaneous adipose tissue (GLIAT) in vitro. The investigations were performed prior to the nicotinic acid therapy, after 6 weeks, and 6 months of drug treatment. Fasting blood glucose levels increased by 13%, whereas k-values fell by 26% after the nicotinic acid treatment. Decrease in k-values was predicted from the initial k-values (R2-value = 0.76). GLIAT increased by 76%, while in the subgroup of eight patients, treated for 6 months with nicotinic acid, GLIAT increased by 331%. The changes in k-values and GLIAT were not significantly interrelated. Serum triglyceride levels were strongly decreased. The most likely explanation for the decrease in intravenous glucose tolerance is that nicotinic acid stimulates glucose output from the liver and that this effect outweighs the stimulating effects of the drug on glucose utilization in extrahepatic tissues. The latter is reflected by the increased uptake of glucose in adipose tissue. A stimulated GLIAT, reflecting formation of alpha-glycerophosphate in adipose tissue, might contribute to the reduction of serum triglyceride levels induced by nicotinic acid, since alpha-glycerophosphate is the acceptor of fatty acids assumed to be liberated from circulating triglycerides by lipoprotein lipase.

Cellular location of thymus-leukemia (TL) antigen as shown by immuno-cryoultramicrotomy

Thymus-leukemia (TL) antigen is a class I molecule of the major histocompatibility complex that is expressed on the surface of mouse cortical thymocytes. Though not expected, it has been reported that TL antigen can be found on isolated mitochondria of TL+ cells. We used immuno-cryoultramicrotomy to look for TL on mitochondria in situ, thereby avoiding the plasma membrane contamination that occurs when isolating organelles. Establishing optimal fixation conditions was crucial, as mitochondrial structure was not preserved by the low concentrations of fixative needed for detection of antibody labeling. The plasma membranes of tissue culture and thymus cells were labeled well with anti-TL antibody and protein A-gold conjugate, while mitochondria within the cells were not labeled. Isolation of mitochondria on a one-step Ficoll gradient resulted in a purer organelle preparation than did isolation of mitochondria by centrifugation alone. Generally, mitchondria within this purer preparation were not labeled. Our data show that under conditions where contamination by plasma membrane is not a major concern, TL antigen cannot be detected on mitochondria.

Increased insulin-stimulated glucose uptake by exercised human muscles one day after prolonged physical exercise

We evaluated whether the increased peripheral insulin sensitivity often reported after physical exercise is generalized or limited to the active musculature. Substrate exchange in leg (previously active) and forearm (previously inactive) were measured by catheterization technique basally and during a hyperinsulinaemic euglycaemic clamp (2 mU insulin kg-1 BW min-1) in nine healthy men before and 1 day after 3-h exercise (50% VO2max). One day after exercise basal glucose uptake was unchanged in the leg, while it was decreased in the forearm (-61%, P less than 0.01) compared with the pre-exercise condition. Glucose uptake during hyperinsulinaemia was increased in the leg (+31%, P less than 0.05), but not in the forearm. Basal lactate release by the leg was increased by the exercise, while lactate release by the forearm was decreased, significantly only during the clamp. These results indicate that local and not systemic factors are responsible for the changes in insulin sensitivity observed in the recovery from physical exercise.

Inhibition of muscular glucose uptake by lipid infusion in man

During a high-dose intravenous infusion of a mixed MCT/LCT-lipid emulsion and a conventional LCT-emulsion respectively, muscle substrate metabolism was investigated using the human forearm technique. With both lipid emulsions, a decrease in fractional muscular glucose extraction was seen, leading to significantly reduced muscular glucose uptake rates. An inverse linear relation between arterial tree fatty acids supply and fractional glucose extraction was seen suggesting that a mechanism according to Randle's glucose fatty acid concept is operating in skeletal muscle in man.

Effect of diet on muscle glycogen and blood glucose utilization during a short-term exercise in man

7 subjects were studied at rest and during a 6 min submaximal exercise (65% of VO2 max) on two occasions, the first preceded by a fat rich diet and the second by a carbohydrate rich diet. Oxygen uptake and respiratory exchange ratio (R) were measured at rest and heart rate both at rest and during exercise. Arterial-femoral venous differences for oxygen, glucose, lactate and beta-hydroxybutyrate and arterial concentrations of free fatty acids were measured at rest and during exercise. Changes in muscle glycogen (in 6 subjects) and lactate concentration were determined by biopsies from m. quadriceps femoris taken before and immediately after exercise. Muscle glycogen decreased less during exercise after the fat than after the carbohydrate diet in 5 of the 6 subjects, whereas blood glucose extraction by the exercising legs did not change with diet. Muscle lactate accumulation and release were smaller after the fat diet. In conclusion, the muscle glycogen utilization during a short-term exercise appeared to be lower after the fat than after the carbohydrate diet, but not the concomitant blood glucose extraction. These differences between diets were similar to those observed after a more prolonged work at the same load.

Effect of diet on the utilization of blood-borne and intramuscular substrates during exercise in man

20 subjects were studied at rest and during a 25 min submaximal exercise (65% of VO2 max) on two occasions, the first preceded by a fat rich diet and the second by a carbohydrate rich diet. Oxygen uptake, respiratory exchange ratio (R) and arterial-femoral venous differences for glucose, lactate, beta-hydroxybutyrate and FFA (based on the fractional extraction of 3H-palmitate) were measured at rest and during exercise. Changes in intramuscular glycogen, triglyceride and lactate concentrations were determined in muscle biopsies taken before and immediately after exercise form m. quadriceps femoris. R was lower after the fat than after the carbohydrate diet and simultaneously the FFA extraction by the exercising leg was higher. The muscle triglycerides did not changes significantly during exercise after either diet. The glucose extraction was insignificantly greater after the fat diet. The glycogen reduction was numerically smaller after the fat diet, but the difference was uncertain and difficult to evaluate due to a large variation after the carbohydrate diet. However, muscle lactate accumulation and release by the exercising leg was smaller after the fat diet, indicating a slower rate of muscle glycogenolysis. It is concluded that a fat rich diet increases the relative contribution of fat to the oxidative metabolism, that this increase, to a great extent, is covered by plasma FFA and that the concomitant decrease in carbohydrate utilization concerns muscle glycogen rather than blood glucose.

Independence of H-2 and viral antigens on the cell surface and absence of H-2 antigens on murine leukemia virus and mouse mammary tumor virus particles

By indirect immunoelectron microscopy we tested for the presence of H-2 antigens on murine mammary tumor virus (MMTV) and murine leukemia virus (MuLV) particles. The association of H-2 antigens and viral antigens on the virus-infected cell surface was investigated with antibody-induced redistribution. Mammary tumor cells and leukemia cell lines with different H-2 genotypes and carrying different MuMTV or MuLV were used. No H-2 antigens could be demonstrated on the envelope of MMTV and MuLV particles, even after the permeabilization of their envelopes with saponin. On the surface of virus-infected cells antibody-induced patching or capping of the viral antigens did not result in copatching or cocapping of the H-2 antigens. In the reciprocal tests no co-redistribution of viral antigens with H-2 antigens was seen. Our experiments failed to show any physical association between H-2 antigens and MMTV or MuLV antigens on the cell surface.

Human adipose tissue blood flow during prolonged exercise, III. Effect of beta-adrenergic blockade, nicotinic acid and glucose infusion

Subcutaneous adipose tissue blood flow (ATBF) was measured in six male subjects by the 133Xe-washout technique during 3-4 h of exercise at a work load corresponding to an oxygen uptake of about 1.71/min. The measurements were done during control conditions, during blockade of lipolysis by nicotinic acid, during acute i.v. beta-adrenergic blockade by propranolol, and during continuous i.v. infusion of glucose. The most pronounced lipid mobilization and utilization during work was seen in the control experiments where ATBF rose 3-fold on average from the initial rest period to the third hour of work. No increase in lipolysis and no increase in ATBF were found when lipolysis was blocked by nicotinic acid (0.3 g/h). Propranolol treatment (0.15 mg/kg) reduced lipolysis and nearly abolished the increase in ATBF during exercise. Intravenous administration of glucose (about 0.25 g/min) did not influence lipid metabolism (evaluated by the respiratory quotient) nor did it reduce the ATBF response to exercise. These results are inconsistent with the hypothesis that increase in ATBF during exercise is elicited via direct stimulation of vascular beta1-receptors, while they are not in disagreement with the hypothesis that adipose tissue vasodilation during exercise is secondary to metabolic events connected to lipolysis.