Mechanism of amino acid-induced skeletal muscle insulin resistance in humans

Diabetes. 2002 Mar;51(3):599-605. doi: 10.2337/diabetes.51.3.599.

Abstract

Plasma concentrations of amino acids are frequently elevated in insulin-resistant states, and a protein-enriched diet can impair glucose metabolism. This study examined effects of short-term plasma amino acid (AA) elevation on whole-body glucose disposal and cellular insulin action in skeletal muscle. Seven healthy men were studied for 5.5 h during euglycemic (5.5 mmol/l), hyperinsulinemic (430 pmol/l), fasting glucagon (65 ng/l), and growth hormone (0.4 microg/l) somatostatin clamp tests in the presence of low (approximately 1.6 mmol/l) and increased (approximately 4.6 mmol/l) plasma AA concentrations. Glucose turnover was measured with D-[6,6-(2)H(2)]glucose. Intramuscular concentrations of glycogen and glucose-6-phosphate (G6P) were monitored using (13)C and (31)P nuclear magnetic resonance spectroscopy, respectively. A approximately 2.1-fold elevation of plasma AAs reduced whole-body glucose disposal by 25% (P < 0.01). Rates of muscle glycogen synthesis decreased by 64% (180--315 min, 24 plus minus 3; control, 67 plus minus 10 micromol center dot l(-1) center dot min(-1); P < 0.01), which was accompanied by a reduction in G6P starting at 130 min (DeltaG6P(260--300 min), 18 plus minus 19; control, 103 plus minus 33 micromol/l; P < 0.05). In conclusion, plasma amino acid elevation induces skeletal muscle insulin resistance in humans by inhibition of glucose transport/phosphorylation, resulting in marked reduction of glycogen synthesis.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Diphosphate / analysis
  • Adult
  • Amino Acids / blood
  • Amino Acids / pharmacology*
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Deuterium
  • Epinephrine / blood
  • Fasting
  • Glucagon / blood
  • Glucose Clamp Technique
  • Glucose-6-Phosphate / analysis
  • Glycogen / analysis
  • Glycogen / biosynthesis
  • Human Growth Hormone / blood
  • Humans
  • Hydrocortisone / blood
  • Hydrogen-Ion Concentration
  • Insulin / blood
  • Insulin / pharmacology
  • Insulin Resistance*
  • Kinetics
  • Magnetic Resonance Spectroscopy
  • Male
  • Muscle, Skeletal / chemistry
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / metabolism
  • Phosphates / analysis
  • Phosphocreatine / analysis
  • Phosphorylation
  • Somatostatin / blood

Substances

  • Amino Acids
  • Blood Glucose
  • Insulin
  • Phosphates
  • Phosphocreatine
  • Human Growth Hormone
  • Somatostatin
  • Glucose-6-Phosphate
  • Adenosine Diphosphate
  • Glycogen
  • Glucagon
  • Deuterium
  • Hydrocortisone
  • Epinephrine