FREE FATTY ACIDS (FFA), A LINK BETWEEN OBESITY AND INSULIN RESISTANCE

Guenther Boden, M.D.

Division of Endocrinology/Diabetes/Metabolism and the General Clinical Research Center, Temple University School of Medicine, Philadelphia, PA

Received 1/21/98 Accepted 1/31/98

6. SIGNIFICANCE

The evidence reviewed here indicates that physiological elevations of plasma FFA increases peripheral (and probably also hepatic) insulin resistance in a dose dependent manner. This FFA induced insulin resistance serves important physiological purposes during periods of prolonged starvation and during normal pregnancy. During starvation, rising plasma FFA produce peripheral insulin resistance, which preserves precious carbohydrate resources for oxidation in the central nervous system. Pregnancy, on the other hand, has been characterized as a state of accelerated starvation (52). FFA rise because of an increase