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A more recent version of this article appeared on August 1, 2006
Originally published In Press as doi:10.1194/jlr.R600011-JLR200 on May 9, 2006
Papers In Press, published online ahead of print May 10, 2006
J. Lipid Res., doi:10.1194/jlr.R600011-JLR200
Submitted on April 5, 2006
Revised on May 3, 2006
Accepted on May 8, 2006
Free fatty acid metabolism in human obesity
Christina Koutsari and Michael D. Jensen
Endocrine Research Unit, Mayo Clinic, Rochester, MN 55905
Corresponding Author: jensen{at}mayo.edu
Adipose tissue lipolysis provides circulating free-fatty acids (FFA) to meet the body's lipid fuel demands. FFA release is well-regulated in normal-weight individuals, however, in upper-body obesity excess lipolysis is commonly seen. This abnormality is considered a cause for at least some of the metabolic defects (dyslipidemia, insulin resistance) associated with upper-body obesity. Normal lipolysis is sex-specific and largely determined by the individuals resting metabolic rate. Women have greater FFA release rates than men without higher FFA concentrations or greater fatty acid oxidation, indicating they have greater non-oxidative FFA disposal, although the processes and tissues involved in this phenomenon are unknown. Therefore, women have the advantage of having greater FFA availability without exposing their tissues to higher and potentially harmful FFA concentrations. Upper-body fat is more lipolytically active than lower-body fat in both women and men. FFA released by the visceral fat depot contributes only a small percentage of systemic FFA delivery. Upper-body subcutaneous fat is the dominant contributor to circulating FFA and the source of the excess FFA release in upper-body obesity. We believe abnormalities in subcutaneous lipolysis could be more important than those in visceral lipolysis as a cause of peripheral insulin resistance. Understanding the regulation of FFA availability will help to discover new approaches to treat FFA-induced abnormalities in obesity.

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