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Blunted lipolytic response to fasting in abdominally obese women: evidence for involvement of hyposomatotropism^1,2

¹ From the Department of General Internal Medicine (MMB, CW, MF, AEM, and HP), the Center for Human Drug Research (JB, MLdK, and AFC), and the Department of Endocrinology (JAR), Leiden University Medical Center, Leiden, Netherlands, and the Department of Endocrinology and Metabolism, Academic Medical Center (HPS), Amsterdam.

Background: Abdominal obesity is associated with a blunted lipolytic response to fasting that may contribute to the preservation of adipose tissue mass.

Objective: To further explore the pathophysiology of blunted lipolysis during fasting in obesity, we simultaneously measured lipolysis and distinct neuroendocrine regulatory hormones in abdominally obese and normal-weight (NW) women.

Design: Eight abdominally obese [± SD body mass index (BMI; in kg/m²): 32.1 ± 2.6] and 6 NW (BMI: 22.7 ± 1.5) women were studied during the last 8 h of a 20-h fast. The glycerol appearance rate and the serum and plasma concentrations of insulin, leptin, cortisol, and growth hormone were measured regularly.

Results: At 13 h of fasting, the mean (±SD) glycerol appearance rate corrected for fat mass was greater in NW women than in obese women (7.2 ± 1.0 and 5.1 ± 0.6 µmol·kg^-1·min^-1, respectively; P = 0.001). After a 20-h fast, lipolysis increased to 8.9 ± 1.5 mmol·kg^-1·min^-1 in NW women (23%), whereas it did not change significantly in obese women (-2%). Fasting decreased insulin concentrations by 30% in both groups, but it did not induce significant changes in leptin concentrations. Mean cortisol concentrations and urinary catecholamine excretion were comparable in both groups. However, mean plasma growth hormone concentrations were higher in NW women than in obese women (1.81 ± 0.98 compared with 0.74 ± 0.52 mU/L; P = 0.046). The relative change in lipolysis tended to correlate with mean plasma growth hormone concentrations (r = 0.515, P = 0.059).

Conclusion: Abdominal obesity-associated hyposomatotropism may be involved in the blunted increase in lipolysis during fasting.

Key Words: Lipid metabolism • somatotropin • starvation • lipolysis rate • obesity • women

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