Hormonal
In women with visceral obesity, skeletal muscle insulin resistance is caused by a diminished capacity for postabsorptive free fatty acid (FFA) utilization, rather than by glucose-FFA substrate competition.
For women with high visceral fat, insulin resistance is linked to their muscles' inability to efficiently use fat for energy when fasting, not necessarily to high fat intake causing competition with glucose. Improving the muscle's capacity to oxidize fat (e.g., through exercise which increases mitochondrial enzymes like CPT and citrate synthase) may be a key target for improving insulin sensitivity.
In summary, visceral adiposity is clearly associated with skeletal muscle insulin resistance but this is not due to glucose-FFA substrate competition. Instead, women with visceral obesity have reduced postabsorptive FFA utilization by muscle.
Why this rating
Study uses rigorous leg balance methods and muscle biopsies in a controlled, healthy premenopausal cohort, though the sample size is small (n=17).
Source
Skeletal muscle utilization of free fatty acids in women with visceral obesity.
Sheri R. Colberg et al. · Journal of Clinical Investigation · 1995
DOI 10.1172/jci117864
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