Hormonal
In insulin-resistant obese women, elevated intramyocellular triglyceride (IMTG) content is specifically associated with insulin resistance in Type I myocytes, whereas Type II myocytes show no such association despite similar or higher total lipid loads.
For older obese women, insulin resistance is not just about how much fat is stored in the muscle overall, but specifically where it is stored. High levels of a specific lipid called ceramide, found alongside IMTG in slow-twitch (Type I) muscle fibers, are strongly linked to insulin resistance. Fast-twitch (Type II) fibers did not show this link. This suggests that improving the health or proportion of slow-twitch fibers, or managing lipid metabolism specifically within them, may be key to improving insulin sensitivity.
IMTG content within type I myocytes, but not type II myocytes, was higher in IR compared with IS subjects (P < 0.005). Insulin sensitivity was negatively correlated with IMTG within type I myocytes (R = -0.51, P < 0.026), but not with IMTG within type II myocytes.
Why this rating
High-quality nested case-control design with gold-standard hyperinsulinemic-euglycemic clamps and precise mass spectrometry, though limited to a specific demographic (older obese women).
Source
Insulin Resistance Is Associated With Higher Intramyocellular Triglycerides in Type I but Not Type II Myocytes Concomitant With Higher Ceramide Content
Paul M. Coen et al. · Diabetes · 2009
DOI 10.2337/db09-0988
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