Ketone body metabolism in lean and obese women.

Previous studies have demonstrated decreases in whole-body and muscle fat oxidation in obese individuals. Because muscle also uses ketone bodies, and because the ketone body oxidation pathway differs from that of fatty acid oxidation, this study was initiated to determine whether there were differences in ketone body metabolism between obese and lean subjects. Plasma beta-hydroxy-butyrate (beta-OHB) concentration was measured in 47 lean and 47 age-matched obese women, and the rate of beta-OHB oxidation by muscle homogenates was measured in a subset of 8 lean and 8 obese women. Plasma free fatty acid levels, which have been reported to correlate with ketone body production, were higher (P<.05) in the obese than in the lean women (662+/- 46 and 463+/- 44 nmol/L, respectively) as was plasma insulin level. However, the beta-OHB concentration was lower in obese than in lean subjects (235+/-17 and 323+/-29 micromol/L, respectively; P<.05). The rate of beta-OHB oxidation was also lower (P<.05) in muscle of the obese than that of the lean group (139.6+/-12.6 vs 254.6+/-30.0 nmol of CO(2) produced per gram of tissue per hour). These data illustrate that production and use of ketone bodies are lower in obese women than in lean controls. The decreased oxidation of ketone bodies by muscle is consistent with aberrations in muscle metabolism in the obese individuals that most likely relates to a decrease in mitochondrial numbers.

Fatty acid oxidation by skeletal muscle homogenates from morbidly obese black and white American women.

The purpose of this study was to determine if there were differences in the capacity of skeletal muscle from morbidly obese Black and White American women to oxidize fatty acids. The oxidation rates of (14)C-palmitate, (14)C-palmitoyl-CoA, and (14)C-palmitoyl-carnitine were measured in whole homogenates of rectus abdominus from Black and White women who were similar in age and body mass index (BMI). The activities of muscle citrate synthase (CS), beta-hydroxy acyl-CoA dehydrogenase (beta-HAD), and mitochondrial and microsomal acyl-CoA synthetase (ACS) were measured in the 2 groups. The results showed that the rate of (14)C-palmitate oxidation by muscle of Black women was 25% that of Whites (8.7 +/- 1.5 v 34.4 +/- 6.8 nmol (14)CO(2) produced/gram tissue wet weight/ hour; P <.05), but the rates of (14)C-palmitoyl-CoA and (14)C-palmitoyl-carnitine oxidation were not different in the 2 groups. No differences were found in the activities of CS or beta-HAD. However, the activities of both mitochondrial and microsomal ACS were lower in the Black women than the Whites (mitochondrial ACS 25.1 +/- 3.9 v 36.4 +/- 5.0 nmol/mg protein/min; P <.05; microsomal ACS 6.2 +/- 0.5 v 8.5 +/- 0.5; nmol/mg protein/min; P <.005). The lower rate of palmitate oxidation, and the lack of differences in the rates of palmitoyl-CoA and palmitoyl-carnitine oxidation indicate that there is a defect in the activation of the fatty acid in the muscle of the Black women. This was confirmed by the decrease in mitochondrial ACS activity in the Black women. The decreased fatty acid oxidation by skeletal muscle of obese Black women could result in shunting these fuels from muscle to adipose tissue for storage, which may contribute to the maintenance of obesity in the Black women.