Is there a metabolic program in the skeletal muscle of obese individuals?
Joseph A Houmard1, Walter J Pories, G Lynis Dohm
1Department of Exercise and Sport Science, College of Health and Human Performance, East Carolina University, Greenville, NC 27834, USA.
Abstract:
Severe obesity (BMI ≥ 40 kg/m(2)) is associated with multiple defects in skeletal muscle which contribute to insulin resistance and a reduction in fatty acid oxidation (FAO) in this tissue. These metabolic derangements are retained in human skeletal muscle cells raised in culture. Together, these findings are indicative of a dysfunctional global metabolic program with severe obesity which is of an epigenetic or genetic origin. Weight loss via gastric bypass surgery can "turn off" and/or correct components of this metabolic program as insulin sensitivity is restored; however, the impairment in FAO in skeletal muscle remains evident. Physical activity can improve FAO and insulin action, indicating that this patient population is not exercise resistant and that exercise offers a pathway to circumvent the abnormal program. Findings presented in this review will hopefully increase the understanding of and aid in preventing and/or treating the severely obese condition.
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