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Intramuscular and Liver Triglycerides Are Increased in the Elderly

Departments of Surgery (M.G.C., C.S.K., M.S.-M., D.C., R.R.W.), Anesthesiology (A.A.), and Internal Medicine (R.U.), The University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, Texas 77550; and Department of Diagnostic and Therapeutic Sciences (B.R.N.), School of Health Related Professions, University of Alabama at Birmingham, Birmingham, Alabama 35294

Address all correspondence and requests for reprints to: Robert R. Wolfe, Ph.D., Shriners Hospitals for Children, 815 Market Street, Galveston, Texas 77550. E-mail: rwolfe{at}utmb.edu.

Magnetic resonance spectroscopy studies have shown that intramyocellular lipids (IMCL) and liver fat (LFAT) levels vary with insulin sensitivity and obesity, which are common in the elderly. Thus, magnetic resonance spectroscopy was used to investigate the hypothesis that IMCL and LFAT are increased in the elderly. IMCL and LFAT in young (aged 20–32 yr) and elderly (aged 65–74 yr) were measured fasted, and glucose, insulin, total free fatty acids levels, and free fatty acids profiles were measured during a 2-h oral glucose tolerance test. Body fat percentage was determined with dual x-ray absorptiometry. The elderly had significantly greater IMCL (0.12 ± 0.01 vs. 0.08 ± 0.01, mean ± SEM; P = 0.01) and LFAT (0.28 ± 0.06 vs. 0.08 ± 0.01; P = 0.004; expressed as ratios to Intralipid standard) than the young. The elderly had increased insulin resistance as calculated by the Matsuda model compared with the young (5.1 ± 0.9 vs. 9.9 ± 1.4; P = 0.02). Regression analysis of all subjects indicated that the increases in IMCL and LFAT were correlated with insulin sensitivity, glycosylated hemoglobin, plasma lipids, and body fat. Furthermore, the correlation between insulin sensitivity and IMCL and LFAT remained significant, after accounting for the effect of body fat. Increases of IMCL and LFAT occur in elderly individuals and may be related to insulin resistance.

This work was supported by the Nelda C. and H. J. Lutcher Stark Foundation (R.U.), Shriners Hospital Grant 8940 (R.R.W.), and the National Institutes of Health (NIH) Claude D. Pepper Older Americans Independence Center Grant P60 AG17231-01 (James S. Goodwin, Chief Medical Director, Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch).

This study was conducted at the General Clinical Research Center, University of Texas Medical Branch (Galveston, TX) and funded by grant M01-RR-00073 from the National Center for Research Resources, NIH, United States Public Health Service.

Abbreviations: AMARES, Method of Accurate, Robust and Efficient Spectral fitting; BMI, body mass index; DAG, diacylglycerol; DEXA, dual x-ray absorptiometry; FFA, free fatty acid; FID, free induction decay; HbA_1c, glycosylated hemoglobin; IMCL, intramyocellular lipids; ISI, insulin sensitivity indices; LDL, low-density lipoprotein; LFAT, liver fat; MRS, magnetic resonance spectroscopy; OGTT, oral glucose tolerance test; TG, triglyceride(s).

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