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The Journal of Clinical Endocrinology & Metabolism Vol. 82, No. 12 4162-4166
Copyright © 1997 by The Endocrine Society


Original Studies

Comparison of Hormone-Sensitive Lipase Activity in Visceral and Subcutaneous Human Adipose Tissue1

Signy Reynisdottir, Michèle Dauzats, Anders Thörne and Dominique Langin

Departments of Medicine and Surgery (A.T.), Huddinge Hospital, Karolinska Institute, 14186 Huddinge, Sweden; and INSERM U-317, Institut Louis Bugnard, Faculté de Médecine, Hôpital Rangueil (M.D., D.L.), 31403 Toulouse, France

Address all correspondence and requests for reprints to: Signy Reynisdottir, M.D., Ph.D., MK Division, Huddinge Hospital, S-141 86 Huddinge, Sweden.


    Abstract
 Top
 Abstract
 Introduction
 Subjects and Methods
 Results
 Discussion
 References
 
The possible role of hormone-sensitive lipase (HSL) in determining regional differences in lipolysis activation in humans was studied in vitro. Small adipose tissue biopsies were obtained from the abdominal sc and omental regions during surgery in 21 subjects spanning a wide range of body mass index (22–50 kg/m2). In lipolysis experiments, isolated fat cells were incubated with lipolytic agents acting at different levels in the lipolytic cascade. The activity and messenger ribonucleic acid expression of HSL were determined. The maximum lipolytic capacity was higher in sc than in omental fat cells as were HSL activity and messenger ribonucleic acid expression. The maximum lipolysis rate was significantly correlated to HSL activity. This is in accordance with the role of HSL as the rate-limiting step of lipolysis. However, adipocytes were 24% larger in the sc than in the omental region, and the lipolysis rate was significantly correlated to fat cell size regardless of either the region of origin or gender. This indicates that the regulation of HSL activity in healthy subjects, which appears to occur at a transcriptional level, is to a large extent dependent on fat cell size.


    Introduction
 Top
 Abstract
 Introduction
 Subjects and Methods
 Results
 Discussion
 References
 
THERE IS increasing evidence for a central role of increased plasma free fatty acids (FFA) in the insulin resistance syndrome and in the associated predisposition to coronary heart disease (1). It has been established for a long time that adipose tissue is a heterogeneous organ with marked variation in fat cell metabolism depending on the anatomical location (2). This is of potential pathophysiological interest in metabolic disorders associated with obesity, such as noninsulin-dependent diabetes mellitus, hypertension, and dyslipidemia, in particular when there is accumulation of fat in the visceral depot (3). One proposed mechanism for this association is that lipolysis, i.e. the release of glycerol and FFA, in visceral adipose tissue may influence carbohydrate and lipid metabolism, with FFA being delivered directly to the liver via the portal circulation (4).

In humans, catecholamines are the most potent activators of lipolysis, the breakdown of triglycerides into glycerol and FFA. They modulate adenylyl cyclase activity via stimulatory ß1-, ß2-, and ß3-adrenoceptors and inhibitory {alpha}2-adrenoceptors (5). When the ß-adrenergic pathway is predominant, the intracellular level of cAMP increases activating the cAMP-dependent protein kinase. The kinase phosphorylates and activates hormone-sensitive lipase (HSL) (6, 7). HSL catalyzes the breakdown of triglycerides and diglycerides, which is the rate-limiting step of adipose tissue lipolysis. Regional differences in HSL activity have recently been described in rats (8, 9), but have not previously been examined in man.

In the present study the possible role of HSL in determining regional differences in the lipolysis rate was investigated in human fat cells from omental and sc abdominal adipose tissue.


    Subjects and Methods
 Top
 Abstract
 Introduction
 Subjects and Methods
 Results
 Discussion
 References
 
Subjects

The study included 21 subjects (9 men and 12 women) who were recruited among otherwise healthy patients undergoing elective open or laparoscopic surgery because of either gallstones or obesity. To examine the role of fat cell size, the subjects were selected to represent a wide range in body weight, but there was no selection on the basis of age or sex. None had jaundice, and all were free from medication. For methodological studies small fragments of adipose tissue from an additional 22 subjects were obtained during surgery. The study was explained in detail to each participant, and consent was obtained. The study was approved by the ethics committee at the Karolinska Institute.

The subjects fasted overnight, and only saline was infused iv before the fat biopsy. The surgical procedures started at 0800 h. General anesthesia was induced by a short acting barbiturate and maintained by phentanyl and nitrous oxide. Fat biopsies (~1–3 g) were removed from both the abdominal sc and the omental adipose tissue of each subject within 30 min after the start of general anesthesia. The tissue was immediately transported to the laboratory in saline.

Isolation of fat cells and determination of fat cell number

This procedure has been described in detail previously (10). Adipose tissue was cut into small fragments (10–20 mg), and isolated fat cells were prepared by collagenase treatment (11). The cells were kept in a Krebs-Ringer phosphate buffer with albumin. The cells were packed through centrifugation at 200 rpm for 1 min. Aliquots of 300 and 200 µL were frozen directly into liquid nitrogen for later analysis of HSL activity and messenger ribonucleic acid (mRNA) expression, respectively. Direct microscopic determination of the fat cell diameter was performed according to the method of DiGirolamo and co-workers (12). An aliquot of the fat cell suspension was placed on a glass slide and examined with a Zeiss microscope (Zeiss, New York, NY) equipped with a caliper scale. The diameters of 100 cells were measured. Mean cell volume, surface area, and weight of the fat cells were calculated, taking into consideration the skewness in the distribution of the cell diameter (13).

The number of fat cells incubated in the lipolysis experiments was determined as follows. The lipids in an aliquot of the incubation mixture were extracted according to the method of Dole and Meinertz (14), and the lipid content was determined gravimetrically. The number of fat cells incubated was obtained by dividing the mean lipid content of the incubation tubes by the mean fat cell weight, assuming that lipids constitute more than 95% of the fat cell weight.

Two ways of determining the number of fat cells homogenized for analysis of HSL activity were compared in separate methodological experiments on small samples of both omental and sc adipose tissue from 32 subjects. First, the number of cells was calculated, as described above, by extraction of the lipids from a 25-µL aliquot of packed fat cells. Second, the number of fat cells was estimated by dividing the amount of packed cells used in the HSL assay (300 µL) by the mean fat cell volume. In simple regression analysis (Fig. 1Go), there was a close correlation between these two methods in both adipose regions examined (omental: r = 0.94; P = 0.0001; sc: r = 0.92; P = 0.0001), and analysis of covariance did not reveal any significant difference between the two regression lines. Although the latter method gave a higher estimate of the cell number by 24 ± 2% in the sc and by 26 ± 3% in the omental fat samples, respectively, the slope of the regression line did not differ significantly from 1 in either region, indicating only a minor effect of variations in cell size and the procedure of packing the fat cells on this relationship. The slopes were 1.1 and 1.3 in omental and sc regions, respectively. As the amount of adipose tissue that can be obtained during laparoscopic surgery is frequently scarce, the latter mode of determination was subsequently used.



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Figure 1. Results of two methods to calculate cell number in 300-µL aliquots of packed fat cells from the sc (open symbols) and omental (filled symbols) regions of 32 subjects. Cell number was calculated from cell volume (y-axis) or lipid weight (x-axis) as described in Materials and Methods. The linear relationship is shown comparing the two methods in omental (r = 0.94; P = 0.0001) and sc fat (r = 0.92; P = 0.0001), respectively.

 
Lipolysis experiments

This assay has previously been described in detail (10). It was performed in 19 of the 21 subjects. A diluted suspension of fat cells was incubated at 37 C in duplicate samples, with or without increasing concentrations (10-3–10-9) of the following lipolytic agents, acting at different levels of the lipolytic cascade: the nonselective ß-adrenergic agonist isoprenaline; forskolin, which stimulates adenylyl cyclase; and dibutyryl cAMP (dcAMP), a phosphodiesterase-resistant cAMP analog that activates cAMP-dependent protein kinase. Glycerol release to the incubation medium was used as an index of the lipolysis rate. After 2-h incubation, an aliquot of the incubation medium was removed for analysis of glycerol content using an automated bioluminescence assay (15).

All of the agonists caused a dose-dependent increase in glycerol release, reaching a plateau at the highest agonist concentrations. The responsiveness to each agonist was determined as the maximum stimulated lipolysis rate. The lipolysis rates in the presence or absence of agonist were related to either lipid weight or the number of incubated cells.

Assay of HSL activity

This assay was performed as described by Fredriksson et al. (16) with some modifications for the handling of small samples as described by Frayn et al. (17). Sufficient material could be obtained for the assay in both adipose regions from 12 subjects. Packed fat cells (exactly 300 µL) that had been stored in liquid nitrogen were homogenized at 4 C in 2.0 mL of a buffer containing 0.25 mol/L sucrose, 1 mmol/L ethylenediamine tetraacetate, 1 mmol/L dithiothreitol, and 20 µg/L of each of the protease inhibitors antipain and leupeptin. The homogenate was then centrifuged at 100,000 x g at 4 C for 45 min. The fat cake was removed, and the fat-free infranatant was recovered for analysis of HSL activity using 1(3)-[3H]-oleoyl-2-O-oleylglycerol as substrate (16). The substrate was obtained from the same source (Department of Medical and Physiological Chemistry, Lund University, Lund, Sweden) as in the original methodological studies. All samples were incubated in triplicate at 37 C for 30 min on one occasion. The substrate for HSL has only one hydrolyzable ester bond at the 1(3) position and is therefore not a substrate for monoacylglycerol lipase, which is abundant in adipose tissue. Furthermore, under the present incubation conditions (pH 7.0 and no apolipoprotein CII present), lipoprotein lipase activity is negligible (16). As the phosphorylated and dephosphorylated forms of the enzyme have the same activity toward this substrate, the total amount of activatable enzyme in the sample is measured (17). HSL hydrolyzes tri- and diacylglycerol at the relative rate of 1:10 (16). Therefore, the sensitivity of the assay is enhanced by the use of a diacylglycerol analog as substrate. One unit of enzyme activity equals 1 µmol fatty acid produced/min at 37 C. Enzyme activity was related to the cell number of the sample, which was determined as described above. The enzyme activity of the fat-free infranatant was proportional to the volume of packed fat cells when multiple samples from one subject were analyzed (r = 0.94; P < 0.01). The within-run coefficient of variation was 7%. The intraindividual coefficient of variation, examined by multiple samples of adipose tissue from one subject, was 11%.

Assay of mRNA levels

Steady state mRNA levels of HSL were measured using a solution hybridization assay in 19 subjects (18, 19). Packed adipocytes (200 µL) were homogenized. and total nucleic acids (TNA) were extracted by phenol-chloroform after digestion with proteinase K (18).

A 453-bp fragment corresponding to nucleotides 1865–2318 of the human HSL complementary DNA (6) was cloned into a pBluescript vector and linearized using EcoRI. Antisense RNA produced using T3 RNA polymerase was labeled by incorporating [35S]UTP into the reaction mixture (17). The specificity of the probe has been ascertained previously (17). An unlabeled sense RNA complementary to the probe was synthesized and used as control. The concentration of the RNA was determined by spectrophotometry.

The radiolabeled probe was hybridized to the samples or the sense RNA for 18 h at 68 C in a buffer containing 25% formamide (19). After hybridization, the samples were treated with ribonuclease for 45 min at 37 C and then precipitated for 30 min at 4 C after addition of trichloroacetic acid. The ribonuclease-resistant precipitated RNA-RNA hybrids were collected under vacuum on a Whatman GF/C filter (Whatman, Clifton, NJ) that was washed with 4% trichloroacetic acid in 1% sodium pyrophosphate and with 70% ethanol before scintillation counting (19).

The HSL mRNA level was related to the content of {gamma}-actin in the nucleic acid extract, measured with the solution hybridization technique described above using a 236-bp probe, donated by Mats Gåfvels, Novum, Huddinge Hospital (Huddinge, Sweden).

Drugs and chemicals

Collagenase prepared from Clostridium histolyticum and BSA (fraction V, lot 63F-0748) were obtained from Sigma Chemical Co. (St. Louis, MO). Isoprenaline was purchased from Hässle (Molndal, Sweden). Glycerol kinase from Escherichia coli (Sigma no. G4509) and ATP monitoring reagent containing firefly luciferase (LKB Vallac, Turku, Finland) were used in the glycerol assay. All other chemicals were commercially available and of the highest grade of purity.

Statistical analysis

Student’s two-tailed t test was used for comparison between adipose regions. Simple regression analysis and analysis of covariance were used in some cases. Data are expressed as the mean ± SEM.


    Results
 Top
 Abstract
 Introduction
 Subjects and Methods
 Results
 Discussion
 References
 
The subjects were 30–53 yr of age (mean ± SE, 41 ± 2 yr; n = 21) with a large variation in body mass index, ranging from 22–50 kg/m2 (32.1 ± 1.7 kg/m2). Adipocytes from the abdominal sc biopsies were, on the average, 24% larger than adipocytes from the omental region (607 ± 47 and 487 ± 61 pL, respectively; P < 0.01).

The results of the lipolysis experiments are summarized in Fig. 2Go. The basal lipolysis rate, i.e. in the absence of agonist, was more than 2-fold higher in the sc compared to the omental adipocytes. The maximum stimulatory effect of the different lipolytic agents used was also greater in the sc compared to the omental adipocytes, although the difference was less pronounced than that for basal lipolytic activity. The increase in the lipolysis rate in sc adipocytes was of the same order of magnitude whether lipolysis was stimulated at the ß-adrenoceptor level with isoprenaline or at postreceptor levels with forskolin or dcAMP. Furthermore, the higher lipolytic capacity in the sc region was also found when the basal values were subtracted and when the results are expressed in relation to lipid weight (data not shown).



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Figure 2. Lipolysis rates in isolated fat cells from the omental (filled bars) and sc (open bars) regions of 19 subjects in the absence (basal) or presence of maximum effective concentrations of each lipolytic agent. ISO, Isoprenaline, a nonselective ß-adrenoceptor agonist; FORSK, forskolin, an activator of adenylyl cyclase. dcAMP is a phosphodiesterase-resistant cAMP analog.

 
The results of the HSL assay are shown in Table 1Go. Enzyme activity was about 80% higher in the sc compared to the omental samples. This increase corresponds to the increase in stimulated lipolytic activity. HSL mRNA levels were higher in TNA extracts from sc compared to omental adipocytes (Table 1Go). The difference was, however, less pronounced than that for HSL activity. There were no significant correlations between HSL mRNA levels, on the one hand, and HSL activity, lipolysis rate, or fat cell size, on the other (data not shown).


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Table 1. HSL activity and mRNA expression

 
The relationship between fat cell size and lipolytic activity was examined using simple regression analysis (Fig. 3aGo). There was a significant correlation between fat cell size and maximum isoprenaline-stimulated lipolysis in each adipose region; the regression lines of the two regions were practically superimposed. A similar pattern was observed when HSL activity was plotted against the maximum lipolysis rate (Fig. 3bGo). Analysis of covariance revealed no significant difference between the regression lines in either case. It is known that variations in fat cell size depend not only on body mass and adipose region but also on gender. Therefore, in Fig. 4Go we have compared the regression lines between cell size and lipolysis in males and females for both sc and omental adipocytes taken together. There were no significant differences between the regression lines as determined by analysis of covariance.



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Figure 3. Linear relationship between maximum isoprenaline-stimulated lipolysis rate and fat cell volume in omental (r = 0.76; P < 0.0005) and sc fat cells (r = 0.62; P < 0.05) of 18 subjects. The relationship between lipolysis rate and HSL activity was examined in omental (r = 0.80; P < 0.005) and sc (r = 0.64; P < 0.05) adipocytes from 12 subjects. Omental adipocytes are indicated with filled symbols; sc adipocytes are indicated with open symbols.

 


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Figure 4. Linear relationship between maximum isoprenaline-stimulated lipolysis rate and fat cell size in both omental and sc adipocytes from 9 male (r = 0.6; P = 0.01) and 11 female (r = 0.74; P = 0.002) subjects. Adipocytes from male subjects are indicated with open symbols, and those from females are indicated with filled symbols.

 

    Discussion
 Top
 Abstract
 Introduction
 Subjects and Methods
 Results
 Discussion
 References
 
The present study suggests an important role of HSL expression and function in the regional variation in adipocyte lipolysis regulation. Previous observations of an increased maximum lipolytic capacity in sc compared to omental adipocytes are confirmed (20). This increase was found with all of the lipolytic agents used, from stimulation at the adrenoceptor level with isoprenaline to activation of cAMP-dependent protein kinase with dcAMP, indicating that the maximum lipolysis rate was determined at or beyond the level of protein kinase activation in the lipolytic cascade. This is in agreement with the report of Vikman et al. (21), who found no regional differences in adenylyl cyclase activation despite larger fat cells in the sc area. The results of the HSL activity assay suggest that the regional difference in lipolysis rate is determined at the level of HSL expression, with higher HSL activity in sc than omental adipocytes. HSL activity was correlated to the maximum lipolysis rate in both adipose regions, which is in accordance with its role as the rate-limiting step of lipolysis. It should be noted that the present enzymatic assay gives an estimate of the total activatable enzyme and does not differentiate between the active phosphorylated and the inactive dephosphorylated states (17). The results indicate, however, that this measure is relevant for determination of the maximum lipolytic capacity.

Previous studies of lipolysis in man have described a stronger lipolytic response to catecholamines in omental cells due to differences at the adrenoceptor level with higher density and thus sensitivity to ß-adrenoceptor stimulation in visceral fat combined with reduced {alpha}2-adrenoceptor expression (22). Receptor affinity for other antilipolytic agents of importance, such as adenosine and insulin, is higher in sc than in visceral fat, further promoting lipolysis from the visceral region (20, 22). However, postreceptor differences and HSL expression have never been studied in man.

A positive relationship was found between lipolytic capacity and fat cell size in the two adipose depots. This observation is in accordance with previous findings (10, 20, 23, 24). It may also explain discrepancies between the present study and previous studies in man and the rat. In severely obese subjects, no difference was found between the lipolysis rates of omental and sc fat cells (25, 26). There were also negligible differences in cell size between the two regions. In the rat, sc adipocytes are characterized by lower maximal lipolysis rate and HSL expression than internal adipocytes. In this species, sc adipocytes are smaller than internal adipocytes (8). From these data it may be speculated that under physiological conditions, the lipolytic capacity and the level of HSL are at least partly determined by fat cell size. In agreement with this hypothesis, the regression lines for the relationship between cell size and lipolysis rate were nearly superimposed for the two adipose regions. It is possible that the increased lipolytic capacity and HSL activity observed in large fat cells is an adaptive mechanism to limit fat cell hypertrophy. This could perhaps explain the decreased HSL activity in sc adipocytes of obese women subjected to a weight reduction program that induced a marked reduction in fat cell size (27). Cell size is probably not the only determinant of maximal lipolytic capacity and HSL expression. In pathological conditions such as familial combined hyperlipidemia and insulin resistance, other factors are probably involved (28, 29).

The exact mechanism behind the increase in HSL activity in the enlarged sc adipocytes can only be speculated upon. Unfortunately, the small amounts of adipose tissue available did not permit direct analysis of HSL protein expression. We did, however, find increased expression of HSL mRNA in sc adipocytes, suggesting that the regional differences at least partly may be determined at a transcriptional level. However, the increase in mRNA levels was less pronounced than the regional differences in HSL activity or lipolysis. Furthermore, we found no significant correlations between mRNA levels and HSL activity or lipolysis rate. This may be interpreted in several ways. First, there may be several different regulatory mechanisms involved. Second, the use of {gamma}-actin mRNA as a reference may cause an underestimation of the HSL mRNA levels. There is evidence that the total amount of RNA is greater in large cells than in small cells derived from different tissues (30). Also, it appears that the expression of {gamma}-actin is correlated to the amount of total cellular RNA (31). However, to our knowledge, this has not been examined in cells of the same origin and degree of differentiation as is the case with adipocytes from individuals with varying degrees of obesity. It should be kept in mind that in adipocytes, the expanded cytoplasm is mainly occupied by the enlarged lipid droplet, and it is uncertain to what degree the increase in fat cell size might influence RNA expression. A measurement of the ratio of RNA to DNA content in the TNA samples could shed some light on these questions. Unfortunately, the amount of tissue available was too small to allow precise determinations of DNA content. To further examine the relationship between cell size and regulation of lipolysis rate would require detailed studies of both transcription and translation, which were beyond the scope of this study.

There was no selection on the basis of gender in this study. Thus, although the study included subjects of both sexes, it did not allow direct comparison between male and female subjects because these were not matched for age or body mass index. Previous studies have suggested, however, that there are gender differences regarding the regional variation in lipolysis rate and fat cell size. In women, the increase in cell size and lipolytic rate in sc as compared to omental adipocytes is maintained with increasing body weight, but appears to be abolished in obese men (24, 25, 32, 33). However, concerning the close correlation observed between cell size and lipolysis rate, we did not find any difference between men and women. This suggests that the factors determining the relationship between cell size and HSL activity are not dependent on gender.

In summary, the present study investigated the possible role of HSL in determining regional differences in lipolytic capacity. We found larger fat cells and higher lipolysis rates, HSL activity, and mRNA expression in sc compared to omental adipocytes. Variations in fat cell size appear largely to explain these differences, as lipolysis rates correlate with fat cell size regardless of the adipose region.


    Acknowledgments
 
The skillful technical assistance of Ms. Eva Sjölin, Kerstin Wåhlén, Britt-Marie Leijonhufvud, and Catharina Sjöberg is appreciated.


    Footnotes
 
1 The laboratories involved in this study participate in the EUROLIP network, supported by the European Union. This work was supported by grants from the Swedish Medical Research Councl (19X-01034 and 3362), the Institut National de la Santé et de la Recherche Médicale, and the Karolinska Institute. Back

Received January 16, 1997.

Revised July 23, 1997.

Accepted August 12, 1997.


    References
 Top
 Abstract
 Introduction
 Subjects and Methods
 Results
 Discussion
 References
 

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A. Tchernof, C. Belanger, A.-S. Morisset, C. Richard, J. Mailloux, P. Laberge, and P. Dupont
Regional differences in adipose tissue metabolism in women: minor effect of obesity and body fat distribution.
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Gender Differences of Regional Abdominal Fat Distribution and Their Relationships with Insulin Sensitivity in Healthy and Glucose-Intolerant Thais
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M.-L. Peyot, C. J. Nolan, K. Soni, E. Joly, R. Lussier, B. E. Corkey, S. P. Wang, G. A. Mitchell, and M. Prentki
Hormone-Sensitive Lipase Has a Role in Lipid Signaling for Insulin Secretion but Is Nonessential for the Incretin Action of Glucagon-Like Peptide 1
Diabetes, July 1, 2004; 53(7): 1733 - 1742.
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P. Kok, M. M. Buijs, S. W. Kok, I. H. A. P. van Ierssel, M. Frolich, F. Roelfsema, P. J. Voshol, A. E. Meinders, and H. Pijl
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J. Lipid Res.Home page
F. B. Kraemer and W.-J. Shen
Hormone-sensitive lipase: control of intracellular tri-(di-)acylglycerol and cholesteryl ester hydrolysis
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V. van Harmelen, A. Dicker, M. Ryden, H. Hauner, F. Lonnqvist, E. Naslund, and P. Arner
Increased Lipolysis and Decreased Leptin Production by Human Omental as Compared With Subcutaneous Preadipocytes
Diabetes, July 1, 2002; 51(7): 2029 - 2036.
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J. Hoffstedt, P. Arner, M. Schalling, N. L. Pedersen, S. Sengul, S. Ahlberg, A. Iliadou, and C. Lavebratt
A Common Hormone-Sensitive Lipase i6 Gene Polymorphism Is Associated With Decreased Human Adipocyte Lipolytic Function
Diabetes, October 1, 2001; 50(10): 2410 - 2413.
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Am. J. Physiol. Endocrinol. Metab.Home page
S. Snitker, J. Hellmer, M. Boschmann, M. B. Monroe, and E. Ravussin
Whole body fat oxidation is related to in situ adipose tissue lipolytic response to isoproterenol in males
Am J Physiol Endocrinol Metab, September 1, 1998; 275(3): E400 - E404.
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V. Large, P. Arner, S. Reynisdottir, J. Grober, V. Van Harmelen, C. Holm, and D. Langin
Hormone-sensitive lipase expression and activity in relation to lipolysis in human fat cells
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