Obesity and Free Fatty Acid Flux

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Thirty percent of Americans are obese. Women are more severely affected than men. African-Americans are more severely affected than Caucasians. To understand the metabolic consequences of obesity, it is essential to know the rate at which free fatty acids (FFA) are released from adipose tissue. Circulating FFA contribute to the complications of obesity particularly diabetes and heart disease. As there are sex and race differences in the prevalence of all these conditions there may be sex and race differences in FFA flux. FFA flux represents the rate at which FFA circulate. FFA flux is the result of three processes going on at the same time, (1) the rate FFA are released from adipose tissue, (2) the rate circulating FFA are used for energy, and (3) the rate FFA leaves the circulation to re-enter adipose tissue. No data is available on whether sex and race differences in FFA flux exist. Further, when comparing subjects of different size, sex and race, it is unknown whether FFA flux should be corrected for lean body mass or resting energy expenditure. To determine if there are sex and race differences in FFA flux and to ensure adequate enrollment of both African American and Caucasians, this investigation is a collaborative effort between the National Institutes of Health (NIH) in Bethesda, Maryland and the Mayo Clinic in Olmsted County, Minnesota. The greater Washington, DC, metropolitan area, where NIH is located, has a large African-American community whereas over 90% of residents of Olmsted County are Caucasians. Therefore, sex differences in FFA flux in African Americans will be studied at the National Institutes of Health. Sex differences in in FFA flux Caucasians will be studied at the Mayo Clinic. The results of the two studies will be combined to determine if there are race differences in FFA flux. At NIH, 50 African-Americans (25M, 25W, age range 18-49 years) will be enrolled. Equal numbers of normal weight, overweight and obese subjects will be recruited. As outpatients, participants will be placed on weight maintaining diets for two weeks and then admitted for a two-day hospital stay. On each in-hospital morning, resting energy expenditure will be measured and stable isotopes infused to measure FFA flux. Stable isotopes are naturally occurring forms of elements, which are safe and non-radioactive. From the study of African-Americans at NIH it will be possible to determine if (a) the rate of FFA release in African-Americans is more highly related to lean body mass or to resting energy expenditure, and (b) if there is a sex difference in this relationship. Then as described above, the results from the Mayo Clinic and NIH will be combined to determine if there are race differences in the FFA flux.