Insulin effects on acetate metabolism.

Acetate metabolism was studied in patients with insulin resistance. To evaluate the interaction between glucose and acetate metabolism, we measured acetate and glucose turnover with a hyperinsulinemic euglycemic clamp (hot clamp) in obese and diabetic patients with insulin resistance (n = 8) and in a control group with normal insulin sensitivity (n = 6). At baseline, acetate turnover and plasma concentrations were similar between the two groups (group means: 4.3 ± 0.4 μmol · kg-1 · min-1 and 128.2 ± 11.1 μmol/l). Acetate concentrations decreased in both groups with hyperinsulinemia but were significantly lower in the insulin-resistant group (20% vs. 12%, P < 0.05). After the hot clamp treatment, acetate turnover increased for the two groups and was higher in the group with normal insulin sensitivity: 8.1 ± 0.7 vs. 5.5 ± 0.5 μmol · kg-1 · min-1 (P < 0.001). No change related to insulin action was observed in either group in the percentage of acetate oxidation. This was ≈70% of overall utilization at baseli...