Brøns C, Jacobsen S, Hiscock N, White A, Nilsson E, Dunger D, Astrup A, Quistorff B, Vaag A. Effects of high-fat overfeeding on mitochondrial function, glucose and fat metabolism, and adipokine levels in low-birth-weight subjects. Am J Physiol Endocrinol Metab 302: E43-E51, 2012. First published September 13, 2011; doi:10.1152/ajpendo.00095.2011.-Low birth weight (LBW) is associated with an increased risk of insulin resistance and downregulation of oxidative phosphorylation (OXPHOS) genes when exposed to a metabolic challenge of high-fat overfeeding (HFO). To elaborate further on the differential effects of HFO in LBW subjects, we measured in vivo mitochondrial function, insulin secretion, hepatic glucose production, and plasma levels of key regulatory hormones before and after 5 days of HFO in 20 young LBW and 26 normalbirth-weight (NBW) men. The LBW subjects developed peripheral insulin resistance after HFO due to impaired endogenous glucose storage (9.42 Ϯ 4.19 vs. 5.91 Ϯ 4.42 mg·kg FFM Ϫ1 ·min Ϫ1 , P ϭ 0.01). Resting muscle phosphorcreatine and total ATP in muscle increased significantly after HFO in LBW subjects only, whereas additional measurements of mitochondrial function remained unaffected. Despite similar plasma FFA levels, LBW subjects displayed increased fat oxidation during insulin infusion compared with normalbirth-weight (NBW) subjects after HFO (0.37 Ϯ 0.35 vs. 0.17 Ϯ 0.33 mg·kg FFM Ϫ1 ·min Ϫ1 , P ϭ 0.02). In contrast to NBW subjects, the plasma leptin levels of LBW subjects did not increase, and the plasma gastric inhibitory polypeptide (GIP) as well as pancreatic polypeptide (PP) levels increased less in LBW compared with NBW subjects during HFO. In conclusion, HFO unmasks dissociation between insulin resistance and mitochondrial dysfunction in LBW subjects, suggesting that insulin resistance may be a cause, rather than an effect, of impaired muscle OXPHOS gene expression and mitochondrial dysfunction. Reduced increments in response to HFO of fasting plasma leptin, PP, and GIP levels may contribute to insulin resistance, lower satiety, and impaired insulin secretion in LBW subjects. insulin resistance; oxidative phosphorylation genes; peroxisome proliferator-activated receptor-␥ coactivator-1␣; incretin hormones IMPAIRED MITOCHONDRIAL FUNCTION and expression of genes involved in oxidative phosphorylation (OXPHOS) in skeletal muscles has been proposed to play an important role in the pathogenesis of insulin resistance and type 2 diabetes (T2D) (19, 23, 29 -31). However, recent investigations have reported discordance between mitochondrial function and muscle insulin sensitivity (1, 10, 38), and the extent to which muscle mitochondrial dysfunction represents a primary defect resulting in insulin resistance, or rather a secondary defect developing as a consequence of insulin resistance, remains controversial.Low birth weight (LBW), reflecting poor foetal growth, has consistently been associated with an increased risk of developing insulin resistance and T2D later in life (12), and this risk seems...