We used tracer and arteriovenous difference techniques in conscious dogs to determine the effect of nonesterified fatty acids (NEFAs) on net hepatic glucose uptake (NHGU E levated levels of nonesterified fatty acids (NEFAs) impair insulin-mediated suppression of endogenous glucose production under postabsorptive conditions (1-9). However, the relationship between NEFA concentrations and net splanchnic or hepatic glucose uptake (HGU) in the postprandial state is less clearly understood. NEFA concentrations and net hepatic or splanchnic uptake of NEFA fall during the postprandial period (10 -12). Postprandial NEFA concentrations are higher in individuals with type 2 diabetes than nondiabetic individuals, even though their insulin concentrations are also higher (13,14). Normally, the liver extracts approximately one-third of a glucose load delivered enterally or into the portal vein (15-17), but net HGU (NHGU) is reduced in individuals with type 2 diabetes (13,18) and in those at risk of developing type 2 diabetes (19,20). Whether an elevation of NEFA concentrations might contribute to impaired postprandial HGU has not been established.We hypothesized that the failure to suppress NEFA concentrations postprandially would reduce NHGU. To test this hypothesis, we studied conscious dogs under euinsulinemic-hyperglycemic conditions as a first step toward understanding the impact of elevated NEFA concentrations in conjunction with the relative insulin deficiency of type 2 diabetes.
RESEARCH DESIGN AND METHODSStudies were carried out on conscious mongrel dogs of both sexes, fasted 42 h, and with a mean weight of 23.6 Ϯ 0.9 kg. The 42-h fast was chosen because it is a time when hepatic glycogen has reached a stable minimum in both dogs and humans (21,22). Approximately 16 days before study, each dog underwent a laparotomy for placement of ultrasonic flow probes (Transonic Systems, Ithaca, NY) around the portal vein and the hepatic artery, as well as insertion of sampling catheters into the left common hepatic vein, the portal vein, and a femoral artery, and the insertion of infusion catheters into a splenic and a jejunal vein (9). Diet, housing, protocol approval, criteria for study, and preparation for study were as previously described (15).Each experiment consisted of a 90-min equilibration period (Ϫ120 to Ϫ30 min), a 30-min basal period (Ϫ30 to 0 min), and a 240-min experimental period (0 -240 min). At Ϫ120 min, priming doses of [U-14 C]glucose (11 Ci/kg) and [3-3 H]glucose (34 Ci/kg) were given, and constant infusions of [U-14 C]glucose (0.4 Ci/min), [3-3 H]glucose (0.35 Ci/min), and indocyanine green dye (0.14 mg/min) (Sigma, St. Louis, MO) were initiated. A constant peripheral infusion of p-aminohippuric acid (PAH) (1.7 mol ⅐ kg Ϫ1 ⅐ min Ϫ1 ) (Sigma) was also started at Ϫ120 min, continuing until 0 min. At 0 min, a constant peripheral infusion of somatostatin (0.8 g ⅐ kg Ϫ1 ⅐ min Ϫ1 ) (Bachem, Torrance, CA) was begun to suppress endogenous insulin and glucagon secretion, and porcine insulin (0.4 mU ⅐ kg Ϫ1 ⅐ min Ϫ1 ...