The intracellular mechanism responsible for insulin receptor-mediated stimulation of glucose transport is partly understood [1±4]. In contrast, much less is known about the signalling pathways that couple the insulin receptor to lipid metabolism. In fat cells, insulin inhibits the mobilization of non-esterified fatty acids (NEFA) in two synergistic ways [5]. Firstly, insulin decreases the rate of lipolysis (i. e. activates antilipolysis). Secondly, insulin increases the rate of re-synthesis of triglycerides from the NEFA that are formed by lipolysis, i. e. the re-esterfication effect.Although the intracellular signalling cascade which regulates antilipolysis has not been studied to the same degree as glucose transport or mitogenesis, similar early steps in the insulin receptor signalling cascade are likely to be involved. The insulin receptor is activated by binding of insulin, which causes the receptor to undergo autophosphorylation on tyrosine residues [1±4]. Autophosphorylation activates the tyrosine kinase of the receptor and allows the receptor Diabetologia (1998) Summary Increased mobilization of non-esterified fatty acids (NEFA) from visceral as opposed to peripheral fat depots can lead to metabolic disturbances because of the direct portal link between visceral fat and the liver. Compared with peripheral fat, visceral fat shows a decreased response to insulin. The mechanisms behind these site variations were investigated by comparing insulin action on NEFA metabolism with insulin receptor signal transduction through the insulin receptor substrate-1 (IRS-1) pathway in omental (visceral) and subcutaneous human fat obtained during elective surgery. Insulin inhibited lipolysis and stimulated NEFA re-esterification. This was counteracted by wortmannin, an inhibitor of phosphaditylinositol (PI) 3-kinase. The effects of insulin on antilipolysis and NEFA re-esterification were greatly reduced in omental fat cells. Insulin receptor binding capacity, mRNA and protein expression did not differ between the cell types. Insulin was four times more effective in stimulating tyrosine phosporylation of the insulin receptor in subcutaneous fat cells (p < 0.001). Similarly, insulin was two to three times more effective in stimulating tyrosine phosphorylation of IRS-1 in subcutaneous fat cells (p < 0.01). This finding could be explained by finding that IRS-1 protein expression was reduced by 50 ± 8 % in omental fat cells (p < 0.01). In omental fat cells, maximum insulin-stimulated association of the p85 kDa subunit of PI 3-kinase to phosphotyrosine proteins and phosphotyrosine associated PI 3-kinase activity were both reduced by 50 % (p < 0.05 or better). Thus, the ability of insulin to induce antilipolysis and stimulate NEFA re-esterification is reduced in visceral adipocytes. This reduction can be explained by reduced insulin receptor autophosphorylation and signal transduction through an IRS-1 associated PI 3-kinase pathway in visceral adipocytes. [Diabetologia (1998 Keywords Tyrosine kinase, insulin receptor substrate...