starvation, trauma, or physical exercise, or after feed-
ing, resulting in an alteration in lipolytic rates and
FFA concentrations. Insulin decreases the activity of
hormone-sensitive lipase, which is responsible for the
breakdown of adipose TG and concomitant release of
the free fatty acids into the circulation. Epinephrine,
norepinephrine, and adrenocorticoids, especially ad-
renocorticotropic hormone, increase the rate of fat
mobilization by stimulating HSL activity.
0011 HSL is hormonally regulated via phosphorylation/
dephosphorylation. The hormone stimulated by
HSL acts through a membrane-bound receptor and
activates the membrane-bound enzyme adenylate
cyclase, resulting in an increase in cyclic adenosine
monophosphate (cAMP) levels in the adipocyte.
cAMP directly activates a protein kinase A (PKA),
which phosphorylates and activates HSL. Lipolytic
agents generally increase the levels of cAMP far
above the concentrations required for maximal
activation of protein kinase A.
0012 Epinephrine is the primary stimulator of lipolysis
working through a b-adrenergic receptor in the
plasma membrane of the adipose cell resulting in
phosphorylation and activation of HSL. The physio-
logical state can affect the sensitivity to epinephrine.
For example, in short-term (3-day) fasting, the
lipolytic responsiveness to epinephrine infusion is
enhanced, whereas in obesity, the responsiveness to
epinephrine is blunted. Catecholamines are able to
stimulate lipolysis via three subtypes of b-adrenergic
receptors, which are positively coupled to adenyl
cyclase by Gs proteins and to inhibit lipolysis via
a2-adrenergic receptors, negatively coupled to the
enzyme by Gi proteins. In humans, the interplay
between a2 and b-adrenergic receptors plays an
important role in modulating cAMP levels in
adipocytes.
0013 However, the inhibition of HSL catalyzes its
dephosphorylation, and so insulin induces a decrease
in cAMP levels and a concomitant decrease in
PKA activity, and inhibits HSL, thus catalyzing its
dephosphorylation. Glucose is the predominant
signal for insulin release, so an effect of glucose intake
on lipolysis would be expected. Thus, in humans, an
increase in glucose concentration in the plasma stimu-
lates insulin release with concomitant increase in glu-
cose uptake and fatty acid reesterification, and a
decrease in lipolysis. The inhibitory effect of glucose
on lipolysis is mediated entirely by insulin.
0014 Under most physiological circumstances, the rate
of lipolysis is largely determined by the balance
between the stimulatory effect of epinephrine and
the inhibitory effect of insulin. For example, in
short-term fasting, there is a marked increase in
the rate of lipolysis, which can be attributed to
both a decrease in blood glucose (and thus insulin)
concentration and an increase in epinephrine concen-
tration and sensitivity to epinephrine. The striking
aspect of the regulation of lipolysis is that the factors
that are primary regulators (insulin and epinephrine)
are not released in response to a signal related to any
aspect of fatty acid metabolism. For example, acute
changes in fatty acid concentrations by infusion do
not affect insulin, catecholamines, or the rate of lipo-
lysis. Therefore, insulin and catecholamines, rather
than being primary regulators of lipolysis, may be
considered to be regulators of other physiological
and metabolic processes that also affect lipolysis. In
fact, the rate of resting lipolysis generally provides
fatty acids at a rate that is far in excess of the rate
required for oxidation. Fatty acids that are released
from adipocytes, but not oxidized, are reesterified,
thereby completing a substrate cycle.
Cellular Uptake of Fatty Acid
0015Fatty acids from the diet or produced by lipolysis are
transported, bound to proteins in blood, and their
cellular uptake is similar. The majority of complex
lipid is hydrolyzed by two related lipases, hepatic
lipase and lipoprotein lipase, and this hydrolysis
enables free fatty acids to enter cells.
0016The uptake of fatty acids across the plasma mem-
brane takes place either by diffusive processes, involv-
ing partitioning of the fatty acid molecule into
the lipid bilayer of the plasma membrane, or by the
presence of different lipid-binding proteins in the cell
membranes, called plasma membrane fatty-acid-
binding proteins (FABPpms).
0017At least five plasma membrane-associated fatty
acid binding proteins were proposed to play a role
in free fatty acid (FFA) uptake, a plasma membrane
fatty-acid-binding protein (FABPpm, 40 kDa), fatty
acid translocase (FAT, 88 kDa), fatty acid transport
protein (FATP 63 kDa), caveolin, and 56-kDa kidney
fatty acid binding protein. Once inside the cell, fatty
acids are bound noncovalently to a family of intra-
cellular fatty acid-binding proteins (FABPs) that may
play a role in the transfer of FFAs to intracellular
destinations where they are used. FABPs comprise a
family of 14–15-kDa proteins that bind long-chain
fatty acids.
Catabolism of Fatty Acids
0018Once within the cell and depending on the tissue and
its metabolic demand, fatty acids are either converted
to tryacylglycerols or membrane phospholipids, or
oxidized in the mitochondria for energy production.
Some metabolic routes are common to most of the
2302 FATTY ACIDS/Metabolism