Sunday, May 5, 2013

Surrogate Biomarkers for NEFA?

For reasons related largely to the difficulty (thus presumably expense) in measuring them, one fasting lipid that is not routinely assessed in lipid panels are the free fatty acids (FFA) aka the non-esterified fatty acids (NEFA -- Wholly irrelevant but I prefer the latter acronym as I like to sound them out in my head and knee-fah "sounds" better than eff eff ay to me).  And yet, like glucose, it is NEFA that is elevated in diabetes.  Unlike glucose, however, NEFA is elevated in non-diabetic obese as well as elevated NEFA preceding frank hyperglycemia in the progression of Type 2.  

One of insulin's primary roles vis a vis adipose tissue is to regulate the "basal" triglyceride/fatty acid cycle, acting on both adipocytes and the liver, to keep NEFA in a relatively small range of levels (amounting to roughly half to three-quarters of a gram in circulation under normal fasted circumstances).  
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