This study was undertaken to examine the contribution of plasma free fatty acid availability upon the regulation of ketone body and endogenous triglyceride concentration in man. This substrate-product relationship was examined both in the basal state and during hormonally induced ketogenic stimulation.

Five insulin-deficient diabetics receiving a fixed dose of exogenous insulin were studied after a twelve-hour fast and twenty-four hours after their last therapeutic insulin injection. Reduction in basal free fatty acid concentration was induced with two weeks of clofibrate administration, and hormonal ketogenic stimulation was induced with glucagon administration.

A highly significant correlation was observed between the basal free fatty acid level and the basal ketone body concentration. This substrate-product relationship persisted throughout hormonally induced ketogenic stimulation, suggesting that the basal free fatty acid concentration is a major determinant of the plasma ketone body concentration in man. In contrast, alterations in basal free fatty acid concentration were not accompanied by consistent changes in plasma triglyceride concentration, suggesting that plasma free fatty acid concentration may not be the principal determinant of the endogenous triglyceride concentration in clofibrate-treated diabetic man.

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