In vitro insensitivity of glucose transport and antilipolysis to insulin due to receptor and postreceptor abnormalities in obese Pima Indians with normal glucose tolerance.

The in vitro sensitivities of glucose transport and antilipolysis to insulin and insulin binding were measured in adipocytes isolated from three groups of normal glycemic male Pima Indians--10 lean (11% to 22% body fat), 11 moderately obese (26% to 34% body fat), and 7 severely obese (37% to 40% body fat) subjects. Both a half-maximum concentration of insulin for the stimulation of glucose transport (ED50 [transport]) and a half-maximum concentration of insulin for the suppression of 25 nmol/L isoproterenol-stimulated lipolysis (ED50 [antilipolysis]) were significantly (P less than 0.05) greater in the moderately obese subjects than in the lean subjects as well as greater in the severely obese group than in the moderately obese group. Mono 125I-(Tyr A14)-insulin binding per cell in the presence of 25, 100, and 200 pm insulin was similar among lean, mildly obese, and severely obese subjects. 125I-insulin binding per cell surface area of adipocytes isolated from either moderately or severely obese Indians was significantly lower (P less than 0.005) than that of lean Indians. However, there was a similar insulin binding per cell surface area between mildly and severely obese subjects. These results indicate that diminished insulin binding per cell surface area may explain decreased sensitivity of transport and antilipolysis to insulin in moderately obese subjects relative to lean subjects. In contrast, these diminished sensitivities in the severely obese subjects relative to moderate obese subjects are not explained by a change in insulin binding and, therefore, are presumably induced by an abnormality of a postbinding step of insulin action.