Nicotinic Acid and Inhibition of Fat Mobilizing Lipolysis. Present Status of Effects on Lipid Metabolism

Abstract

In the beginning of the 1960’s inhibition of fat mobilizing lipolysis (FML) was introduced as a tool in experimental medicine and as a new principle in the treatment of certain metabolic disorders (1,2). There were two major reasons for this at that time. First, we had found that nicotinic acid has a very powerful pharmacological fat mobilizing lipolysis inhibitory (FMLI) property thereby reducing the levels of circulating plasma free fatty acids (FFA) (3,4). Secondly, models for the metabolic conseguences of excessive FFA mobilization were just being developed (Figure 1). These models predicted that excessive FFA mobilization might cause certain unwanted metabolic effects such as hyperlipidemia and ketosis. Therefore it became of clinical interest to consider the use of inhibitors of FFA mobilization in acute as well as chronic situations. Today these models are in principle still believed to be valid. The major causes and effects of excessive FFA mobilization are summarized in Tables 1 and 2. Some areas where the use of compounds with FMLI property might be of benefit are summarized in Table 3.