Immobilisation induces sizeable and sustained reductions in forearm glucose uptake in just 24 h but does not change lipid uptake in healthy men

Key points The trajectory, magnitude and localisation of metabolic perturbations caused by immobilisation (IMM) are unresolved. Forearm glucose uptake (FGU) in response to glucose feeding was determined in healthy men before and during 72 h of forearm IMM, and the same measurements were made in the non-IMM contralateral limb at baseline and 72 h. In a similar study design, FGU and forearm lipid uptake were determined after a high fat mixed-meal (HFMM) in IMM and non-IMM limbs. FGU was reduced by 38%, 57% and 46% following 24, 48 and 72 h IMM, respectively, but was unchanged in the non-IMM limb. A similar FGU response to IMM was observed after a HFMM, and forearm lipid uptake was unchanged. A sizeable reduction in FGU occurs in just 24 h of IMM, which is sustained thereafter and specific to the IMM limb, making unloading per se the likely rapid driver of dysregulation. The trajectory and magnitude of metabolic perturbations caused by muscle disuse are unknown yet central to understanding the mechanistic basis of immobilisation-associated metabolic dysregulation. To address this gap, forearm glucose uptake (FGU) was determined in 10 healthy men (age 24.9 +/- 0.6 years, weight 71.9 +/- 2.6 kg, BMI 22.6 +/- 0.6 kg/m(2)) during a 180 min oral glucose challenge before (0) and after 24, 48 and 72 h of arm immobilisation, and before and after 72 h in the contralateral non-immobilised arm (Study A). FGU was decreased from baseline at 24 h (38%, P = 0.04), 48 h (57%, P = 0.01) and 72 h (46%, P = 0.06) of immobilisation, and was also 63% less than the non-immobilised limb at 72 h (P = 0.002). In a second study, FGU and forearm lipid uptake were determined in nine healthy men (age 22.4 +/- 1.3 years, weight 71.4 +/- 2.8 kg, BMI 22.6 +/- 0.8 kg/m(2)) during a 420 min mixed-meal challenge before (0) and after 24 and 48 h of arm immobilisation and before and after 72 h in the contralateral non-immobilised arm (Study B). FGU responses were similar to Study A, and forearm lipid uptake was unchanged from pre-immobilisation in both arms over the study. A sizeable decrement in FGU in response to glucose feeding occurred within 24 h of immobilisation that was sustained and specific to the immobilised limb. Increasing lipid availability had no additional impact on the rate or magnitude of these responses or on lipid uptake. These findings highlight a lack of muscle contraction per se as a fast-acting physiological insult to FGU.

Automated summary

The study reveals that immobilisation leads to a significant reduction in forearm glucose uptake within a short period of time, while lipid uptake remains unchanged. This effect is specific to the immobilised limb, highlighting the impact of muscle disuse on metabolic dysregulation.