Studies on the insulin-antagonistic effect of catecholamines in normal man

✍ Scribed by I. Lager; S. Attvall; B. M. Eriksson; H. von Schenk; U. Smith

• Publisher: Springer
• Year: 1986
• Tongue: English
• Weight: 889 KB
• Volume: 29
• Category: Article
• ISSN: 0012-186X
• DOI: 10.1007/bf00506530

✦ Synopsis

The insulin-antagonistic effect of adrenaline was studied in seven healthy subjects with the euglycaemic clamp technique using two insulin infusion rates (40 and 1200 mU. (m 2)-l min-1). The adrenergic receptor mediating the adrenaline effect was characterized by concomitant infusion of propranolol (j31 +fl2-antagonist) or metoprolol (ill-antagonist). Each subject was studied four times (placebo, adrenaline, adrenaline + propranolol, adrenaline + metoprolol). Glucose turnover was measured with D(3-3H)-glucose. Similar plasma insulin levels were reached in all studies with the two insulin infusion rates (mean; placebo 51 _+ 3 and 7421 +_ 337 mU/l respectively). Glucose production was completely inhibited by the low insulin level during placebo infusion. Adrenaline antagonized this effect so that a significant glucose production was seen at the low but not at the high insulin level. Proprano-1ol, but not metoprolol, reversed this insulin-antagonistic ef-feet of adrenaline. Glucose utilization increased from 2.53 _+ 0.17 to 7.28 _+ 0.88 mg. kg -1. rain -~ during placebo when the insulin levels were increased from 4 + 0.3 to 51 _+ 3 mU/1. Increasing the insulin levels 150-fold to ~7500 mU/1 only doubled the glucose utilization (14.68 + 1.14 mg. kg -1. min-l). Adrenaline induced a pronounced inhibition of glucose utilization at both insulin levels (78% and 37% inhibition respectively). Propranolol, but not metoprolol, prevented this effect of adrenaline. Thus, physiological adrenaline levels exert a pronounced insulin-antagonistic effect which is mediated by fl2-receptor stimulation. The inhibitory effect on glucose uptake is maintained even at high insulin levels when hepatic glucose production is completely abolished.