Effect of epinephrine on amino acid and energy metabolism in humans.

Epinephrine was infused for 8.5 h into five normal, healthy, young adult men on four different occasions at 0, 0.5, 1, and 2 micrograms/min to elevate circulating levels of epinephrine into the high physiological range as seen in stress and trauma. Energy expenditure, heart rate, and blood pressure were measured at hourly intervals. [1-13C]leucine, [ring-2H5]phenylalanine, and [2-15N]glutamine were infused during the last 3.5 h to follow essential amino acid and glutamine kinetics. This design was adapted to study the effects of epinephrine on energy and protein metabolism after acute and temporary metabolic responses to epinephrine had occurred. Plasma glucose was significantly increased by approximately 20 mg/dl from 83 mg/dl (saline infusion) at all levels of epinephrine infusion. Amino acid levels were depressed with epinephrine infusion, with the largest drop occurring for the essential amino acids (-27% at the 2.0-micrograms/min dose). Energy expenditure was increased with epinephrine infusion in a dose-dependent fashion (+17% increase at 2.0 micrograms/min infusion). These effects were sustained for the duration of 8.5 h epinephrine infusion. There was no significant change in leucine or phenylalanine flux, indicative of protein breakdown, or in leucine oxidation. Glutamine flux was significantly (but modestly, +7%) increased at only the 2.0-micrograms/min infusion rate. Changes in kinetics that altered amino acid levels were not apparent by 7 h of epinephrine infusion (the beginning of the plateau period for the tracer infusion study). Although epinephrine can produce long-term elevations of metabolic rate, its effects on protein metabolism are minimal beyond acute changes affecting amino acid levels.