Metabolic and Vascular Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Department of Physiology, Monash University, Melbourne, Victoria, Australia.
Diabetes Obes Metab. 2019 Feb;21(2):276-284. doi: 10.1111/dom.13516. Epub 2018 Sep 24.
To quantify acute energy expenditure, supraclavicular skin temperature and cardiovascular responses to four doses of the β3-adrenoceptor agonist, mirabegron.
A total of 17 individuals (11 men, six women) participated in this ascending-dose study, receiving single 50-, 100-, 150- and 200-mg doses of mirabegron on four separate days with 3 to 14 days wash-out between each dose. All variables were measured each visit from baseline to 180 minutes post mirabegron treatment. To determine brown adipose tissue (BAT) thermogenic efficacy at each dose, energy expenditure and supraclavicular skin temperature were compared from baseline to 180 minutes post mirabegron treatment. To examine safety, changes in cardiovascular variables at 100, 150 and 200 mg were compared with the standard clinical dose of 50 mg.
Energy expenditure significantly increased after the 100- (35.6 ± 5.4 kJ/h) and 200-mg (35.6 ± 13.1 kJ/h) doses (P ≤ 0.05), and trended towards an increase after 150 mg (24.1 ± 13.6 kJ/h). Supraclavicular skin temperature increased after 50- (0.22 ± 0.1°C), 100- (0.30 ± 0.1°C) and 150-mg mirabegron doses (0.29 ± 0.1°C; P ≤ 0.05). The change in systolic blood pressure was greater after 150- (7.1 ± 1.3 mm Hg) and 200-mg doses (9.3 ± 1.9 mm Hg) than after the 50-mg dose (2.2 ± 1.3 mm Hg; P ≤ 0.05). The change in heart rate was greater after 200 mg (9.0 ± 2.2 bpm) compared with 50 mg (2.9 ± 1.4 bpm; P ≤ 0.05).
A 100-mg dose of mirabegron increases energy expenditure and supraclavicular skin temperature in a β3-adrenoceptor-specific manner, without the off-target elevations in blood pressure or heart rate observed at higher doses.
定量测定 4 种剂量β3-肾上腺素能受体激动剂米拉贝隆对急性能量消耗、锁骨上皮肤温度和心血管的影响。
共有 17 名个体(11 名男性,6 名女性)参与了这项递增剂量研究,在 4 天内分别接受了单次 50、100、150 和 200mg 的米拉贝隆剂量,每个剂量之间有 3 至 14 天的洗脱期。每次就诊时,所有变量均从基线测量至米拉贝隆治疗后 180 分钟。为了确定每种剂量的棕色脂肪组织(BAT)产热功效,将基线至米拉贝隆治疗后 180 分钟的能量消耗和锁骨上皮肤温度进行比较。为了检查安全性,将 100、150 和 200mg 时的心血管变量变化与 50mg 的标准临床剂量进行比较。
100mg(35.6±5.4kJ/h)和 200mg(35.6±13.1kJ/h)剂量后,能量消耗显著增加(P≤0.05),150mg 剂量后有增加趋势(24.1±13.6kJ/h)。锁骨上皮肤温度在 50mg(0.22±0.1°C)、100mg(0.30±0.1°C)和 150mg 米拉贝隆剂量后升高(0.29±0.1°C;P≤0.05)。150mg(7.1±1.3mmHg)和 200mg(9.3±1.9mmHg)剂量后的收缩压变化大于 50mg(2.2±1.3mmHg)剂量(P≤0.05)。200mg 时心率变化大于 50mg(9.0±2.2bpm)(2.9±1.4bpm;P≤0.05)。
100mg 剂量的米拉贝隆以β3-肾上腺素能受体特异性方式增加能量消耗和锁骨上皮肤温度,而在较高剂量时不会出现血压或心率的非靶向升高。