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肾上腺素和去甲肾上腺素对人体的代谢作用:与生长抑素相关的研究

Metabolic effects of adrenaline and noradrenaline in man: studies with somatostatin.

作者信息

Pernet A, Walker M, Gill G V, Orskov H, Alberti K G, Johnston D G

出版信息

Diabete Metab. 1984 May;10(2):98-105.

PMID:6146542
Abstract

The metabolic responses to infusion of adrenaline (6 micrograms/min) and of noradrenaline (5 micrograms/min) for 120 minutes have each been studied in five normal males with and without concurrent somatostatin (250 micrograms/h). Adrenaline induced marked and sustained hyperglycaemia (maximal blood glucose at 75 min, 9.0 +/- 0.4 mmol/l) while noradrenaline induced only a mild and transient blood glucose rise. Blood lactate was elevated by adrenaline (2.57 +/- 0.47 mmol/l with adrenaline, 0.62 +/- 0.06 mmol/l with saline at 120 min, p less than 0.02). Pyruvate levels rose proportionately less so that the circulating lactate:pyruvate ratio was increased (16.6 +/- 1.3 with adrenaline, 11.4 +/- 0.9 with saline at 120 min, p less than 0.05). Lactate and pyruvate levels were unaffected by noradrenaline. Both catecholamines increased circulating non-esterified fatty acid (NEFA) and glycerol to peak at 30 min, while maximal 3-hydroxybutyrate concentrations were achieved at 50 min (0.26 +/- 0.07 mmol/l with adrenaline; 0.23 +/- 0.06 mmol/l with noradrenaline; 0.03 +/- 0.01 mol/l with saline, both p less than 0.05). Insulin levels were partially suppressed by noradrenaline, while a small rise in circulating insulin was observed with adrenaline which was also associated with a large rebound rise in insulin secretion on cessation of the infusion. Mild and transient hyperglucagonaemia was observed with adrenaline while stimulation of glucagon secretion was more sustained with noradrenaline. Somatostatin suppressed insulin, glucagon and growth hormone secretion and both magnified and prolonged the hyperglycaemic effect of adrenaline (maximal at 105 min, 11.3 +/- 0.5 mmol/l, p less than 0.01 versus adrenaline alone).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在5名正常男性中,分别研究了静脉输注肾上腺素(6微克/分钟)和去甲肾上腺素(5微克/分钟)120分钟的代谢反应,研究过程中部分受试者同时使用了生长抑素(250微克/小时)。肾上腺素引起显著且持续的高血糖(75分钟时血糖最高,为9.0±0.4毫摩尔/升),而去甲肾上腺素仅引起轻微且短暂的血糖升高。肾上腺素使血乳酸升高(输注120分钟时,使用肾上腺素时血乳酸为2.57±0.47毫摩尔/升,使用生理盐水时为0.62±0.06毫摩尔/升,p<0.02)。丙酮酸水平升高幅度相对较小,因此循环中的乳酸/丙酮酸比值升高(输注120分钟时,使用肾上腺素时为16.6±1.3,使用生理盐水时为11.4±0.9,p<0.05)。去甲肾上腺素对乳酸和丙酮酸水平无影响。两种儿茶酚胺均使循环中非酯化脂肪酸(NEFA)和甘油升高,并在30分钟时达到峰值,而3-羟基丁酸的最大浓度在50分钟时达到(使用肾上腺素时为0.26±0.07毫摩尔/升;使用去甲肾上腺素时为0.23±0.06毫摩尔/升;使用生理盐水时为0.03±0.01毫摩尔/升,p均<0.05)。去甲肾上腺素部分抑制胰岛素水平,而肾上腺素使循环胰岛素水平略有升高,且在输注停止后胰岛素分泌出现大幅反弹升高。使用肾上腺素时观察到轻度且短暂的高胰高血糖素血症,而去甲肾上腺素对胰高血糖素分泌的刺激作用更持久。生长抑素抑制胰岛素、胰高血糖素和生长激素的分泌,且增强并延长了肾上腺素的高血糖作用(105分钟时血糖最高,为11.3±0.5毫摩尔/升,与单独使用肾上腺素相比,p<0.01)。(摘要截断于250字)

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