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老年人肾上腺素清除率降低以及对肾上腺素的血糖敏感性降低。

Reduced epinephrine clearance and glycemic sensitivity to epinephrine in older individuals.

作者信息

Marker J C, Clutter W E, Cryer P E

机构信息

Division of Endocrinology, Diabetes and Metabolism, Division of Geriatrics, General Clinical Research Center, and Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, Missouri 63110, USA.

出版信息

Am J Physiol. 1998 Nov;275(5):E770-6. doi: 10.1152/ajpendo.1998.275.5.E770.

Abstract

To test the hypothesis that glycemic sensitivity to epinephrine is reduced in older individuals and to assess the impact of a sedentary lifestyle on responses to the hormone, we performed 30-min sequential intravenous infusions of epinephrine (0, 41, 82, 164, 246, and 328 pmol. kg-1. min-1) in young (n = 10) and older (n = 23) healthy subjects. We performed these again after 12 mo of physical training, which raised peak O2 consumption from 24.4 +/- 1.0 to 30.4 +/- 1.4 ml. kg-1. min-1 (P < 0.01) in most of the older subjects (n = 21). During epinephrine infusions, plasma epinephrine concentrations were higher (P = 0.0001) in older than in young subjects (e.g., final values of 7,280 +/- 500 vs. 4,560 +/- 380 pmol/l, respectively), indicating that the clearance of epinephrine from the circulation was reduced in the older individuals. Plasma epinephrine concentration-response curves disclosed reduced glycemic sensitivity to the hormone in the older subjects (P = 0.0001), a finding plausibly attributed to increased sympathetic neural activity, as evidenced here by higher plasma norepinephrine concentrations (P = 0.0001) in the older subjects and consequent desensitization of cellular responsiveness to catecholamines. Training did not correct reduced epinephrine clearance, reduced glycemic sensitivity to epinephrine, or raised norepinephrine levels. We conclude that aging is associated with reduced clearance of epinephrine from the circulation and reduced glycemic sensitivity to epinephrine, the latter plausibly attributed to an age-associated increase in sympathetic neural norepinephrine release. These age-associated changes are not the result of a sedentary lifestyle.

摘要

为了验证老年人对肾上腺素的血糖敏感性降低这一假设,并评估久坐不动的生活方式对激素反应的影响,我们对年轻(n = 10)和年长(n = 23)的健康受试者进行了30分钟的肾上腺素(0、41、82、164、246和328 pmol·kg-1·min-1)连续静脉输注。在12个月的体育锻炼后,我们再次进行了这些操作,在大多数年长受试者(n = 21)中,这使峰值耗氧量从24.4±1.0提高到30.4±1.4 ml·kg-1·min-1(P < 0.01)。在肾上腺素输注期间,年长受试者的血浆肾上腺素浓度高于年轻受试者(P = 0.0001)(例如,最终值分别为7280±500和4560±380 pmol/l),这表明年长个体中肾上腺素从循环中的清除率降低。血浆肾上腺素浓度-反应曲线显示,年长受试者对该激素的血糖敏感性降低(P = 0.0001),这一发现可能归因于交感神经活动增加,年长受试者中较高的血浆去甲肾上腺素浓度(P = 0.0001)以及随之而来的细胞对儿茶酚胺反应性的脱敏证明了这一点。锻炼并未纠正肾上腺素清除率降低、对肾上腺素的血糖敏感性降低或去甲肾上腺素水平升高的情况。我们得出结论,衰老与肾上腺素从循环中的清除率降低以及对肾上腺素的血糖敏感性降低有关,后者可能归因于与年龄相关的交感神经去甲肾上腺素释放增加。这些与年龄相关的变化不是久坐不动的生活方式导致的结果。

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