Effects of adrenaline on lactate, glucose, lipid and protein metabolism in the placebo controlled bilaterally perfused human leg.
Level 2 - randomized trial
Randomized within-subject controlled trial in humans
PubMed 21624100 · doi:10.1111/j.1748-1716.2011.02316.x
What was done
Seven healthy volunteers underwent bilateral femoral artery and vein catheterization during a 3-h basal period and a subsequent 3-h hyperinsulinemic (0.6 mU kg⁻¹ min⁻¹) euglycemic clamp. One femoral artery received adrenaline (0.4 μg min⁻¹ m⁻²) while the contralateral leg received saline as a placebo control. Lipid metabolism was measured using [9,10-³H]palmitate, amino acid metabolism using ¹⁵N-phenylalanine, and glucose and lactate via raw arterio-venous concentration differences.
What was found
Femoral vein plasma adrenaline increased approximately eightfold in the adrenaline-perfused leg with unaltered blood flow. Adrenaline significantly increased local lactate release from 0.01 to 0.25 mmol min⁻¹ per leg. Palmitate release increased from 11.5 to 16.9 μmol min⁻¹ per leg in the basal state and from 2.62 to 8.44 μmol min⁻¹ per leg during the clamp. Glucose uptake during the clamp fell from approximately 180 to 30 μmol min⁻¹ per leg. Phenylalanine kinetics were not affected.
Why it matters
By using a bilateral perfused leg model to avoid confounding systemic endocrine responses, this study establishes that adrenaline directly induces muscle insulin resistance, stimulates lipolysis, and drives local lactate release without directly altering peripheral protein metabolism.
Limits
The sample size is very small (n = 7), and participant demographics such as sex and age are not reported in the abstract. The acute 3-hour infusion model in healthy individuals may not fully reflect the sustained, complex systemic alterations found in critically ill patients. Measure-specific variance and exact p-values were omitted from the abstract.
Cited by
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