Glucose-induced thermogenesis in patients with small cell lung carcinoma. The effect of acute beta-adrenergic inhibition.
Seven patients with histologically verified small cell lung carcinoma were given an oral glucose load of 75 g on two occasions to examine the effect of glucose on whole body and forearm thermogenesis with and without acute beta-adrenergic inhibition with propranolol. Whole body energy expenditure was measured by the open circuit ventilated hood system. Forearm blood flow was measured by venous occlusion strain-gauge plethysmography. The uptake of oxygen in the forearm was calculated as the product of the forearm blood flow and the difference in arteriovenous oxygen concentration. The glucose-induced thermogenesis in the 120 min following the glucose load was significantly reduced by beta-adrenergic inhibition with approximately 50% from 63.9 +/- 5.8 kJ 120 min-1 (mean +/- SE) to 27.8 +/- 9.8 kJ 120 min-1 (P < 0.01). Almost the entire reduction took place from 60 to 120 min (P < 0.005). The integrated glucose-induced forearm oxygen uptake in the period 60-120 min following the glucose load was significantly reduced after beta-adrenergic inhibition from 103 +/- 28 mumol 100 g-1 60 min-1 to 29 +/- 29 mumol 100 g-1 60 min-1 (P < 0.05). The noreadrenaline concentration in the arterial blood was not increased in the baseline period compared to healthy elderly; it increased following the glucose load while there was no demonstrable increase in adrenaline concentration in the two experiments. It is suggested that these patients have increased sensitivity of the beta-adrenergic receptors and an early facultative component of the glucose-induced thermogenesis in part takes place in the forearm.
Simonsen
L
L
Department of Clinical Physiology/Nuclear Medicine Hvidovre Hospital, Denmark.
Bülow
J
J
Tuxen
C
C
Christensen
N J
NJ
D000368:Aged; D001783:Blood Flow Velocity; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D018288:Carcinoma, Small Cell / Q000378:metabolism*; D002395:Catecholamines / Q000097:blood; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D005542:Forearm / Q000098:blood supply; D005947:Glucose / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008175:Lung Neoplasms / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D011433:Propranolol / Q000494:pharmacology*
D001786:Blood Glucose; D002395:Catecholamines; D007773:Lactates; D019344:Lactic Acid; D011433:Propranolol; D005947:Glucose