Effects of dopexamine in comparison with fenoterol on carbohydrate, fat and protein metabolism in healthy volunteers.
OBJECTIVE
In critically ill patients adrenergic agonists are used to treat haemodynamic disorders. Their metabolic actions should be considered in controlling metabolic homeostasis. Dopexamine has assumed effects on carbohydrate, fat and protein metabolism. The aim of this study was to define its metabolic actions and compare these with those of fenoterol by using a stable isotope dilution technique.


METHODS
Prospective, randomized experimental study.


METHODS
Experimental section of a university anaesthesiology department.


METHODS
Twenty-seven healthy male volunteers in three groups with nine participants each.


METHODS
Participants received a 4-h infusion of dopexamine (2.25 microg/kg per min), fenoterol (at least 0.025 microg/kg per min) or saline.


RESULTS
Before and every 80 min during drug infusion, we measured endogenous glucose production and the plasma appearance rates for leucine and urea. In addition, we measured plasma concentrations of glucose, lactate, free fatty acids (FFAs), noradrenaline, adrenaline, insulin, glucagon and potassium. Endogenous glucose production did not differ among the groups. Glucose plasma concentration and glucose clearance remained constant during the dopexamine infusion. Fenoterol increased glucose plasma concentration and decreased glucose clearance. Lactate, FFAs, insulin and noradrenaline plasma concentrations were increased and the rate of leucine appearance was decreased by both drugs. The rate of urea appearance did not differ from the control group.


CONCLUSIONS
Dopexamine has no or only weak effects on carbohydrate metabolism, its effects on fat and protein metabolism are comparable to those of fenoterol. This metabolic profile may be advantageous in increasing cardiac output in patients with impaired glucose tolerance.
University Clinic of Anaesthesiology, University Clinics Ulm, Steinhoevelstrasse 9, 89075 Ulm, Germany. wolfgang@geisser.org
Wolfgang
W
Geisser
Josef
J
Vogt
Ulrich
U
Wachter
Hannes
H
Hofbauer
Michael
M
Georgieff
Hermann
H
Ensinger
D000318:Adrenergic beta-Agonists / Q000494:pharmacology*; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002153:Calorimetry, Indirect; D050260:Carbohydrate Metabolism; D004298:Dopamine / Q000031:analogs & derivatives* / Q000494:pharmacology*; D004734:Energy Metabolism / Q000187:drug effects; D005280:Fenoterol / Q000494:pharmacology*; D006801:Humans; D019344:Lactic Acid / Q000097:blood / Q000378:metabolism; D050356:Lipid Metabolism; D008297:Male; D011446:Prospective Studies; D011506:Proteins / Q000378:metabolism*
D000318:Adrenergic beta-Agonists; D001786:Blood Glucose; D011506:Proteins; D005280:Fenoterol; D019344:Lactic Acid; C046318:dopexamine; D004298:Dopamine