The beta-1 adrenergic antagonist, atenolol, decreases acylation stimulating protein, exercise capacity and plasma free fatty acids in men with type 2 diabetes.
OBJECTIVE
Atenolol is a beta-1 adrenergic antagonist commonly prescribed for the treatment of systemic hypertension or coronary artery disease yet its use in individuals with type 2 diabetes mellitus (T2DM) is controversial due to potentially negative side effects on insulin resistance. Non-esterified fatty acid (NEFA) metabolism is altered in T2DM especially under conditions of metabolic stress such as exercise or the postprandial state. We evaluated atenolol effects on circulating NEFA and related hormones in men with T2DM during acute cardiorespiratory exercise in both the fasting and postprandial state, including the adipokine acylation stimulating protein (ASP) which stimulates adipose tissue NEFA uptake.


RESULTS
Ten men with T2DM underwent four 1-h exercise sessions at 60% of their maximal oxygen uptake (VO(2max)) under the following conditions: 1) fasting (F), and 2) 2 h postprandial (PP) without medication; and 3) fasting (F-Atenolol), and 4) 2 h postprandial (PP-Atenolol) after a one-week treatment with atenolol. Results were tested for the effects of atenolol via two-way ANOVA for the F vs F-Atenolol and PP vs PP-Atenolol states separately. Atenolol treatment decreased fasting and postprandial glycerol (p < 0.0001) and NEFA (p < 0.0001), postprandial epinephrine (p = 0.048), postprandial cortisol (p = 0.02), postprandial ASP (p = 0.04) and postprandial dopamine (p < 0.004).


CONCLUSIONS
Atenolol alters fatty acid metabolism and associated metabolic hormones including ASP during exercise in men with T2DM and its effects are more apparent during conditions of stress such as the postprandial state, acute exercise and obesity.
Y2186, 2725 Chemin Ste-Foy, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada G1V 4G5.
J
J
Smith
A
A
Ferland
J
J
Méthot
P
P
Brassard
S
S
Lacroix
P
P
Poirier
K
K
Cianflone
D058671:Adrenergic beta-1 Receptor Antagonists / Q000494:pharmacology*; D000328:Adult; D001262:Atenolol / Q000494:pharmacology*; D003176:Complement C3; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004298:Dopamine / Q000097:blood; D002149:Energy Intake; D004837:Epinephrine / Q000097:blood; D015444:Exercise / Q000502:physiology*; D005215:Fasting; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005990:Glycerol / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D019518:Postprandial Period
D058671:Adrenergic beta-1 Receptor Antagonists; C038245:C3 protein, human; D003176:Complement C3; D005230:Fatty Acids, Nonesterified; D036341:Intercellular Signaling Peptides and Proteins; D001262:Atenolol; D005990:Glycerol; D010100:Oxygen; D004298:Dopamine; D006854:Hydrocortisone; D004837:Epinephrine