METABOLIC RESPONSE TO SIMULTANEOUS INFUSION OF EPINEPHRINE AND PROPRANOLOL IN OBESE ADOLESCENTS

Eighteen studies were performed in 5 grossly obese adolescents in order to determine whether or not epinephrine and/or Propranolol are capable of decreasing the hyperinsulinemia characteristic of obese subjects and to study the metabolic response during the administration of these drugs. When epinephrine (6 μg./min.) was infused during a protein-glucose meal, there was a 50 per cent (or greater) decrease in the release of immunoreactive insulin as compared with the response to protein-glucose alone. However, the basal level of immunoreactive insulin was unchanged. There were also a marked hyperglycemia as well as a concomitant rise in the plasma free fatty acids. Plasma level of immunoreactive human growth hormone were undetectable. Epinephrine (10 μg./min.) in combination with Propranolol (80 μg./min.) resulted in a marked decrease in both the basal level and the subsequent release of immunoreactive insulin. Hyperglycemia was present and the plasma free fatty acids showed a precipitous fall. One patient had a brisk immunoreactive growth hormone response of 7 mμg./ml. after cessation of the infusion. When epinephrine (2 μg./min.) was simultaneously infused with Propranolol (80 μg./min.) only a slight decrease in the basal level of immunoreactive insulin was observed. The inhibition of the subsequent insulin release was mild and transitory. Again hyperglycemia occurred and the plasma levels of immunoreactive growth hormone were almost undetectable. Propranolol alone (80 μg./min.) did not affect the basal level or the subsequent release of immunoreactive insulin. One subject had a peak plasma immunoreactive growth hormone value of 5.9 mμg./ml. shortly after the infusion began. It is concluded that Propranolol and epinephrine in specific dose combinations have a synergistic action on the inhibition of insulin release in obese adolescents. © 1969.