Epinephrine's ketogenic effect in humans is mediated principally by lipolysis

A. Avogaro, P. E. Cryer, D. M. Bier

Research output: Contribution to journalArticle

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To quantify epinephrine's effects on acetoacetate and β-hydroxybutyrate kinetics, we infused subjects with 0.3 and 2.5 μg/min epinephrine, either alone or with a concomitant somatostatin infusion with insulin, glucagon, and growth hormone replaced at postabsorptive levels (islet clamp). Additional subjects received no epinephrine but sequential infusions of heparin plus 10% Intralipid at rates of 0.5 and 3.0 ml/min. Both epinephrine and Intralipid increased ketone body appearance (unaffected by islet clamp), augmented the interconversion rates between ketone bodies and, during the 2.5 μg/min infusion, caused a marked increase in β-hydroxybutyrate appearance. The fraction of plasma free fatty acid (FFA) flux appearing as plasma ketones increased from 6 to 7% in the basal state to 11% at the high-epinephrine infusion. This fraction was also unaffected by the islet clamp and was not different from values obtained at similar Intralipid plus heparin-induced elevations in plasma FFA levels. We conclude that epinephrine's ketogenic effect in humans is primarily the result of its lipolytic effect, is accompanied by a significantly increased rate of ketone body interconversion, is manifest largely as an increase in plasma β-hydroxybutyrate appearance at high plasma epinephrine values, and is not limited by portal insulin at post- absorptive levels.

Original languageEnglish
Pages (from-to)E250-E260
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Issue number2 26-2
StatePublished - Jan 1 1992


  • acetoacetate
  • catecholamines
  • free fatty acids
  • kinetics
  • stable isotopes
  • β- hydroxybutyrate

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