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Metabolic studies in human obesity during overnutrition and undernutrition: Thermogenic and hormonal responses to norepinephrine

  • Harvey L. Katzeff
    Correspondence
    Address reprint requests to Harvey L. Katzeff, MD, S-807, Department of Medicine, Cornell University Medical College, 515 East 71st, New York, NY 10021.
    Affiliations
    Metabolic Unit, Department of Medicine, University of Vermont College of Medicine, Burlington, USA.

    the Department of Medicine, Beth Israel Hospital, Boston, USA.
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  • Maureen O'Connell
    Affiliations
    Metabolic Unit, Department of Medicine, University of Vermont College of Medicine, Burlington, USA.

    the Department of Medicine, Beth Israel Hospital, Boston, USA.
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  • Edward S. Horton
    Affiliations
    Metabolic Unit, Department of Medicine, University of Vermont College of Medicine, Burlington, USA.

    the Department of Medicine, Beth Israel Hospital, Boston, USA.
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  • Elliot Danforth Jr
    Affiliations
    Metabolic Unit, Department of Medicine, University of Vermont College of Medicine, Burlington, USA.

    the Department of Medicine, Beth Israel Hospital, Boston, USA.
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  • James B. Young
    Affiliations
    Metabolic Unit, Department of Medicine, University of Vermont College of Medicine, Burlington, USA.

    the Department of Medicine, Beth Israel Hospital, Boston, USA.
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  • Lewis Landsberg
    Affiliations
    Metabolic Unit, Department of Medicine, University of Vermont College of Medicine, Burlington, USA.

    the Department of Medicine, Beth Israel Hospital, Boston, USA.
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      Abstract

      Overfeeding increases the thermogenic response of norepinephrine (NE) in normal but not in certain genetically obese rodents. It has been suggested that human obesity may be associated with a similar thermogenic defect. To determine whether there are differences in the thermogenic sensitivity to NE in human obesity, energy expenditure in response to graded infusions of NE (0.05, 0.10, 0.15, 0.20 μg/min/kg fat-free mass) was measured in six lean and six obese subjects (9.5 ± 1.8 v 36.3 ± 3.8% body fat P < 0.005). Resting metabolic rate (RMR), thermogenic response to NE, and thermogenic response to exercise were measured during weight maintenance and during the third week of feeding 1000 extra Kcal/d in the lean and obese subjects. These components of energy expenditure were also measured in the obese subjects during the third week of a 589 Kcal/d diet. Resting metabolic rate increased during overfeeding in lean (6.6%, P < 0.05) but not in the obese subjects (2.7%, P=NS) and fell during underfeeding in the obese (−9.1%,P < 0.02). There was a logarithmic increment above baseline in VO2v plasma NE concentration during the NE infusions (r=0.75, P < 0.005) in lean subjects which was unaltered by overfeeding. The obese exhibited equivalent VO2 responses to NE to that measured in the lean. Supine plasma NE concentrations were lower but metabolic clearance rates (MCR) of NE were similar in the obese compared to lean subjects during both weight maintenance and overfeeding. Overfeeding minimally increased plasma concentration but not MCR of NE in both groups. The thermogenic response to exercise was similar in the lean and obese subjects and was unaltered by overfeeding or underfeeding. The increments in plasma glycerol and free fatty acid in response to the NE infusions were proportional to the total fat mass of each individual and were greater in the obese subjects. Overfeeding partially suppressed the lipolytic response to NE in both groups and underfeeding increased the lipolytic response in the obese. There are no differences in thermogenic responses to NE in human obesity to account for excessive fat deposition. Overfeeding does not increase the thermogenetic responses to NE in humans as has been reported in small mammals.
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