Effect of beta 2-agonist treatment on insulin-stimulated peripheral glucose disposal in healthy men in a randomised placebo-controlled trial

S.M.M. van Beek, Y.M.H. Bruls, F. Vanweert, C.E. Fealy, N.J. Connell, G. Schaart, E. Moonen-Kornips, J.A. Jorgensen, F.M. Vaz, E.T.H.C. Smeets, P.J. Joris, A. Gemmink, R.H. Houtkooper, M.K.C. Hesselink, T. Bengtsson, B. Havekes, P. Schrauwen, J. Hoeks*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

beta(2)-agonist treatment improves skeletal muscle glucose uptake and whole-body glucose homeostasis in rodents, likely via mTORC2-mediated signalling. However, human data on this topic is virtually absent. We here investigate the effects of two-weeks treatment with the beta(2)-agonist clenbuterol (40 mu g/day) on glucose control as well as energy- and substrate metabolism in healthy young men (age: 18-30 years, BMI: 20-25 kg/m(2)) in a randomised, placebo-controlled, double-blinded, cross-over study (ClinicalTrials.gov-identifier: NCT03800290). Randomisation occurred by controlled randomisation and the final allocation sequence was seven (period 1: clenbuterol, period 2: placebo) to four (period 1: placebo, period 2: clenbuterol). The primary and secondary outcome were peripheral insulin-stimulated glucose disposal and skeletal muscle GLUT4 translocation, respectively. Primary analyses were performed on eleven participants. No serious adverse events were reported. The study was performed at Maastricht University, Maastricht, The Netherlands, between August 2019 and April 2021. Clenbuterol treatment improved peripheral insulin-stimulated glucose disposal by 13% (46.6 +/- 3.5 versus 41.2 +/- 2.7 mu mol/kg/min, p = 0.032), whereas skeletal muscle GLUT4 translocation assessed in overnight fasted muscle biopsies remained unaffected. These results highlight the potential of beta(2)-agonist treatment in improving skeletal muscle glucose uptake and underscore the therapeutic value of this pathway for the treatment of type 2 diabetes. However, given the well-known (cardiovascular) side-effects of systemic beta(2)-agonist treatment, further exploration on the underlying mechanisms is needed to identify viable therapeutic targets.beta 2-agonist treatment improves skeletal muscle glucose uptake and whole-body glucose homeostasis in rodents. Here the authors report that two-weeks of treatment with the beta 2-agonist clenbuterol improves insulin-stimulated glucose disposal in healthy young men in a double-blinded, randomized cross-over trial.
Original languageEnglish
Article number173
Number of pages15
JournalNature Communications
Volume14
Issue number1
DOIs
Publication statusPublished - 12 Jan 2023

Keywords

  • BETA(2)-ADRENERGIC AGONIST TREATMENT
  • LIPOPROTEIN-LIPASE ACTIVITY
  • TANDEM MASS-SPECTROMETRY
  • BRANCHED-CHAIN
  • ENERGY-EXPENDITURE
  • AMINO-ACIDS
  • BLOOD-FLOW
  • CLENBUTEROL
  • RESISTANCE
  • OBESE

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