Exercise and Inflammation in the Elderly (IRIS)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
University of Maryland
Johns Hopkins University
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00753363
First received: September 12, 2008
Last updated: April 7, 2014
Last verified: April 2014
  Purpose

Persistent low-grade inflammation and impaired fibrinolysis, are independent predictors of several chronic diseases highly prevalent in the older veteran population including CVD, stroke, and diabetes. Inflammation is likely to be a causative underlying mechanism of insulin resistance. Lifestyle changes such as weight loss and physical activity are advocated for the treatment of these chronic diseases and endpoints, and data are emerging which suggest that these treatments may be beneficial, in part, due to their anti-inflammatory effects. Identification of effective therapies that reduce chronic inflammation for veterans is important given the widespread adverse health effects of a chronically elevated inflammatory state.


Condition Intervention
Inflammation
Insulin Sensitivity
Other: Weight Loss
Other: Aerobic Exercise Training

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Basic Science
Official Title: Exercise, Inflammation and Pro-thrombotic Modulators in the Elderly

Resource links provided by NLM:


Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • Insulin Sensitivity [ Time Frame: Before and after the exercise training or weight loss intervention. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Adipose tissue and skeletal muscle inflammation [ Time Frame: Before and after the exercise training or weight loss intervention. ] [ Designated as safety issue: No ]
  • Body composition and fitness [ Time Frame: Before and after the exercise training or weight loss intervention. ] [ Designated as safety issue: No ]

Estimated Enrollment: 200
Study Start Date: April 2007
Estimated Study Completion Date: November 2015
Primary Completion Date: November 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1
6 months of aerobic exercise training
Other: Aerobic Exercise Training
6 months of aerobic exercise training
Experimental: Arm 2
6 months of weight loss
Other: Weight Loss
6 months of weight loss

Detailed Description:

This study will compare the effects of 6 month randomized trial of aerobic exercise (AEX) vs. weight loss (WL) in older individuals on:

  1. adipokine secretion and expression (TNFalpha, adiponectin, PAI-1);
  2. adipose tissue and skeletal muscle inflammatory proximal receptor expression (adipoR1, adipoR2, TNFR1, TNFR2 expression) and intermediate signaling pathways (AMPK, IKKalpha, NFkB, JNK activity), and the terminal inhibitory action on IRS-1 tyrosine phosphorylation, IRS-1 phosphorylation (Ser307) and Akt; and
  3. whether the changes in ligand concentrations, receptor expression, and signal transduction are associated with changes in peripheral (whole body insulin sensitivity by a hyperinsulinemic-euglycemic clamp), hepatic (hepatic glucose production, HGP), and cell-type specific (insulin stimulated glucose transport in adipocytes) insulin sensitivity.

The prevention and treatment of insulin resistance, the metabolic syndrome, and their CVD complications through exercise and weight loss could improve veterans' health and reduce health care costs. Knowledge of their effectiveness has important implications for the cardiovascular health of veterans given the widespread adverse health effects of chronic inflammation on vascular biology, skeletal muscle function and insulin action.

  Eligibility

Ages Eligible for Study:   45 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Male and Female
  • 45-80 yrs of age
  • Non-smoking for one year
  • BMI greater than 20 kg/m2 and less than 50 kg/m2
  • Menopause over 1 year

Exclusion Criteria:

  • Symptomatic heart disease, CAD, CHF, or uncontrolled hypertension (BP over 180/100 mm Hg) unless medically stabilized
  • Currently being treated for active cancer
  • Type 1 diabetes; Insulin or oral agent treatment for diabetes, poorly controlled diabetes FBS over 160 mg/dl
  • Allergic to lidocaine
  • Untreated dyslipidemia with National Cholesterol ATPIII 10 year cardiac risk score greater than 10% (www.nhbli.nih.gov/guidelines/cholesterol/atp3upd04.htm), or receiving TG lowering meds
  • Other systemic disorders that are not medically treated and stable
  • Taking beta-blockers, oral steroids, warfarin or any other medications interfering with fat/muscle metabolism that may not be safely discontinued temporarily for specific procedures (ie for 72 hours prior)
  • Abnormal response to exercise test (ST segment depression greater than 2mm, chest pain, significant arrhythmias, extreme shortness of breath, cyanosis, exercising BP above 240/120mm Hg, or other contraindications to exercise) *requires follow up treatment w/ primary MD for continued participation in study
  • Abnormal liver function
  • Abnormal renal function (BUN above 40 mg/dl, Cr above 2 mg/dl)
  • Chronic pulmonary disease
  • Anemia Hct below 35 mg/dl, platelets below 100,000/cm3
  • MMSE below 24, dementia or unstable clinical depression by exam
  • Aerobically trained with VO2max greater than 2 SD above age-adjusted mean
  • Exercise group only: History of CVA (by medical history) with symptoms limiting the ability to exercise
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00753363

Locations
United States, Maryland
VA Maryland Health Care System, Baltimore
Baltimore, Maryland, United States, 21201
Sponsors and Collaborators
University of Maryland
Johns Hopkins University
Investigators
Principal Investigator: Alice Ryan, PhD VA Maryland Health Care System, Baltimore
  More Information

No publications provided

Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00753363     History of Changes
Other Study ID Numbers: AGCG-003-05F
Study First Received: September 12, 2008
Last Updated: April 7, 2014
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Glucose Metabolism

Additional relevant MeSH terms:
Inflammation
Insulin Resistance
Pathologic Processes
Hyperinsulinism
Glucose Metabolism Disorders
Metabolic Diseases

ClinicalTrials.gov processed this record on August 19, 2014