Study of Changes in Skeletal Muscle After Caloric Restriction
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Purpose
Research has shown that fat stored within muscles affects the muscle's sensitivity to insulin and ability to handle blood glucose. The purpose of this study is to examine the effects of weight loss surgery-induced caloric restriction on the accumulation and types of fats within skeletal muscle, as well as the effects of such caloric restriction on insulin sensitivity and inflammatory responses in skeletal muscle. The investigator proposes that caloric restriction will result in decreases in diacylglycerols enriched with saturated fat and increases in diacylglycerols enriched with monounsaturated fats.
| Condition |
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Obesity |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Diacylglycerols and Insulin Action in Skeletal Muscle Upon Caloric Restriction |
- UPLC-ESI MS/MS profiling of lipd extracts from muscle biopsies to evaluate effects of gastric bypass induced-caloric restriction on diacylglycerol molecular species accumulation. [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- To evaluate the effects of gastric bypass induced-caloric restriction on skeletal muscle insulin action via a hyperinsulinemic-euglycemic clamp and profiling markers of insulin signaling. [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- To evaluate the effects of gastric bypass induced-caloric restriction on lipid-mediated inflammatory responses by profiling cytokines and free fatty acids in blood and inflammation markers in skeletal muscle biopsies. [ Time Frame: 1 year ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples With DNA
Whole blood, plasma, muscle tissue
| Estimated Enrollment: | 24 |
| Study Start Date: | March 2011 |
| Estimated Study Completion Date: | November 2013 |
| Estimated Primary Completion Date: | November 2013 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
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Normal body weight
Female subjects, ages 21-65 yrs, with BMI of 21-27 kg/m2 with normal glucose tolerance.
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Roux-en-Y gastric bypass
Female subjects ages 21-65 with insulin resistance and scheduled for Roux-en-Y gastric bypass at Vanderbilt University Medical Center will be studied before and 4-6 weeks after surgery.
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Detailed Description:
We hypothesize that in a setting of surgically-induced weight loss decrements in select DAGs result in improved glucose utilization, altered insulin signaling and decreased inflammatory responses. We propose to examine the impact of molecular DAG species accumulation on glucose utilization, insulin signaling and inflammation in skeletal muscle from morbidly obese subjects before/after 10% weight loss facilitated by Roux-en-Y Gastric Bypass (RYGB). We will compare these results to those from a control, normal weight cohort
The detected differences in DAG molecular species, insulin action, inflammatory responses between normal and obese subjects (before/after weight loss) will emphasize pathways coordinately altered as a consequence of adiposity and RYGB surgery. The primary endpoints for this study will be: Insulin sensitivity (glucose Rd, insulin levels, DAG mass, DAG species amounts).Secondary endpoints will be: FFA levels, inflammatory cytokine production, and insulin signaling in skeletal muscle.
Eligibility| Ages Eligible for Study: | 21 Years to 65 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
Female subjects approved for Roux-en-Y gastric bypass surgery at Vanderbilt University Medical Center.
Inclusion Criteria:
For Normal Weight Subjects:
- Age 21-65 years
- BMI of 21 to 27 kg/m2
- Normal glucose tolerance as determined by OGTT on day of screening
- No family history of diabetes
For Morbidly Obese Subjects:
- Age 21-65 years
- BMI of 30 to 65 kg/m2
- Scheduled for Roux-en-Y gastric bypass at Vanderbilt Medical Center
- Insulin resistant as determined by OGTT on day of screening
Exclusion Criteria (for all subjects):
- Clinically significant heart disease
- Clinically significant hepatic or renal disease
- Pregnancy
- Breastfeeding
- Any abnormality that would preclude safe completion of study
- Use of statins
- Use of thiazide or furosemide diuretics, beta blockers, or other chronic medications with known adverse effects on glucose tolerance levels unless subject has been on stable dose of such medications for the past 3 months before entering the study
Contacts and Locations| United States, Tennessee | |
| Vanderbilt University Medical Center | |
| Nashville, Tennessee, United States, 37232 | |
| Principal Investigator: | Charles R Flynn, PhD | Vanderbilt University |
| Study Chair: | Naji Abumrad, MD | Vanderbilt University |
More Information
No publications provided
| Responsible Party: | Charles R. Flynn, Assistant Professor, Vanderbilt University |
| ClinicalTrials.gov Identifier: | NCT00993460 History of Changes |
| Other Study ID Numbers: | IRB #091145 |
| Study First Received: | October 7, 2009 |
| Last Updated: | November 19, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Vanderbilt University:
|
Obesity Insulin sensitivity Inflammation |
Additional relevant MeSH terms:
|
Obesity Overnutrition Nutrition Disorders |
Overweight Body Weight Signs and Symptoms |
ClinicalTrials.gov processed this record on May 23, 2013