Fatty Acid Metabolism and Insulin Sensitivity: the Role of Endurance Exercise

Sponsor
University of Michigan (Other)
Overall Status
Completed
CT.gov ID
NCT00795860
Collaborator
American Diabetes Association (Other), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (NIH)
36
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2
43
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Study Details

Study Description

Brief Summary

Clearly the effects of diet and exercise are beneficial for obese persons, but the underlying mechanisms for the improvements in metabolic health are not completely clear. Although mounting evidence suggests that alterations in lipid metabolism in persons with abdominal obesity are associated with a several medical complications, including diabetes, little is known about the factors responsible for this effect. The project in this application is designed to examine how the addition of endurance exercise training to a weight-loss program alters whole-body fatty acid availability, uptake, and oxidation as well as the expression of cellular factors that regulate these processes. In addition, we will evaluate whether these alterations are associated with improvements in insulin sensitivity. In the end, these experiments will provide insight into the cellular and whole-body adaptations in fatty acid metabolism in response to weight-loss and exercise training that may lead to enhancement of insulin sensitivity. Identifying relationships between gene expression, whole-body fatty acid metabolism and clinical outcome measurements, such as insulin sensitivity, may lead to improvements in the therapeutic and/or the preventative approach to obesity and its co-morbidities.

Condition or Disease Intervention/Treatment Phase
  • Behavioral: Weight loss - diet only
  • Behavioral: Weight loss plus exercise
N/A

Detailed Description

Despite robust findings emphasizing the importance of weight-loss and exercise for the prevention and management of insulin resistance and Type 2 diabetes, the mechanisms responsible for the improvements in metabolic health are not completely understood. Mounting evidence suggests that abnormalities in fatty acid metabolism in persons with abdominal obesity are associated with insulin resistance. Alterations in fatty acid mobilization and oxidation may be primary adaptations responsible for the improvements in metabolic health after weight-loss and endurance exercise training. We hypothesize that a disparity between muscle fatty acid uptake and oxidation is regulated by the expression of genes and proteins that participate in intracellular transport, trafficking, and metabolism of fatty acids. We believe that alterations in the expression of these factors in response to weight-loss and endurance exercise training will underlie changes in the non-oxidative disposal of fatty acids, and thereby improve insulin sensitivity. We will determine the effects of weight-loss and exercise training on whole-body fatty acid mobilization and oxidation and the expression of factors that regulate these processes in skeletal muscle. In addition, we will evaluate how these alterations are associated with improvements in insulin sensitivity. These studies will provide insight into how cellular alterations with weight-loss and exercise training and the accompanying changes in whole-body fatty acid metabolism may lead to improvements in metabolic health.

Study Design

Study Type:
Interventional
Actual Enrollment :
36 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Basic Science
Official Title:
Fatty Acid Metabolism and Insulin Sensitivity: the Role of Endurance Exercise
Actual Study Start Date :
Jun 1, 2003
Actual Primary Completion Date :
Jan 1, 2007
Actual Study Completion Date :
Jan 1, 2007

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Weight loss - diet only

Behavioral: Weight loss - diet only
Subjects adhere to a reduced calorie diet until they lose exactly 12% of their initial body weight. After they achieve this weight loss goal, they are placed on a weight-maintaining diet for 3-4 weeks before follow-up experiments are performed. Subjects meet weekly with a research dietitian throughout their weigh-loss and weight maintenance program.

Experimental: Weight loss plus exercise

Behavioral: Weight loss plus exercise
Subjects adhere to a reduced calorie diet and perform 4 session of endurance exercise training per week until they lose exactly 12% of their initial body weight. Exercise training consists of stationary bicycle exercise. the exercise duration and intensity ramp up over the first few weeks of training until subjects exercise 45 min per session at an intensity of 85% of their maximal heart rate. 3 of the 4 exercise session each week are supervised by an Exercise physiologist. After they achieve the 12% weight loss goal, they are placed on a weight-maintaining diet for 3-4 weeks before follow-up experiments are performed. Subjects meet weekly with a research dietitian throughout their weigh-loss and weight maintenance program.

Outcome Measures

Primary Outcome Measures

  1. Insulin sensitivity [before and after 12% weight loss (3-6 months)]

Secondary Outcome Measures

  1. Rate of fatty acid mobilization in plasma [Before and after 12% weight loss (3-6 months)]

  2. Abundance and activity of Pro-inflammatory factors in skeletal muscle [Before and after 12% weight loss (3-6 months)]

  3. whole body and skeletal muscle oxidative capacity [Before and after 12% weight loss (3-6 months)]

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 45 Years
Sexes Eligible for Study:
Female
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  • Female

  • Age = 18-45

  • Premenopausal

  • Body mass index ≥ 30 kg/m2

  • Waist circumference ≥ 100 cm

Exclusion Criteria:
  • Evidence of metabolic or cardiovascular disease

  • Pregnancy

  • Allergies to soybeans or eggs

  • Hyperlipidemia (fasting plasma triglyceride concentration > 125 mg/dl)

  • Hematocrit < 34%

Contacts and Locations

Locations

Site City State Country Postal Code
1 University of Michigan Ann Arbor Michigan United States 48109

Sponsors and Collaborators

  • University of Michigan
  • American Diabetes Association
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Investigators

  • Principal Investigator: Jeffrey Horowitz, PhD, University of Michigan

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Jeffrey F Horowitz, Professor, University of Michigan
ClinicalTrials.gov Identifier:
NCT00795860
Other Study ID Numbers:
  • ADA - 1-03-JF-10 (completed)
  • ADA grant# 1-03-JF-10
First Posted:
Nov 21, 2008
Last Update Posted:
Oct 16, 2017
Last Verified:
Oct 1, 2017
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Jeffrey F Horowitz, Professor, University of Michigan
Additional relevant MeSH terms:

Study Results

No Results Posted as of Oct 16, 2017