Clincosm LogoSign in Get a demo

The Effect of Lifestyle-induced Hepatic Steatosis on Glucagon-stimulated Amino Acid Turnover

Sponsor
Malte Palm Suppli, MD (Other)
Overall Status
Recruiting
CT.gov ID
NCT04859322
Collaborator
Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark (Other), Clinical Metabolomics Core Facility, Department of Clinical, Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark (Other), Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark (Other), Department of Biomedical Sciences & NNF Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Other), Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health, and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Other)
20
Enrollment
1
Location
1
Arm
10
Anticipated Duration (Months)
2
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Many patients with type 2 diabetes exhibit elevated plasma concentrations of the glucose-mobilising pancreatic hormone glucagon; i.e. hyperglucagonaemia. This contributes to the hyperglycaemic state of the patients and is considered an important component in the pathophysiology of type 2 diabetes; but the mechanisms underlying this phenomenon remain unclear. The liver constitutes the main target organ of glucagon, and studies have shown that hyperglucagonaemia goes hand in hand with hyperaminoacidaemia and that both are associated with non-alcoholic fatty liver disease (NAFLD), independently of the presence of type 2 diabetes. In line with this, several recent studies support the existence of a feedback-cycle between the liver and the pancreatic alpha cells, governed by circulating glucagon and amino acids. The investigators hypothesise that the presence of hepatic steatosis results in hepatic glucagon resistance at the level of amino acid turnover, i.e. impaired glucagon-induced suppression of circulating amino acid concentrations. If this hypothesis proves correct, it would establish build-up of fat in the liver as a core mechanism underlying hyperglucagonaemia and, since the hyperglucagonemia is at least partly responsible for the fasting hyperglycaemia, as an important contributor to the hyperglycaemia of type 2 diabetes.

Condition or Disease Intervention/Treatment Phase
N/A

Study Design

Study Type:
Interventional
Anticipated Enrollment :
20 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Basic Science
Official Title:
The Effect of Lifestyle-induced Hepatic Steatosis on Glucagon-stimulated Amino Acid Turnover
Actual Study Start Date :
Feb 8, 2021
Anticipated Primary Completion Date :
Dec 9, 2021
Anticipated Study Completion Date :
Dec 9, 2021

Arms and Interventions

Arm Intervention/Treatment
Experimental: Healthy Participants

20 healthy participants included in the arm for 3 experimental days each. On each experimental day infusions of stable isotope glucose (0,6 micromol/kg/min), glucagon (1 hour low; 0,6 ng/kg/min, 2 hours high; 4,0 ng/kg/min), somatostatin (450 micrograms/hour) and insulin (0,1 mU/kg/min) will be administered. Between the first two experimental days the participants will follow a sedentary lifestyle combined with a high-calorie diet intervention

Drug: Glucagon
Pancreatic clamp
Other Names:
  • Insulin
  • Somatostatin
  • 6,6 H2-glucose

    		•

    Outcome Measures

    Primary Outcome Measures

    1. Nadir of the total amino acid concentration during a two-hour high physiological glucagon infusion during a pancreatic clamp with somatostatin [depending on the nadir between time 60 minutes and time 180 minutes]

      micromol/liter

    Secondary Outcome Measures

    1. average slope of the curve describing the change in the total amino acid concentration during 'supraphysiological' glucagon infusion [between time 60 minutes and time 180 minutes]

      micromol/liter/minute

    2. the incremental area under the curve (iAUC) for total amino acid concentrations during 'supraphysiological' glucagon infusion [between time 60 minutes and time 180 minutes]

      micromol/liter

    3. the percentage change in amino acid concentration during the last hour of the 'supraphysiological' glucagon infusion as assessed by baseline subtracted AUC [between time 60 minutes and time 180 minutes]

      micromol/liter

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    20 Years to 65 Years
    Sexes Eligible for Study:
    Male
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:

    • Normal fasting plasma glucose and glycated haemoglobin (HbA1c) <42 mmol/mol

    • Body mass index (BMI) between 18.5 and 25 kg/m2

    • Haemoglobin >8.3 mmol/l

    • Habitual diet in accordance with the Nordic Nutrition Recommendations

    • Age between 20 and 65 years

    • Oral and written informed consent

    Exclusion Criteria:

    • Diabetes

    • First-degree relatives with diabetes

    • Fasting plasma triacylglycerol indicating dyslipidemia (≥2 mmol/l)

    • Nephropathy (estimated glomerular filtration rate (eGFR) <60 ml/min and/or microalbuminuria with an albumin to creatinine ratio of 30-300 μg/mg)

    • Known liver disease and/or alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) >2 × normal values

    • Signs of liver fibrosis and/or steatosis evaluated by FibroScan (CAP value >2380 dB/m and/or kPa >65.0) and/or FIB-4 score (>1.45)

    • 5% steatosis evaluated by MRI carried out before experimental Day A (see Methods)

    • Use of medication

    • Use of dietary protein supplementation or any other dietary supplements that cannot be paused during participation

    • Excessive training habits, defined as >2 weekly strength and/or aerobic training sessions

    • Pregnancy and/or breastfeeding

    • Implanted metal objects incompatible with magnetic resonance imaging (MRI)

    • Any condition that the investigator feels would interfere with trial completion

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Center for Clinical Metabolic Research Hellerup Copenhagen Denmark 2900

    Sponsors and Collaborators

    • Malte Palm Suppli, MD
    • Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark
    • Clinical Metabolomics Core Facility, Department of Clinical, Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
    • Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
    • Department of Biomedical Sciences & NNF Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
    • Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health, and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Investigators

    None specified.

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Malte Palm Suppli, MD, MD, University Hospital, Gentofte, Copenhagen
    ClinicalTrials.gov Identifier:
    NCT04859322
    Other Study ID Numbers:
    • SIRG-2
    First Posted:
    Apr 26, 2021
    Last Update Posted:
    Apr 30, 2021
    Last Verified:
    Apr 1, 2021
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:
    Liver Diseases
    Fatty Liver
    Non-alcoholic Fatty Liver Disease
    Glucagon
    Somatostatin

    Study Results

    No Results Posted as of Apr 30, 2021