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Mechanisms of Insulin Resistance in Humans

This study is currently recruiting participants.
Verified by Department of Veterans Affairs, April 2008

Sponsored by: Department of Veterans Affairs
Information provided by: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00330967
  Purpose

The objectives of the study are to:

  1. compare the inflammatory response and insulin resistance in skeletal muscles during a systemic infusion of lipid with that during a local infusion of lipid into the femoral artery. which would cause minimal or no systemic hyperlipidemia but local plasma free fatty acid (FFA) concentrations similar to those during the systemic lipid infusion, and
  2. determine the inflammatory response and insulin resistance in skeletal muscle during an infusion of lipid into the femoral artery as described above after NP-KB inhibition by high dose salicylate treatment in humans.

Condition Intervention
Inflammation
Insulin Resistance
Drug: 20% Intralipid
Drug: Salicylate

ChemIDplus related topics:   Insulin    Dextrose    Lipids   

U.S. FDA Resources

Study Type:   Observational
Study Design:   Other, Prospective
Official Title:   Mechanisms of Insulin Resistance in Humans

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • degree of insulin resistance and inflammation [ Time Frame: immediate ] [ Designated as safety issue: No ]

Biospecimen Retention:   Samples Without DNA

Biospecimen Description:

Blood samples, muscle biopsies


Estimated Enrollment:   32
Study Start Date:   April 2006
Estimated Study Completion Date:   February 2009
Estimated Primary Completion Date:   December 2008 (Final data collection date for primary outcome measure)

Groups/Cohorts Assigned Interventions
1
healthy subjects
Drug: 20% Intralipid
lipid infusion
2
healthy subjects different from group 1
Drug: 20% Intralipid
lipid infusion
Drug: Salicylate
treatment with anti-inflammatory agent

Detailed Description:

Insulin resistance in skeletal muscle is a characteristic abnormality in obesity and the metabolic syndrome and a major factor responsible for the development of type 2 diabetes. Although the mechanisms responsible for muscle insulin resistance are largely unclear, lipid oversupply is an important factor. Among numerous potential mechanisms whereby lipid oversupply may cause muscle insulin resistance, current evidence points towards inflammation as being critical. Recent studies in animals, however, indicate that the inflammatory response in skeletal muscles may require the presence of circulating pro-inflammatory factors suggesting that the inflammation induced insulin resistance in skeletal muscles may be a secondary event. More specifically, activation of Nuclear Factor-Kappa B(NF-kB), and inflammatory master switch that drives the production of numerous pro-inflammatory cytokines in fat and liver, has been implicated in causing insulin resistance in skeletal muscles by increasing circulating pro-inflammatory cytokines. In contrast, animal studies have found that activation of NP-KB directly in skeletal muscles has no or little effect on its insulin sensitivity but does produce other abnormalities such as increased proteasome activity. The study shall therefore be undertaken to determine to what extent lipid-induced inflammation and insulin resistance in skeletal muscles requires the presence of circulating proinflammatory factors in humans.

  Eligibility
Ages Eligible for Study:   21 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample

Study Population

healthy subjects


Criteria

Inclusion Criteria:

  • two groups of 16 healthy subjects

Exclusion Criteria:

  • diabetes or impaired glucose tolerance
  • peripheral vascular disease
  • pulmonary disease
  • clinically significant hepatic or renal disease
  • triglycerides >200mg/dl
  • anemia
  • abnormal PT, PTT or INR
  • pregnancy or lactation
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00330967

Contacts
Contact: Rosemarie Vedda, PA-C     (602) 277-5551 ext 6183     rosemarie.vedda@va.gov    

Locations
United States, Arizona
Carl T. Hayden VA Medical Center     Recruiting
      Phoenix, Arizona, United States, 85012
      Contact: Rosemarie Vedda, PA-C     602-277-5551 ext 6183     rosemarie.vedda@va.gov    
      Principal Investigator: Christian Meyer, MD            

Sponsors and Collaborators

Investigators
Principal Investigator:     Christian Meyer, MD     Carl T. Hayden VA Medical Center    
  More Information


Publications of Results:
Hundal RS, Petersen KF, Mayerson AB, Randhawa PS, Inzucchi S, Shoelson SE, Shulman GI. Mechanism by which high-dose aspirin improves glucose metabolism in type 2 diabetes. J Clin Invest. 2002 May;109(10):1321-6.
 
Hirosumi J, Tuncman G, Chang L, Gorgun CZ, Uysal KT, Maeda K, Karin M, Hotamisligil GS. A central role for JNK in obesity and insulin resistance. Nature. 2002 Nov 21;420(6913):333-6.
 
Kim JK, Kim YJ, Fillmore JJ, Chen Y, Moore I, Lee J, Yuan M, Li ZW, Karin M, Perret P, Shoelson SE, Shulman GI. Prevention of fat-induced insulin resistance by salicylate. J Clin Invest. 2001 Aug;108(3):437-46.
 
Yuan M, Konstantopoulos N, Lee J, Hansen L, Li ZW, Karin M, Shoelson SE. Reversal of obesity- and diet-induced insulin resistance with salicylates or targeted disruption of Ikkbeta. Science. 2001 Aug 31;293(5535):1673-7. Erratum in: Science 2002 Jan 11;295(5553):277.
 
Richardson DK, Kashyap S, Bajaj M, Cusi K, Mandarino SJ, Finlayson J, DeFronzo RA, Jenkinson CP, Mandarino LJ. Lipid infusion decreases the expression of nuclear encoded mitochondrial genes and increases the expression of extracellular matrix genes in human skeletal muscle. J Biol Chem. 2005 Mar 18;280(11):10290-7. Epub 2004 Dec 14.
 
Thamlikitkul V, Kobwanthanakun S, Pruksachatvuthi S, Lertluknithi R. Pharmacokinetics of rheumatic fever prophylaxis regimens. J Int Med Res. 1992 Feb;20(1):20-6.
 
Arkan MC, Hevener AL, Greten FR, Maeda S, Li ZW, Long JM, Wynshaw-Boris A, Poli G, Olefsky J, Karin M. IKK-beta links inflammation to obesity-induced insulin resistance. Nat Med. 2005 Feb;11(2):191-8. Epub 2005 Jan 30.
 

Responsible Party:   Department of Veterans Affairs ( Meyer, Christian - Principal Investigator )
Study ID Numbers:   ENDA-029-05F
First Received:   May 26, 2006
Last Updated:   May 5, 2008
ClinicalTrials.gov Identifier:   NCT00330967
Health Authority:   United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Fat Emulsions, Intravenous  
Free Fatty Acids  
Glucose Clamp Technique  
Inflammation  
Insulin Resistance
Muscle, Skeletal
NF-Kappa B
Salicylates

Study placed in the following topic categories:
Hyperinsulinism
Metabolic Diseases
Salicylates
Insulin Resistance
Metabolic disorder
Glucose Metabolism Disorders
Insulin
Inflammation

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Pharmacologic Actions
Pathologic Processes
Analgesics, Non-Narcotic
Sensory System Agents
Therapeutic Uses
Anti-Inflammatory Agents, Non-Steroidal
Analgesics
Peripheral Nervous System Agents
Antirheumatic Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on October 03, 2008




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