Brown Adipose Tissue as Nutrient Buffer Through Diet Induced Thermogenesis

Not Applicable

Recruiting

• Conditions: Brown Adipose Tissue; Metabolic Disease
• Interventions: Other: Carbohydrate; Other: Fat; Other: Protein

• Registration Number: NCT06078345
• Lead Sponsor: University Hospital, Basel, Switzerland

Brief Summary

To test the hypothesis that active BAT improves metabolic health by buffering postprandial metabolites plasma metabolites and energy expenditure will be compared in volunteers with and without active BAT. Both groups will receive test meals with protein, fat and carbohydrates separately, so that the individual impacts of these macronutrients on diet induced thermogenesis and the buffering function of BAT can be derived. BAT biopsies will be taken before and after the test meals for molecular analysis.

Detailed Description

In this prospective interventional study healthy individuals will be screened for presence of active BAT: Maximal BAT activity will be achieved by a mild cold stimulus over 2 hous and quantified by 18F-FDG-PET/CT 30 min after injection of 75 MBq of 18F-FDG.

Individuals with FDG-PET positive BAT will be included as BAT-positive subjects (n=15) and individuals with absence of FDG-positive BAT will be included as BAT-negative subjects (n=15) and then take part in three study visits in random order.

During the study visits participants will consume a standardized isocaloric liquid meal consisting of A) glucose (OGTT) B) fat and C) protein.

Energy expenditure will be measured by indirect calorimetry before as well as hourly after the meal for 5 hours. Blood samples will be taken before and at 30 minute intervals after the meal for 5 hours for analysis of blood glucose, triglycerides, FAAs, representative amino acids, insulin and noradrenaline.

Subjects will undergo ultrasound-guided biopsy of the supraclavicular fat depot in the fasting state and after one of the test meals so that biopsies from 5 individuals in each group after each test meal will be obtained.

Study Timeline

• Study First Submitted: 2023-10-05
• Study First Submitted QC: 2023-10-05
• Study First Posted: 2023-10-11
• Study Start: 2023-10-12
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-05
• Last Update Posted: 2024-12-11
• Primary Completion: 2025-06-30
• Study Completion: 2025-06-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• BMI 18.5 to 28 kg/m2
• Able to give informed consent as documented by signature

Exclusion Criteria

• Concomitant medication other than prescription free analgesics (paracetamol and NSAID) and oral contraceptives

• Other clinically significant concomitant disease states (e.g., renal failure, hepatic dysfunction, cardiovascular disease, diabetes mellitus)

• Hyper- or hypothyroidism

• Smoker / habitual tobacco use

• Weight change of >5% within 3 months prior to inclusion

• Hypersensitivity to cold (e.g. Raynaud syndrome)

• Known or suspected non-compliance, drug or alcohol abuse

• Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant

• Enrolment of the investigator, his/her family members, employees and other dependent persons

• Enrolment into another study using ionizing radiation within the previous 12 months

• Enrolment into another study including a pharmacological or nutritional intervention

• Pregnancy or lactation

• Lab parameters

  • Serum-Creatinine: above 1.5x upper limit of normal (ULN)
  • Glycated Hemoglobin (HbA1c): above 6.0%
  • Random plasma glucose >11 mM

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
BAT positive	Carbohydrate	Maximal activated supraclavicular BAT SUVmean \>1,5 g/ml-
BAT positive	Fat	Maximal activated supraclavicular BAT SUVmean \>1,5 g/ml-
BAT negative	Fat	Maximal activated supraclavicular BAT SUVmean \<1,5 g/ml
BAT negative	Protein	Maximal activated supraclavicular BAT SUVmean \<1,5 g/ml
BAT negative	Carbohydrate	Maximal activated supraclavicular BAT SUVmean \<1,5 g/ml
BAT positive	Protein	Maximal activated supraclavicular BAT SUVmean \>1,5 g/ml-

Primary Outcome Measures

Name	Time	Method
AUC Glucose	1h before and 5 hours after nutritional intervention	Area under the curve (AUC) of glucose after the oral glucose load in participants with functional BAT as compared to participants without functional BAT

Secondary Outcome Measures

Name	Time	Method
AUC triglycerides	1h before and 5 hours after nutritional intervention	AUC of plasma triglycerides after lipid test meal in participants with functional BAT as compared to participants without functional BAT.
AUC Branched chain amino acids	1h before and 5 hours after nutritional intervention	AUC of BCAAs after protein load in in participants with functional BAT as compared to participants without functional BAT
Diet induced thermogenesis	1h before and 5 hours after nutritional intervention	Diet-induced thermogenesis: AUC of EE above RMR in response to the respective macronutrient (carbohydrate, protein or fat). Measured by indirect calorimetry. The results for each macronutrient will be compared between the BAT positive and BAT negative participants.

Trial Locations

Locations (1)

University Hospital Basel, Dept. of Endocrinology; 🇨🇭 Basel, Switzerland