MedPath

Hormonal Regulation of Body Weight Maintenance

Not Applicable
Completed
Conditions
Insulin Resistance
Obesity
Hormone Disturbance
Weight Loss
Weight Gain
Adipose Tissue
Skeletal Muscle
Interventions
Behavioral: placebo
Behavioral: multimodal lifestyle intervention
Registration Number
NCT00850629
Lead Sponsor
Charite University, Berlin, Germany
Brief Summary

The investigators here propose to perform a collaborative clinical research effort including a randomized controlled trial investigating the mechanisms of weight maintenance and their relation to a lifestyle intervention in children, adolescents and adults. The detailed investigation and analysis of the variability and dynamics of the endocrine circuits responding to a negative energy balance and weight loss will be accompanied and enhanced by specific clinical projects targeting peripheral and central-nervous aspects of hormonal counter-regulation after weight loss. Mechanisms of endocrine counter-regulation and potential therapeutic approaches will be studied.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
286
Inclusion Criteria
  • BMI > 27 kg/m2 (adults)
Exclusion Criteria
  • weight loss of more than 5kg in the last 2 months

  • pregnancy, breastfeeding

  • patients with:

    • severe heart failure
    • impaired hepatic or renal function
    • anaemia
    • disturbed coagulation (biopsies will not be taken in those subjects)
    • infection, malabsorption
    • severe hypertension
    • cancer within the last 5 years
    • eating disorders or any other psychiatric condition that would interact with the trial intervention
    • any other endocrine disorder
  • changes of smoking habits or diets within the last 3 months prior to study inclusion

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placeboplaceboPlacebo
lifestyle interventionmultimodal lifestyle interventionAfter an initial weight loss, the weight regain will be measured during multimodal lifestyle intervention in children, adolescents and adults
Primary Outcome Measures
NameTimeMethod
BMI will be assessed during lifestyle intervention in (1) children and adolescents and (2) adults vs. placebo21 months

BMI (kg/m2) will be analyzed after intentional weight loss in two comparable parts of a randomized controlled trial including (1) children and adolescents and (2) adults. Therefore effects of a multimodal lifestyle intervention will be compared to placebo.

Secondary Outcome Measures
NameTimeMethod
Evaluation of catecholamines during follow up48 months

Measurement of catecholamines during follow up until the 48 months

Evaluation of leptin during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of leptin at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of catecholamines during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of catecholamines at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of glucagon-like peptide 1 (GLP1) during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of GLP1 at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of leptin during follow up48 months

Measurement of leptin during follow up until the 48 months

Evaluation of glucose-dependent insulinotropic polypeptide (GIP) during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of GIP at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of thyroid hormones during follow up48 months

Measurement of thyroid hormones during follow up until the 48 months

Evaluation of insulin during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of insulin at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of cortisol during follow up48 months

Measurement of cortisol during follow up until the 48 months

Evaluation of IGF1 during follow up48 months

Measurement of IGF1 during follow up until the 48 months

Evaluation of cortisol during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of cortisol at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of GLP1 during follow up48 months

Measurement of GLP1 during follow up until the 48 months

Evaluation of GIP during follow up48 months

Measurement of GIP during follow up until the 48 months

Evaluation of thyroid hormones during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of thyroid hormones at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of insulin during follow up48 months

Measurement of insulin during follow up until the 48 months

Evaluation of natriuretic peptide during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of natriuretic peptide at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Evaluation of natriuretic peptide during follow up48 months

Measurement of natriuretic peptide during follow up until the 48 months

Evaluation of respiratory coefficient during lifestyle interventionmonth -3, month 0, month 12, month 18, month 24, month 36, month 48

Measurement of respiratory coefficient at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and and after additional 36 months follow up

Prediction of body weight regainmonth 18, month 48

No additional measurement will be done. However, we will analyse the predictive impact of already measured parameters on long-term course of BMI (18 and 48 months) using mathematical models

Evaluation of insulin-like growth factor 1 (IGF1) during lifestyle interventionmonth -3, month 0, month 12, month 18

Measurement of IGF1 at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and after additional 6 months follow up

Prediction of energy expendituremonth 18, month 48

No additional measurement will be done. However, we will analyse the predictive impact of already measured parameters on energy expenditure (18 and 48 months) using mathematical models

body compositionmonth -3, month 0, month 12, month 18, month 24, month 36, month 48

Whole body fat mass (kg, %) will be measured at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and and after additional 36 months follow up

Measurement of messenger ribonucleic acid (mRNA) changes in adipose and skeletal muscle before (T-3), after weight loss (T0) and after as well as after 12 months randomized lifestyle intervention (or placebo)month -3, month 0, month 12

Measurement of systemic and tissue specific changes in adipose tissue and skeletal muscle using RNA sequencing (counts)

Prediction of insulin sensitivitymonth 18, month 48

No additional measurement will be done. However, we will analyse the predictive impact of already measured parameters on insulin sensitivity (18 and 48 months) using mathematical models

changes acylcarnitinesmonth 12, month 18, month 24, month 36, month 48

Analysis of acylcarnitines after 12 months randomized lifestyle intervention (or placebo) and and after additional 36 months follow up

Evaluation of blood pressure during lifestyle interventionmonth -3, month 0, month 12, month 18, month 24, month 36, month 48

Measurement of blood pressure at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and and after additional 36 months follow up

Evaluation of free fatty acids (FFAs) during lifestyle interventionmonth -3, month 0, month 12, month 18, month 24, month 36, month 48

Measurement of FFAs at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and and after additional 36 months follow up

Measurement of insulin sensitivitymonth -3, month 0, month 12

Measurement of systemic and tissue specific changes in adipose and muscle insulin sensitivity using hyperinsulinemic clamp (mg•kg-1•min-1/(mU•L-1)) before (T-3), after weight loss (T0) and after as well as after 12 months randomized lifestyle intervention (or placebo)

Prediction of muscle massmonth 18, month 48

No additional measurement will be done. However, we will analyse the predictive impact of already measured parameters on muscle mass (18 and 48 months) using mathematical models

Prediction of fat massmonth 18, month 48

No additional measurement will be done. However, we will analyse the predictive impact of already measured parameters on fat mass (18 and 48 months) using mathematical models

BMI course after a lifestyle intervention in (1) children and adolescents and (2) adults vs. placebomonth 24, month 36, month 48

BMI (kg/m2) after the randomized control trial (RCT) (18 months) will be analyzed up to 48 months.

changes of fatty acids during the interventionmonth -3, month 0, month 12, month 18, month 24, month 36, month 48

Analysis of fatty acids at baseline, after 3 months of weight loss, as well as after 12 months randomized lifestyle intervention (or placebo) and and after additional 36 months follow up

Trial Locations

Locations (1)

Charite

🇩🇪

Berlin, Germany

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