Regulation of Branched-chain Amino Acid Metabolism in Pre-Diabetes: Responses to Exercise Training and Gastric Bypass Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Branched-chain Amino Acid Metabolism
- Sponsor
- Duke University
- Enrollment
- 132
- Locations
- 1
- Primary Endpoint
- Changes in Branched-chain Amino Acid Metabolism in Pre-Diabetes at Baseline and post-intervention
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Elevated circulating levels of certain amino acids (the building blocks of protein) are strongly associated with insulin resistance. This study will investigate the metabolism of these amino acids in individuals with normal glucose metabolism compared to overweight or obese pre-diabetic individuals. The purpose of this study is to determine how elevated levels of the branched-chain amino acids may contribute to the development of insulin resistance and ultimately diabetes. An additional purpose is to determine whether exercise or gastric bypass (GBP) surgery intervention can correct aberrations in branched-chain amino acid metabolism as insulin sensitivity improves. This information will be used to further our understanding of the development of insulin resistance and type 2 diabetes in at-risk populations and potentially improve clinical treatment of such conditions.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Lean and Overweight Pre-diabetic (PD) groups: 40-65 years
- •Obese Gastric Bypass (GBP) patients: 30-65 years
- •Body Mass Index (BMI) within desired range for group:
- •Lean group: 18.0 - 24.9
- •Overweight PD group: 25.0 - 35.4
- •GBP group: 35.0 - 50.0
- •Fasting Plasma Glucose level within desired range for group:
- •Lean: \< 99 mg/dL
- •PD: \> 105 - \< 126 mg/dL
- •GBP: \> 99
Exclusion Criteria
- •Smoker: Tobacco use within the last 12 months
- •Dieting or intending to diet (excluding intention for gastric bypass procedure in GBP group)- Not weight stable for \> six months or weight loss exceeding five pounds in last six months
- •Use of potential confounding medications, e.g. Niacin containing drugs
- •History of diabetes, heart disease or taking medication for those conditions
- •History of hypertension (high blood pressure) not controlled with medication
- •Pregnant or intending to become pregnant
- •Unwillingness to participate in study visits, submit to skeletal muscle biopsies and all other study testing or continuously participate in the exercise training intervention program for six months if in overweight PD group
- •Orthopedic limitations, musculoskeletal disease and/or injury
- •Allergic to xylocaine
- •Inability to give blood continuously through an intravenous catheter
Outcomes
Primary Outcomes
Changes in Branched-chain Amino Acid Metabolism in Pre-Diabetes at Baseline and post-intervention
Time Frame: Baseline and pre- and post-intervention: 1) Lean Group-Baseline measures only; 2)Pre-Diabetic group - Baseline and 6-months post exercise intervention; 3) GBP group - Baseline and 3-months post Gastric Bypass Surgery
1. Lean Healthy Controls - Baseline only 2. Pre-Diabetic Group - Baseline and 6-months post the Aerobic and Resistance combined exercise training intervention 3. Gastric Bypass Group - Baseline and 3-months post Gastric Bypass surgery
Secondary Outcomes
- Changes in Insulin Sensitivity at Baseline and post-intervention(Baseline and pre- and post-intervention: 1) Lean Group-Baseline measures only; 2)Pre-Diabetic group - Baseline and 6-months post exercise intervention; 3) GBP group - Baseline and 3-months post Gastric Bypass Surgery)