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Nicotinamide Adenine Dinucleotide and Skeletal Muscle Metabolic Phenotype

Phase 2
Conditions
Aging
Interventions
Dietary Supplement: Nicotinamide Riboside
Other: Placebo
Registration Number
NCT02950441
Lead Sponsor
University of Birmingham
Brief Summary

This study is designed to assess the physiological consequences of elevating Nicotinamide Adenine Dinucleotide (NAD+) availability using Nicotinamide Riboside (NR) supplementation in skeletal muscle tissue, and examine its effect upon muscle metabolic phenotype.

Detailed Description

-NAD+ sensitive metabolic decline in ageing, including sarcopenia, leads to a reduction in energy metabolism, contribute to chronic inflammation, disposing individuals to metabolic disease and overall decreased later-life health. Prominent metabolic changes include a decline in NAD+ content and deterioration in muscle NAD+ mediated signalling and mitochondrial function, ultimately compromising skeletal muscle and whole body energy homeostasis.

The most efficient means to boost NAD+ in muscle appears to be oral delivery of NR, and participants will be supplemented with 1000mg NR (2x x250mg tablets twice daily) for 3 weeks.

* Hypothesis: elevating skeletal muscle NAD+ bioavailability using NR supplementation will increase markers of mitochondrial function and that will manifest as a more favourable metabolic profile.

* Study Setting: the study will be carried out at the NIHR/Wellcome Trust Clinical Research Facility, Queen Elizabeth Hospital Birmingham.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
12
Inclusion Criteria
  • Male sex
  • Age 70-80 years
  • BMI 20-30kg/m2
  • Participants who are able to discontinue aspirin for 3 days prior to the muscle biopsy
  • Participants who are able to discontinue statins and vitamin D supplements for a week before the second visit and for the duration of the study
Exclusion Criteria
  • Serious active medical conditions including inflammatory diseases or malignancies
  • Significant past medical history including diabetes mellitus, ischaemic heart disease, cerebrovascular disease, significant respiratory disease requiring medication, epilepsy
  • High blood pressure (BP>160/100mmHg)
  • Oral Anticoagulants (like Warfarin, Dabigatran, Rivaroxaban) or Clopidogrel therapy which will increase the risk of bruising following a muscle biopsy

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Nicotinamide RibosideNicotinamide Riboside1000mg (2x250mg tablets twice daily)
PlaceboPlaceboTwo tablets twice daily
Primary Outcome Measures
NameTimeMethod
Skeletal muscle NAD+ levels in vastus lateralis biopsy using targeted metabolomicsFollowing 3 weeks of NR supplementation
Mitochondrial function assessment in skeletal muscle using high resolution respirometryFollowing 3 weeks of NR supplementation

Mitochondrial function assessment on muscle biopsies using high resolution respirometry

Secondary Outcome Measures
NameTimeMethod
Improvement in lipid profileFollowing 3 weeks of NR supplementation
24 hour urine collection - NAD+ metabolomics and changes in steroid ratios using Gas chromatography/ mass spectrometryFollowing 3 weeks of NR supplementation
Improvement in response to oral glucose tolerance test/HOMA-IRFollowing 3 weeks of NR supplementation
Muscle Arterio-Venous Difference - Tissue-specific metabolite trafficking, oxygen consumption and CO2 productionFollowing 3 weeks of NR supplementation
Changes in resting metabolic rate using indirect calorimetryFollowing 3 weeks of NR supplementation
Muscle strength - grip testingFollowing 3 weeks of NR supplementation
Muscle biopsy: adaptive expression profile (genomic)Following 3 weeks of NR supplementation

Trial Locations

Locations (1)

University Hospitals Birmingham NHS Foundation Trust

🇬🇧

Birmingham, West Midlands, United Kingdom

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