Effect of Weight Loss on Body Composition and Metabolic Function in Women With Lipedema
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 19
- 试验地点
- 2
- 主要终点
- Change in thigh subcutaneous adipose tissue volume
研究概览
简要总结
Lipedema is a disorder characterized by massive, bilateral accumulation of fat below the waist and in the legs. Enlargement of the lower extremities is often accompanied by leg pain and accumulation of fluid. Little is known about the functional changes that lead to fat accumulation and pain in women with lipedema. The goals of this project are to conduct a comprehensive characterization of abdominal and femoral fat tissues in lean and obese women with lipedema and to evaluate the potential effect of diet-induced weight loss as a therapy.
Once enrolled in the study, the following tests will be conducted on lean women with lipedema: characterization of body composition (fat tissue distribution), insulin sensitivity (response to insulin) and adipose tissue biology. The following tests will be conducted on obese women with lipedema: characterization of body composition (fat tissue distribution), insulin sensitivity (response to insulin), adipose tissue biology, and immune system function/inflammation. As control, we will have BMI-matched women that are metabolically normal lean (MNL), metabolically normal obese (MNO) and metabolically abnormal obese (MAO) already analyzed in different studies at Washington University (IRB# 201512086). MNL, MAO and MNO subjects underwent the same testing described above for the lipedema. Therefore, we will use the data generated from IRB# 201512086 as comparison groups in the statistical analysis to understand differences and similarities between lipedema and obesity.
A second aim of the study is to determine the effect of diet-induced weight loss on body composition, insulin sensitivity, and adipose tissue biology in women with lipedema. The results from this second aim of the study will hopefully provide important insights on the efficacy of diet therapy in managing lipedema.
详细描述
Once informed consent has been obtained, participants will complete 1 screening visit.
The screening visit includes a medical history, physical examination, pregnancy test (for women of childbearing potential), blood tests, urine drug test, an oral glucose tolerance test, resting electrocardiogram (ECG), and questionnaires.
Baseline testing will be performed in 2 visits requiring 1 inpatient overnight stay and will require approximately 30 hours in total to complete testing. Testing will include imaging scans to determine thigh fat mass; abdominal (belly) fat mass and liver fat content; DXA scan to assess whole-body and leg fat mass; blood samples; hyperinsulinemic-euglycemic clamp procedure; immune system function/inflammation (performed exclusively in people with obesity and lipedema and BMI-matched controls); and adipose tissue (fat) biopsies.
Once Baseline Testing is completed, participants will start 5-10% dietitian and/or behaviorist guided weight-loss for about 4 to 6 months.
Participant will keep a food diary and have weekly visits (in person or remote) with a study dietitian and/or behaviorist.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 68 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Diagnosis of Lipedema
- •Lean women with lipedema (BMI >19.5 kg/m² and <26.0 kg/m²)
- •Women with obesity and lipedema (BMI >30.0 kg/m² and <50.0 kg/m²)
排除标准
- •Medical, surgical or biological menopause
- •Previous bariatric surgery
- •Diagnosis of Type 2 Diabetes
- •HbA1C <5.7%
- •Structured exercise >2 days/week for ≥35 minutes of intense exercise (e.g., jogging, activity that cause heavy breathing and sweating) or ≥150 minutes per week of structured exercise (e.g., brisk walking)
- •Unstable weight (>4% change in weight during the last 2 months before entering the study)
- •Significant organ system dysfunction (e.g., diabetes, severe pulmonary, kidney or cardiovascular disease)
- •Cancer or cancer that has been in remission for <5 years
- •Polycystic Ovary Syndrome
- •Major psychiatric illness
- •Conditions that render participant unable to complete all testing procedures (e.g., severe ambulatory impairments, limb amputations, or metal implants that interfere with imaging procedures; coagulation disorders)
- •Use of medications that are known to affect the study outcome measures (e.g., steroids, non-statin lipid-lowering medications) or increase the risk of study procedures (e.g., anticoagulants) and that cannot be temporarily discontinued for this study
- •Smoke cigarettes >10 cigarettes/week
- •Consume >14 units of alcohol per week
- •Pregnant or lactating women
- •Persons who are not able to grant voluntary informed consent
- •Persons who are unable or unwilling to follow the study protocol or who, for any reason, the research team considers not an appropriate candidate for this study, including non-compliance with screening appointments or study visits.
结局指标
主要结局
Change in thigh subcutaneous adipose tissue volume
时间窗: Before and after 5-10% weight loss (3-4 months)
Thigh subcutaneous adipose tissue volume assessed by magnetic resonance imaging.
Whole-body insulin sensitivity
时间窗: Baseline testing
Whole-body insulin sensitivity determined by using the hyperinsulinemic-euglycemic clamp procedure between women with obesity and women with obesity and lipedema.
次要结局
- Thigh subcutaneous adipose tissue volume(Baseline testing)
- Change in whole-body insulin sensitivity(Before and after 5-10% weight loss (3-4 months))
- Leg fat mass(Baseline testing)
- Change in leg fat mass(Before and after 5-10% weight loss (3-4 months))
- Adipose tissue immune cells(Baseline testing)
- Change in adipose tissue immune cells(Before and after 5-10% weight loss (3-4 months))