Adipose Tissue Pre and Post Bariatric Surgery

• Conditions: Obesity
• Interventions: Procedure: Bariatric surgery; Other: Blood sampling; Other: Blood pressure; Other: Anthropometric measurements; Other: Body composition; Other: Resting metabolic rate; Other: Food intake; Procedure: Adipose tissue biopsy

• Registration Number: NCT05304325
• Lead Sponsor: Institut de Recherches Cliniques de Montreal

Brief Summary

Published data suggest that inflammation and fibrosis of adipose tissue could be factors favoring the development of insulin resistance in obese individuals and that a decrease in the activity of the AMP-activity kinase protein (AMPK) could lead to these dysfunctions. However, very few data are available in humans.

There is also growing interest in persistent organic pollutants (POPs) as a cardiometabolic and type 2 diabetes (T2D) risk factor. There is some evidence to suggest that POPs directly contribute to lipid metabolism dysfunction and insulin resistance. Additionally, POPs are stocked in adipose tissue. The accumulation of POPs in adipose tissue therefore limits their bioavailability to other organs, thus reducing their systemic toxicity. It has been observed that a large amplitude weight loss leads to a significant increase in POPs in the blood.

The goal of this project is to identify adipose tissue factors/dysfunctions that contribute to insulin resistance and type 2 diabetes associated with obesity in humans and thus raise avenues for screening and treatment of these metabolic complications. More specifically, the objectives are:

* To study the relationship between AMPK, fibrosis and inflammation of adipose tissue and their role in the development of insulin resistance and T2D associated with obesity;

* To examine the relationship between POPs and the cardiometabolic profile.

Detailed Description

Not available

Study Timeline

• Study Start: 2012-04-25
• Status Verified: 2022-03
• Study First Submitted: 2022-03-14
• Study First Submitted QC: 2022-03-22
• Last Update Submitted: 2022-03-22
• Study First Posted: 2022-03-31
• Last Update Posted: 2022-03-31
• Primary Completion: 2022-07-31
• Study Completion: 2022-09-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 98

Inclusion Criteria

1. Awaiting bariatric surgery
2. BMI ≥ 35 kg/m2 without cardiometabolic complications or ≥ 30 kg/m2 if presence of type 2 diabetes or hypertension
3. ≥ 18 years old
4. Non smoker
5. Sedentary (less than 3 hours of regular physical activity per week)

Exclusion Criteria

1. Type 1 diabetes
2. Acute event in the last 3 months (myocardial infarction, cerebrovascular hemorrhage or transient cerebral ischemia, unstable angina, peripheral vascular disease, revascularization or angioplasty, recent hospitalization for more than 4 days)
3. Infection in the last month (fever, antibiotics treatment)
4. Cancer in the last 3 years
5. Chronic inflammatory disease
6. Pharmacologic treatment (any medication affecting glucose metabolism (except those for diabetes), hypotensive medication unless stable dose for at least 1 month, lipid-lowering medication unless stable dose for at least 1 month)
7. Uncontrolled disease of pituitary or thyroid gland
8. Bleeding disorders
9. Alcohol or drug abuses
10. Claustrophobia

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Obese insulin-resistant	Food intake	-
Obese with type 2 diabetes	Anthropometric measurements	-
Obese with type 2 diabetes	Body composition	-
Obese insulin-sensitive	Resting metabolic rate	-
Obese with type 2 diabetes	Blood pressure	-
Obese with type 2 diabetes	Bariatric surgery	-
Obese with type 2 diabetes	Blood sampling	-
Obese with type 2 diabetes	Resting metabolic rate	-
Obese insulin-sensitive	Bariatric surgery	-
Obese with type 2 diabetes	Food intake	-
Obese insulin-resistant	Resting metabolic rate	-
Obese insulin-resistant	Adipose tissue biopsy	-
Obese insulin-sensitive	Anthropometric measurements	-
Obese insulin-resistant	Blood pressure	-
Obese insulin-sensitive	Adipose tissue biopsy	-
Obese insulin-resistant	Blood sampling	-
Obese insulin-resistant	Anthropometric measurements	-
Obese with type 2 diabetes	Adipose tissue biopsy	-
Obese insulin-sensitive	Blood pressure	-
Obese insulin-sensitive	Body composition	-
Obese insulin-resistant	Body composition	-
Obese insulin-sensitive	Blood sampling	-
Obese insulin-sensitive	Food intake	-
Obese insulin-resistant	Bariatric surgery	-

Primary Outcome Measures

Name	Time	Method
Adipose tissue fibrosis using qRT-PCR, immunoblotting, histochemistry and immunohistochemistry	6 months after bariatric surgery

Secondary Outcome Measures

Name	Time	Method
Food quality using the Food Frequency Questionnaire	6 months after bariatric surgery
Persistant organic pollutants measured by high-resolution chromatography combined with high-resolution mass spectrometry	6 months after bariatric surgery
AMP-activated protein kinase	6 months after bariatric surgery
Calory intake	6 months after bariatric surgery
Inflammation in adipose tissue using qRT-PCR, immunoblotting and immunohistochemistry	6 months after bariatric surgery

Trial Locations

Locations (1)

Institut de recherches cliniques de Montréal; 🇨🇦 Montreal, Quebec, Canada