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临床试验/NCT03965130
NCT03965130已完成1 期

The Effect of Glucagon on Rates of Hepatic Mitochondrial Oxidation and Pyruvate Carboxylase Flux in Man Assessed by Positional Isotopomer NMR Tracer Analysis (PINTA)

Yale University1 个研究点 分布在 1 个国家目标入组 10 人开始时间: 2019年6月5日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
1 期
状态
已完成
入组人数
10
试验地点
1
主要终点
Rates of Hepatic Mitochondrial Oxidation

研究概览

简要总结

It is well established that alterations in the portal vein insulin:glucagon ratio play a major role in the dysregulated hepatic glucose metabolism in type 2 diabetes but the molecular mechanism by which glucagon promotes alterations in hepatic glucose production and mitochondrial oxidation remain poorly understood. This is borne out of the fact that both glucagon agonists and antagonists are being developed to treat type 2 diabetes with unclear mechanisms of action.

This study will directly assess rates of mitochondrial oxidation and pyruvate carboxylase flux for the first time in humans using PINTA analysis as well as the effects of glucagon. The results will have important implications for the possibility of intervening in the pathogenesis of non alcoholic fatty liver and type 2 diabetes via chronic dual GLP-1/glucagon receptor antagonism and provide an important rationale for why a dual agonist may be more efficacious for treatment of non alcoholic fatty liver and T2D than GLP-1 alone.

详细描述

Objectives:

To examine rates of hepatic mitochondrial oxidation in healthy volunteers with liver lipid less than 2%.

To examine the effects of glucagon on hepatic glucose and fat metabolism in vivo, this study will apply a novel Positional Isotopomer NMR Tracer Analysis (PINTA) method to quantify rates of hepatic mitochondrial oxidation and pyruvate carboxylase flux, which has been cross-validated in awake rodents and humans (Perry et al. Nature Communications 2017). Preliminary rodent studies have found that glucagon stimulates intrahepatic lipolysis through an InsP3R-I-dependent process, leading to increases in hepatic acetyl-CoA content, which allosterically activates pyruvate carboxylase activity and flux, and that this phenomenon explains its acute, transcription-independent effect to acutely stimulate hepatic gluconeogenesis in vivo (unpublished results). In addition, using PINTA analysis it has been shown that glucagon stimulates hepatic mitochondrial oxidation through calcium signaling in awake mice, and that this process can be exploited by short-term continuous glucagon treatment leading to two-fold increases in hepatic mitochondrial fat oxidation, which in turn results in large reductions in hepatic steatosis and marked improvements in glucose tolerance through reversal of hepatic insulin resistance in a high fat fed rat model of non alcoholic fatty liver.

Hypothesis:

  1. A physiological increase in plasma glucagon concentrations will promote a significant increase in rates of hepatic mitochondrial oxidation in healthy humans.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Crossover
主要目的
Basic Science
盲法
None

入排标准

年龄范围
21 Years 至 65 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Non smoking
  • Taking no medications except birth control

排除标准

  • Any systemic or organ disease
  • Taking any drug or medications other than birth control (women)

研究组 & 干预措施

Control

Experimental

The same participants will not receive glucagon during the PINTA study

干预措施: Control Study (Other)

Glucagon

Experimental

Participants will receive glucagon during the PINTA study

干预措施: Glucagon (Biological)

结局指标

主要结局

Rates of Hepatic Mitochondrial Oxidation

时间窗: 5 hours

Rates of pyruvate carboxylase flux and citrate synthesis flux will be assessed using GC/MS and NMR analyses of plasma glucose 13C enrichments after the \[3-13C\]lactate infusion

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Sponsor

研究点 (1)

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