- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04056000
Lipodystrophy and Fat Metabolism During Exercise (FAT)
The Regulation of Fat Metabolism in a Cyclist With Lipodystrophy: a Case Study
Mandibular dysplasia with deafness and progeroid features (MDP) syndrome is a rare genetic metabolic disorder that causes lipodystrophy: the inability of the body to store subcutaneous adipose tissue (fat under the skin). This creates a unique scenario where any ingested fat is diverted to the abdomen and liver, often leading to diabetes.
The investigators have an opportunity to study an individual with MDP who has competed in and won national para-cycling championships and is able to prevent/control his diabetes by regular bicycle training. He has approached us for advice on nutritional strategies to improve his cycling performance, and insight into how he uses fat during exercise.
The investigators also wish to study a moderately-trained cyclist with Familial partial lipodystrophy (FPL). Those with FPL show a different pattern of lipodystrophy than those with MDP, allowing us to further increase the investigator's understanding of fat utilisation in those with lipodystrophy during exercise.
The investigators know how subcutaneous fat is used during exercise, and how duration, nutrition, carbohydrate availability, and exercise intensity can affect this. The investigators aim to investigate these processes during exercise in MDP and FPL. This will potentially provide nutrition and performance advice to the individuals, and insight on fat use in lipodystrophy and diabetes.
Study Overview
Status
Conditions
Detailed Description
During prolonged sub-maximal endurance exercise, both fat and carbohydrate are readily used substrates. The relative contribution and regulation of either is dependent on substrate availability (endogenous and exogenous), the duration of exercise, and the intensity of exercise. For example, exercising under fasted or caffeine supplemented conditions increases adipose tissue lipolysis, free fatty acid availability, and thus fat utilisation, whilst exercising under fed or carbohydrate loaded conditions increases glucose availability from elevated liver and muscle glycogen stores, and thus carbohydrate utilisation. This is important during prolonged sub-maximal exercise because when the limited endogenous carbohydrate stores are depleted, the body must rely more on fat. However, it is not known whether this regulation is present in conditions such as MDP and FPL where there is essentially no adipose tissue.
The investigators have an opportunity to study an individual with MDP who has competed in and won national para-cycling championships. He has approached us for advice on nutritional strategies to improve his cycling performance, and insight into how he uses fat during exercise. Intriguingly, the individual has provided anecdotal evidence that exercising under fasted conditions severely impairs his performance but that the use of caffeine improves his performance. He also states that he uses carbohydrate feeding strategies before and during prolonged exercise but is unsure whether it helps or not. This raises two fundamental questions that should be answered before any nutritional advice should be given (e.g. should a pre-exercise fat feeding or low glycemic index carbohydrate strategy be adopted?):
- Do fasting and caffeine stimulate lipolysis in lipodystrophy and, if so, where is the fat coming from?
- Does carbohydrate feeding before exercise impair lipolysis in lipodystrophy?
In order to answer these questions, the investigators need to directly measure rates of fat and carbohydrate utilisation from the circulation and muscle stores during exercise in the individual and a control participant using a stable isotope infusion approach. As well as providing results of significant scientific interest to the lipodystrophy field (researchers, clinicians, patients) and answering fundamental exercise physiology questions on substrate availability, the investigators hope that the outcomes will offer a substantial platform for improving the participant's knowledge of exercise nutrition and exercise performance.
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Devon
-
Exeter, Devon, United Kingdom, EX4 4JA
- School of Sport and Health Sciences
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
SUBJECT WITH FPL
Inclusion:
• Already known to researchers. Male, 29 years old.
CONTROL SUBJECT 1
Inclusion:
- Highly trained, elite-level cyclist (VO2max > 80 ml/kg/min)
- Registered with, and racing under the jurisdiction of, British Cycling
- ~< 10% of body fat
- Male
- 18 - 35 years old
Exclusion:
- Any diagnosed metabolic impairment, as this may affect normal metabolism.
- Any diagnosed cardiovascular disease or hypertension to avoid any complications associated with heavy exercise.
- Chronic use of any prescribed or over-the-counter pharmaceuticals.
CONTROL SUBJECT 2
Inclusion:
- Recreationally active, preferably with experience of cycling training.
- Similar (± 5 ml⋅kg-1⋅min-1) VO2max¬ to that of the participant with MDP
Exclusion:
- Any diagnosed metabolic impairment, as this may affect normal metabolism.
- Any diagnosed cardiovascular disease or hypertension to avoid any complications associated with heavy exercise.
- Chronic use of any prescribed or over-the-counter pharmaceuticals.
SUBJECT WITH FPL
Inclusion:
- Recreationally active, preferably with experience of cycling training.
- Similar (± 5 ml⋅kg-1⋅min-1) VO2max¬ to that of the participant with MDP
- Diagnosis with FPL
Exclusion:
- Female
- Any diagnosed cardiovascular disease or hypertension to avoid any complications associated with heavy exercise.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Exercising following the ingestion of a high-carbohydrate br
60 minutes of cycling, with the ingestion of a high-carbohydrate breakfast and 200 mg of caffeine.
|
200 mg of caffeine, 60 minutes before exercise
Ingestion of a high-carbohydrate breakfast 60 minutes before exercise
See intervention name
|
EXPERIMENTAL: Exercising following the ingestion of caffeine only
60 minutes of cycling, with the ingestion of 200 mg of caffeine.
|
200 mg of caffeine, 60 minutes before exercise
See intervention name
|
EXPERIMENTAL: Exercising in the absence of breakfast or caffeine ingestion
60 minutes of cycling, without the ingestion of breakfast, or caffeine.
|
See intervention name
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Substrate utilisation
Time Frame: Throughout the 60 minute cycle
|
n..b. Please be aware that the below is a single, composite measure, wherein no single outcome measure cannot exist without the other. As such, it is presented as is, below. How carbohydrate and caffeine ingestion can affect the contribution to energy expenditure during 1 hour of exercise at 55%Wmax from:
This will be calculated from
|
Throughout the 60 minute cycle
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Heart rate
Time Frame: Throughout the 60 minute cycle
|
Heart rate will be measured throughout with the use of a heart rate monitor.
|
Throughout the 60 minute cycle
|
Plasma glucose concentrations
Time Frame: Throughout the 60 minute cycle
|
A cannula will be used to draw blood from subjects at several time points.
Whole blood samples will be analysed immediately for plasma glucose.
|
Throughout the 60 minute cycle
|
Plasma lactate concentrations
Time Frame: Throughout the 60 minute cycle
|
A cannula will be used to draw blood from subjects at several time points.
Whole blood samples will be analysed immediately for plasma lactate.
|
Throughout the 60 minute cycle
|
Plasma NEFA concentrations
Time Frame: Throughout the 60 minute cycle
|
A cannula will be used to draw blood from subjects at several time points.
At the end of the trial, plasma samples will be moved to a -80°C freezer for later analysis for NEFA.
|
Throughout the 60 minute cycle
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Andrew Davenport, MSc, The University of Exeter
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Metabolic Diseases
- Skin Diseases
- Genetic Diseases, Inborn
- Lipid Metabolism Disorders
- Laminopathies
- Skin Diseases, Metabolic
- Lipodystrophy
- Lipodystrophy, Familial Partial
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Purinergic Antagonists
- Purinergic Agents
- Phosphodiesterase Inhibitors
- Purinergic P1 Receptor Antagonists
- Central Nervous System Stimulants
- Caffeine
Other Study ID Numbers
- 258840
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Healthy
-
Prevent Age Resort "Pervaya Liniya"RecruitingHealthy Aging | Healthy Diet | Healthy LifestyleRussian Federation
-
Maastricht University Medical CenterCompletedHealthy Volunteers | Healthy Subjects | Healthy AdultsNetherlands
-
Yale UniversityNot yet recruitingHealth-related Benefits of Introducing Table Olives Into the Diet of Young Adults: Olives For HealthHealthy Diet | Healthy Lifestyle | Healthy Nutrition | CholesterolUnited States
-
Hasselt UniversityRecruitingHealthy | Healthy AgingBelgium
-
Galera Therapeutics, Inc.Syneos HealthCompleted
-
Galera Therapeutics, Inc.Syneos HealthCompletedHealthy | Healthy VolunteersAustralia
-
University of PennsylvaniaActive, not recruitingHealthy | Healthy AgingUnited States
-
Chalmers University of TechnologyGöteborg UniversityCompletedHealthy | Nutrition, HealthySweden
-
University of ManitobaNot yet recruitingHealthy | Healthy Diet
Clinical Trials on Caffeine
-
Southern Illinois University CarbondaleCompleted
-
Sharp HealthCareCompletedCaffeineUnited States
-
University of TorontoCanadian Institutes of Health Research (CIHR); Nutrigenomix Inc.Unknown
-
Pennington Biomedical Research CenterCompletedHealthy VolunteersUnited States
-
Vienna Institute for Research in Ocular SurgeryUnknown
-
Seoul St. Mary's HospitalCompletedApnea of Prematurity | Caffeine | PretermKorea, Republic of
-
University of ExeterCompleted
-
David Grant U.S. Air Force Medical CenterWithdrawnCardiovascular InjuryUnited States
-
St. Mary's University, TwickenhamNot yet recruiting
-
Escola Superior de Tecnologia da Saúde de CoimbraCompleted