De Novo Lipogenesis and Insulin Sensitivity in Obese (DELISA)

February 14, 2023 updated by: Michaela Siklova, Charles University, Czech Republic

The Role of De Novo Lipogenesis in Regulation of Insulin Sensitivity in Adipose Tissue in Obese

Disturbances of de novo lipogenesis (DNL) are one of the features of dysfunction of adipose tissue (AT). Disturbances of DNL play a role in development of metabolic complications of obesity. The goal of this project is to investigate novel pathways of DNL regulation. DNL will be studied during nutritional interventions in healthy and obese subjects in exposure to 2-days high carbohydrate diet preceded by a) 2-days fasting b) several weeks´ ketogenic diet. This nutritional protocol creates conditions for the study of prominent changes in DNL: suppression of DNL during fasting or ketogenic diet followed by stimulation during high-carbohydrate diet. Systemic phenotypic features and molecular indices of DNL regulation in AT will be followed during the protocols. Specific attention will be paid to newly reported pathway- hormone sensitive lipase and transcription factor ChREBP. The results will contribute to development of pharmacological approaches in the treatment of metabolic complications of obesity, targeted selectively to AT, without side effects in other tissues.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The main goal of the proposed project is to characterize the regulation of de novo lipogenesis in AT, a pathway strongly associated with insulin sensitivity in humans. The project should provide information that will bring proof-of-concept for the development of AT DNL-targeting therapeutic strategies to decrease the metabolic risk in obese individuals. Two protocols in lean and obese women to modulate (inhibit/induce) DNL will be implemented: 1) two days of fasting followed by two days of high-carbohydrate diet refeeding (FAST/RF) in lean and obese women; 2) "fasting-mimicking" intervention in obese women with high fat low carbohydrate ketogenic diet followed by two days of high-carbohydrate diet refeeding (KETO/RF). KETO diet should provide long lasting AT DNL inhibition, and as such it should further highlight the processes necessary for DNL activation in the refeeding phase. The unique protocols proposed in the application will allow to investigate in humans the relationship between AT DNL and whole body insulin sensitivity and glucose tolerance. Moreover, the state of the art experimental methodologies applied for the analyses of AT samples should uncover the possible mechanisms of regulation of DNL by ChREBP, HSL and other factors as well as the related AT secretory capacity in humans. The findings obtained in lean subjects will be compared to obese subjects, as the deregulated response of these pathways might be expected. The project will provide a proof-of-principle for the role of AT DNL in the regulation of insulin sensitivity in lean and obese individuals. The results will indicate novel pathways for future development of drugs targeting the relevant sites in AT in the context of treatment of obesity-induced insulin resistance and associated disorders.

Study Type

Interventional

Enrollment (Actual)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Czechia
      • Prague, Czechia
        • Faculty Hospital Kralovske Vinohrady
      • Prague, Czechia, 100 00
        • Charles University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

25 years to 45 years (Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • sedentary premenopausal women
  • lean (n=20-25, age 25-40 years, BMI 20-25 kg/m2)
  • obese (n=20-25, age 25-40 years, BMI 30-40 kg/m)

Exclusion Criteria:

  • diagnosed cancer
  • diabetes (T1DM and T2DM)
  • liver and renal diseases
  • major cardiovascular event
  • bariatric surgery
  • allergy to lidocaine
  • positive serology for hepatitis (B and C) and HIV
  • smoking above 10 cigarettes/day, alcohol consumption above 66g/day
  • sleep apnea
  • poor venous status
  • weight-change more than 3kg in last 3 months
  • untreated hyper- or hypo-thyroidism
  • long term use of medication and/or steroids
  • shift workers and individuals with abnormal sleep/wake pattern

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: FAST Lean
Short-term fasting (FAST), comparator group of lean subjects
Behavioral: Fasting/refeeding
2-days fasting followed by 2-days of refeeding. During the fasting period the subjects will be hospitalized to control their state of health and ensure fasting compliance. During refeeding the standardized meals will be provided to cover individual daily requirements (60% carbohydrates, 15% protein, 25 % fat).
Other Names:
  • FAST obese
Experimental: FAST Obese
Short-term fasting (FAST), experimental group of obese subjects
Behavioral: Fasting/refeeding
2-days fasting followed by 2-days of refeeding. During the fasting period the subjects will be hospitalized to control their state of health and ensure fasting compliance. During refeeding the standardized meals will be provided to cover individual daily requirements (60% carbohydrates, 15% protein, 25 % fat).
Other Names:
  • FAST obese
Experimental: KETO Obese
Medium-term ketogenic diet intervention (KETO), experimental group of obese subjects
Behavioral: Ketogenic diet/ fasting
1 month of fasting-mimicking ketogenic diet and subsequent 2-days of refeeding. The subjects will be instructed by nutritional specialist to follow isocaloric ketogenic diet consisting of 6% carbohydrates, 17 % of proteins and 77% fat to cover individual energy demand. During refeeding the standardized meals will be provided to cover individual daily requirements (60% carbohydrates, 15% protein, 25 % fat).
Other Names:
  • KETO obese

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Insulin sensitivity
Time Frame: through study completion, an average of 1 year
Change in insulin sensitivity index (ΔiAUC insulin/ΔiAUC glucose from OGTT)
through study completion, an average of 1 year
De Novo Lipogenesis in adipose tissue
Time Frame: through study completion, an average of 1 year
Change in mRNA expression of lipogenic genes and by targeted and non-targeted lipid analysis (ΔCT)
through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
gene expression profiling of adipose tissue
Time Frame: through study completion, an average of 1 year
Change in long non-coding RNA analysis by microarrays (ΔCT)
through study completion, an average of 1 year

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Exploratory outcome into adipose tissue lipolysis
Time Frame: through study completion, an average of 1 year
Change in glycerol, FFA concentration in AT explants
through study completion, an average of 1 year
Exploratory outcome into liver lipogenesis
Time Frame: through study completion, an average of 1 year
Change in amount of liver fat and VLDL-TG composition
through study completion, an average of 1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Charles University, Czech Republic

Collaborators

Institut National de la Santé Et de la Recherche Médicale, France
Faculty Hospital Kralovske Vinohrady

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2019

Primary Completion (Actual)

March 11, 2022

Study Completion (Actual)

March 11, 2022

Study Registration Dates

First Submitted

January 23, 2020

First Submitted That Met QC Criteria

February 6, 2020

First Posted (Actual)

February 7, 2020

Study Record Updates

Last Update Posted (Actual)

February 15, 2023

Last Update Submitted That Met QC Criteria

February 14, 2023

Last Verified

February 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NV19-01-00263

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

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