- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT07566845
Women With Previous GDM and the Effects of HIIT. (GDM-HIIT)
Deep Metabolic and Molecular Phenotyping of Women With Previous Gestational Diabetes Mellitus and the Responses to High-intensity Interval Training.
The goal of this clinical trial is to investigate if women with previous gestational diabetes (pGDM) are characterized with unique metabolic and molecular alterations compared to women without pGDM. Furthermore if 8 weeks of high-intensity interval training (HIIT) can improve these alterations. The main questions we aim to answer are:
- Women with pGDM have metabolic abnormalities compared with women without pGDM, and that these metabolic abnormalities are explained by unique molecular abnormalities in skeletal muscle and adipose tissue.
- Eight weeks of HIIT combining rowing and cycling can markedly improve these metabolic abnormalities in women with pGDM and these improvements are explained by beneficial cellular and molecular changes in skeletal muscle and adipose tissue.
Researchers will compare 20 women with pGDM to 20 glucosetolerant without pGDM, who are matched on age, BMI and times since last pregnancy.
Participants will undergo a screening visit and examinations on two separate days before (day 1 and day 2) and two separate days after (day 3 and day 4) 8-weeks of HIIT, in all cases after an overnight fast (≥ 12 h). Day 1 and day 3 will include assessment of body composition and VO2max. On day 2 and day 4, the insulin sensitivity, substrate metabolism, and β-cell function of the participants will be examined by a Botnia-clamp combined by indirect calorimetry. Skeletal muscle biopsies from m. vastus lateralis and subcutaneous abdominal adipose tissue biopsies are taken in the basal and insulin-stimulated states of each clamp.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Tipo di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Region Syddanmark
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Odense, Region Syddanmark, Danimarca, 5000
- Steno Diabetes Center Odense, Odense University Hospital
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Age 25-45 years
- BMI 20-35 kg/m2
- 2-8 years since the last pregnancy
- No known diabetes or PCOS
- No previous bariatric surgery
- No known disease
- Be drug-naive
- Have a regular menstrual cycle (23-35 days)
- Not be pregnant or planning pregnancy during the study period
- Low or moderate level of physical activity must be (max 2 hours of moderate exercise weekly).
- All participants should be able to provide informed consent
- Women without pGDM must not have known hypertension or first-degree relatives with diabetes.
Exclusion Criteria:
- Abnormal cardiac stethoscopy, ECG or screening blood tests
- Positive plasma GAD-65 antibodies
- Positive plasma choriogonadotropine
- Undiagnosed T2D based on fasting plasma glucose (≥ 7.0 mmol/mol), plasma HbA1c (≥ 48 mmol/mol), or 2-h plasma glucose during an oral glucose tolerance test (OGTT) (≥ 11.1 mmol/mol)
- Dyslipidemia (plasma LDL-cholesterol > 5.0 mmol/l)
- In women with pGDM: Undiagnosed severe hypertension (blood pressure > 160/100)
- In women without pGDM: Undiagnosed hypertension (blood pressure >140/90 mmHg) or impaired glucose tolerance (fasting plasma glucose at 6.16.9 mmol/l, plasma HbA1c at 42-47 mmol/mol, or a 2-h glucose at 7.8-11.0 mmol/l during an OGTT).
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Prevenzione
- Assegnazione: Non randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Sperimentale: Women with previous gestational diabetes mellitus
Women with previous gestational diabetes mellitus, aged 25-45, who gave birth 2-8 years ago.
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The training intervention consists of 8-weeks of HIIT combining rowing and cycling on ergometers with two supervised sessions weekly in small groups of up to 10 participants.
All HIIT sessions will start with a 10-min warm-up period followed by training blocks of 5 x 1 min high-intensity intervals (100-110% of Wattmax corresponding to ≥ 85% of maximum heart rate (HRmax)) each interspersed by 1 min active or resting recovery.
Between the training blocks, the participants will have a 4-min break in which they shift from cycling to rowing or vice versa.
The number of training blocks will gradually increase from two to five blocks during the 8-week intervention period with one block being added every second week.
Halfway through the HIIT-protocol the workload will be adjusted according to a midway VO2max test.
Participants will wear a heart monitor during training sessions.
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Comparatore attivo: Women without previous gestational diabetes
Women without previous gestational diabetes mellitus, aged 25-45, who gave birth 2-8 years ago.
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The training intervention consists of 8-weeks of HIIT combining rowing and cycling on ergometers with two supervised sessions weekly in small groups of up to 10 participants.
All HIIT sessions will start with a 10-min warm-up period followed by training blocks of 5 x 1 min high-intensity intervals (100-110% of Wattmax corresponding to ≥ 85% of maximum heart rate (HRmax)) each interspersed by 1 min active or resting recovery.
Between the training blocks, the participants will have a 4-min break in which they shift from cycling to rowing or vice versa.
The number of training blocks will gradually increase from two to five blocks during the 8-week intervention period with one block being added every second week.
Halfway through the HIIT-protocol the workload will be adjusted according to a midway VO2max test.
Participants will wear a heart monitor during training sessions.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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β-cell function by OGTT
Lasso di tempo: At screening visit.
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Will be estimated as the disposition index (DI) by oral glucose tolerance test (OGTT) derived indices of insulin sensitivity and insulin secretion, after a 2-hour OGTT (75g) with measurement of plasma glucose, serum insulin and serum C-peptide at 0, 30 and 120 min.
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At screening visit.
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β-cell function by Botnia-clamp
Lasso di tempo: At examination day 2 and 4.
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β-cell function adjusted for insulin sensitivity will be determined by calculating the DI as a product of the acute insulin response to glucose (AIRg) and insulin-stimulated glucose infusion rate (GIR).
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At examination day 2 and 4.
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Whole body composition (lean body mass and fat mass)
Lasso di tempo: At examination day 1 and 3.
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Will be obtained by a dual-energy X-ray absorptiometry (DXA) scanning (Prodigy Advance, GE Healthcare, CHI, US)
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At examination day 1 and 3.
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Lean body mass
Lasso di tempo: At examination day 1 and 3.
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Will be obtained by a dual-energy X-ray absorptiometry (DXA) scanning (Prodigy Advance, GE Healthcare, CHI, US)
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At examination day 1 and 3.
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Fat mass
Lasso di tempo: At examination day 1 and 3.
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Will be obtained by a dual-energy X-ray absorptiometry (DXA) scanning (Prodigy Advance, GE Healthcare, CHI, US)
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At examination day 1 and 3.
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Cardiorespiratory fitness (maximal oxygen consumptions (VO2-max))
Lasso di tempo: At examination day 1 and 3.
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Will be determined by an incremental exercise test on a cycle ergometer (SRM Ergometer System, Jülich, DE) combined with mixed chamber cardiopulmonary exercise analyzer (Oxigraf, Model O2CPX, California, US)
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At examination day 1 and 3.
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Insulin sensitivity by Botnia-clamp
Lasso di tempo: At examination day 2 and 4.
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Consisting of a hyperinsulinemic-euglycemic clamp (insulin 40mU/min/m2 for 3 h) combined with a 60 min intravenous glucose tolerance test (IVGGT) using a glucose bolus (0.3 kg per kg body weight with a maximum of 25 g glucose).
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At examination day 2 and 4.
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Plasma-specific metabolomics by LC- and GC-MS
Lasso di tempo: At examination day 2 and 4.
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Liquid chromatography (LC)- and gas chromatography (GS)-based mass spectrometry (MS) will be used to detection, identification, and quantitation of very large numbers of metabolites in the micro- and nano-molar range in body fluids, such as blood.
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At examination day 2 and 4.
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Tissue-specific metabolomics by LC- and GC-MS
Lasso di tempo: At examination day 2 and 4.
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Liquid chromatography (LC)- and gas chromatography (GS)-based mass spectrometry (MS) will be used to detection, identification, and quantitation of very large numbers of metabolites in the micro- and nano-molar range in body tissues.
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At examination day 2 and 4.
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Proteomics
Lasso di tempo: At examination day 2 and 4.
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To identify biological processes and signaling networks altered in women with pGDM and changed in response to HIIT, we will apply unbiased mass-spectrometry based proteome analysis of the skeletal muscle and adipose tissue biopsies.
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At examination day 2 and 4.
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Phosphoproteomics
Lasso di tempo: At examination day 2 and 4.
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To identify biological processes and signaling networks altered in women with pGDM and changed in response to HIIT, we will apply unbiased mass-spectrometry based phosphoproteome analysis of the skeletal muscle and adipose tissue biopsies.
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At examination day 2 and 4.
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Transcriptional profiling and gene expression
Lasso di tempo: At examination day 2 and 4.
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High-resolution transcriptional profiling of abdominal adipose tissue and skeletal muscle biopsies will be performed using total RNA sequencing with next generation sequencing (TruSeq® Stranded Total RNA Library Prep Gold; Illumina). Gene expressions are quantified using Targeted quantitative real-time PCR (qRT-PCR) and Western Blotting. |
At examination day 2 and 4.
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Mitochondrial respiration
Lasso di tempo: At examination day 2 and 4.
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Will be measured on permeabilized muscle fibers, and analyzed by measuring oxygen consumption when adding substrates, uncouplers, and inhibitors to the chambers of a high-resolution oxygraphy.
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At examination day 2 and 4.
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Lipid droplets by TEM
Lasso di tempo: At examination day 2 and 4.
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The morphology, volume, and localization of lipid droplets in muscle biopsies from the study cohorts will be determined by Transmission Electron Microscopy (TEM).
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At examination day 2 and 4.
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Mitochondria by TEM
Lasso di tempo: At examination day 2 and 4.
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The morphology, volume, and localization of mitochondria in muscle biopsies from the study cohorts will be determined by Transmission Electron Microscopy (TEM).
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At examination day 2 and 4.
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Lipid droplet interaction with mitochondria by TEM
Lasso di tempo: At examination day 2 and 4.
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The the physical interaction between lipid droplets and mitochondria in muscle biopsies from the study cohorts will be determined by Transmission Electron Microscopy (TEM).
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At examination day 2 and 4.
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Protein abundance
Lasso di tempo: At examination day 2 and 4.
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Protein abundance will be studied in skeletal muscle and adipose tissue biopsies by Western blotting procedures.
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At examination day 2 and 4.
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Phosphorylation of enzymes
Lasso di tempo: At examination day 2 and 4.
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Phosphorylation of enzymes will be studied in skeletal muscle and adipose tissue biopsies by Western blotting procedures.
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At examination day 2 and 4.
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Lipid profile
Lasso di tempo: At examination day 2 and 4.
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Plasma total cholesterol, HDL-cholesterol, LDL-cholesterol, non-HDL-cholesterol and triglycerides determined by blood tests.
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At examination day 2 and 4.
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HbA1c
Lasso di tempo: At examination day 2 and 4.
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Determined by blood tests.
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At examination day 2 and 4.
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Insulin
Lasso di tempo: At examination day 2 and 4.
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Determined by blood tests.
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At examination day 2 and 4.
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Glucose
Lasso di tempo: At examination day 2 and 4.
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Determined by blood tests.
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At examination day 2 and 4.
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C-peptide
Lasso di tempo: At examination day 2 and 4.
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Determined by blood tests.
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At examination day 2 and 4.
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Levels of systemic low-grade inflammation
Lasso di tempo: At examination day 2 and 4.
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Circulating levels of adiponectin, leptin, interleukin-6 (IL-6), fibroblast growth factor 21 (FGF21), angiopoietin-like 4 (ANGPTL4) and growth differentiation factor 15 (GDF15) will be measured in bloodsamples.
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At examination day 2 and 4.
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Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: Kurt Højlund, Prof. Dr. med., Steno Diabetes Center Odense, Odense University Hospital
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Stimato)
Completamento dello studio (Stimato)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Malattie urogenitali
- Malattie del sistema endocrino
- Malattie urogenitali femminili e complicanze della gravidanza
- Malattie metaboliche
- Complicazioni della gravidanza
- Disturbi del metabolismo del glucosio
- Diabete mellito
- Malattie nutrizionali e metaboliche
- Diabete, gestazionale
- Diabete mellito, tipo 2
- Attività motoria
- Movimento
- Fenomeni fisiologici muscoloscheletrici
- Fenomeni fisiologici muscoloscheletrici e neurali
- Condizionamento fisico, umano
- Esercizio
- Allenamento a intervalli ad alta intensità
Altri numeri di identificazione dello studio
- 25/55674
Piano per i dati dei singoli partecipanti (IPD)
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