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Mechanisms of Age-Related Muscle Loss

2017년 4월 12일 업데이트: University of Birmingham

Influence of Increasing Physical Activity on Body Composition, Metabolic Health and Muscle Anabolism in Old Obese Adults

Two independent, but interrelated conditions that have a growing impact on healthy life expectancy and health care costs in developed nations are the age related loss of muscle mass (sarcopenia) and obesity. Sarcopenia affects approximately one third of adults over 60 years of age and more than 50% of those over 80 years, which is of concern when one considers that the most rapidly expanding population demographic in the UK is adults >80 years of age.

Skeletal muscle is important in regulating blood glucose and insulin sensitivity. Thus, sarcopenia may play a role in exacerbating insulin resistance and progression toward Type II diabetes (T2D). Indeed, the highest incidence of T2D in the UK has been noted to occur in adults >65 years. Obesity is a major risk factor for chronic diseases including T2D and cardiovascular disease. Progression towards obesity is associated with a concomitant decrease in muscle mass, producing an unfavorable ratio of fat to muscle. Thus, obesity in old age may exacerbate the progression of sarcopenia.

For the proposed study the investigators will conduct preliminary laboratory tests to characterize body composition, insulin sensitivity, systemic inflammation, aerobic capacity and muscle protein metabolism (in the fasted and fed state) in healthy older and obese older adults for comparison against healthy young individuals.

연구 개요

상태

완전한

정황

상세 설명

Twenty healthy young (aged 18-35), healthy old and obese older adults (aged ≥65) will be recruited. Old groups will be matched for age and sexual dimorphism. Obese participants will be classed as prediabetic based on a fasting A1C between 5.7 and 6.4% and impaired fasting glucose between 5.6 and 6.9 mmol/L. Obese participants will habitually take between 2000-5000 steps per day, whilst healthy young and old participants will complete >5000 steps per day.

VISIT 1 Preliminary assessments - Over a 3day period, participants will be instructed to wear a portable pedometer, to allow visual feedback on step count, and an armband accelerometer to determine habitual daily energy expenditure and the intensity of physical activity. In addition, participants will log their dietary intake.

VISIT 2 Body composition and metabolic profiling After consuming a standardized meal the previous evening, participants will report to the Wellcome Trust Clinical Research Facility in a 10 hour fasted state at approximately 09.00. Participants will be weighed in light clothing and blood pressure will be measured. Thereafter, body composition will be determined using dual energy Xray absorptiometry (DXA) and resting metabolic rate (RMR) via ventilated hood and continuous gas collection. Following RMR, a catheter will be inserted into a forearm vein and a resting, fasted blood sample obtained to determine postprandial insulin sensitivity using the HOMA-IR index.

VISIT 3 Muscle protein metabolism Participants will return to the lab in a 10 hour fasted-state at approximately 07.00 having refrained from strenuous exercise for 48 hours previously. Catheters will be inserted into the antecubital vein of both forearms. A primed, continuous infusion of isotopically labeled amino acid will be infused into one arm and the other will be used for frequent blood sampling. Muscle biopsies will be obtained 3 and 7 hours into the infusion to determine postabsorptive and postprandial rates of muscle protein synthesis.

연구 유형

관찰

등록 (실제)

38

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

65년 (고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

샘플링 방법

비확률 샘플

연구 인구

  • Young lean healthy inidivduals aged 18-35.
  • Lean healthy older individuals aged 65-85.
  • Obese inactive older individuals aged 65-85.

설명

Inclusion Criteria:

  1. Age: 65-85 years old for older individuals and 18-35 years for younger individuals
  2. Sex: Men and women
  3. BMI: 18-25 kg/m2 for healthy non-obese young and elderly control group and >30 kg/m2 for obese older participants.
  4. Diagnosis / General Health: For healthy elderly, good general health (no known cardiovascular or metabolic disease), nonsmokers, accustomed to normal levels of activity as assessed by pedometer and accelerometer devices during baseline testing (>5000 steps per day). For obese elderly, general good health (no known cardiovascular or metabolic disease), nonsmokers, with low levels of physical activity as assessed by pedometer and accelerometer devices during baseline testing (<4000 steps per day). Fasting blood glucose must be <5.6 mmol/mL for healthy older adults and between 5.6 and 6.9 mmol/mL for obese older adults. Fasting concentrations of A1C should be <5.7% for healthy and between 5.7 and 6.4% for prediabetic older adults. These values are in line with the type 2 diabetes classification listed by The American Diabetes Association (DIABETES CARE, VOLUME 33, SUPPLEMENT 1, JANUARY 2010).
  5. Compliance: understands and is willing, able and likely to comply with all study procedures and restrictions.
  6. Consent: demonstrates understanding of the study and willingness to participate as evidenced by voluntary written informed consent.

Exclusion Criteria:

  1. Health problems such as: heart disease, rheumatoid arthritis, diabetes, poor lung function, uncontrolled hypertension, or any health conditions that might put the participant at risk for this study.
  2. Recent failure to obtain clearance for exercise participation from family physician/medical doctor.
  3. Regular consumption of any analgesic or anti-inflammatory drug(s), prescription or nonprescription.
  4. Taking any medications known to affect protein metabolism (i.e. b-blockers, corticosteroids, nonsteroidal anti-inflammatories, or prescription strength acne medications). Medications will be deemed inappropriate based on the Chief Investigators discretion
  5. Individuals who complete fewer than 1000 steps per day (as assessed by pedometer prior to the study) or those who participate in regular structured exercise (running or strength training) more than 2 times per week.
  6. Participants will be excluded if they fail to comply with the physical activity demands of the study. Exclusion will occur if the following are not met. Failure to meet the expected daily step count target on more than one occasion per week during the 21 day intervention will be deemed as failure to comply.
  7. Participants who have previously (within 5 years of the present study) undergone infusion of an amino acid tracer and/or had 4 or more muscle biopsies obtained from the quadriceps region will be excluded.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 관찰 모델: 보병대
  • 시간 관점: 단면

코호트 및 개입

그룹/코호트
Obese older individuals
Lean older individuals
Young lean individuals

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Myofibrillar protein synthesis rates via mass spectrometry
기간: 2 years
Postabsorptive and postprandial myofibrillar protein synthesis rates between groups and following the activity intervention
2 years

2차 결과 측정

결과 측정
측정값 설명
기간
Muscle fibre properties via immunohistochemical staining
기간: 2 years
muscle fibre type (i.e. I and II) and cross sectional area
2 years
Muscle fibre lipid content immunofluorescent staining
기간: 2 years
Intramyocellular lipid content in Type I and II fibres
2 years
Physical activity levels via accelerometry
기간: 2 years
Daily average time spent in sedentary, light, moderate or vigorous intensity activity
2 years
Inflammation via plasma/insulin assays
기간: 2 years
Blood markers of inflammation, interleukin 6 and c-reactive protein
2 years
Insulin sensitivity via plasma assays
기간: 2 years
Blood samples will be analyzed for insulin, glucose and hbA1C for indication of whole-body insulin sensitivity
2 years
Body composition via dual x-ray absorptiometry
기간: 2 years
DXA-derived fat and fat free mass will be measured
2 years
Intramuscular signaling via western blot
기간: 2 years
Western blots for phosphorylation of key anabolic signaling proteins
2 years
Dietary intake via dietary logs
기간: 2 years
Diet logs will be assessed for total energy and macronutrient intake
2 years
Daily step count by pedometer
기간: 2 years
Average daily step count assessed via waist worn pedometer
2 years

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여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

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연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2014년 8월 1일

기본 완료 (실제)

2016년 3월 1일

연구 완료 (실제)

2016년 8월 1일

연구 등록 날짜

최초 제출

2017년 3월 28일

QC 기준을 충족하는 최초 제출

2017년 4월 12일

처음 게시됨 (실제)

2017년 4월 13일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2017년 4월 13일

QC 기준을 충족하는 마지막 업데이트 제출

2017년 4월 12일

마지막으로 확인됨

2017년 4월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • RG-13_183

개별 참가자 데이터(IPD) 계획

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약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

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미국 FDA 규제 기기 제품 연구

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