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Completed

NCT Number: NCT01748994

Cellular Dynamics of Subcutaneous Fat Distribution in Obese Women

The body shape of obese women varies between having the majority of fat either above the waist ("apple" shape) or below the waist ("pear" shape). The study will investigate what restricts: apple"-shaped women from being "pear"-shaped at the cellular level. Since "pear" shaped women tend to have better health, this study will open the door to future research in regulating body shape and thus improving health.

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Key information

Age range

18 year–40 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States

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About this study

Adipose tissue expandability and the distribution of stored fat in the body are stronger predictors of health risk. A better understanding of the factors that determine regional fat mass growth may lead to developing new strategies for prevention or treatment of metabolic complications of obesity. The objective of this proposal is to study the responsiveness of different fat depots to adipogenic stimulation in upper-body and lower-body obese women.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • You are a pre-menopausal woman between 18-40 years of age
  • Your Body Mass Index (BMI, weight-to-height2 ratio) is 27 - 38 kg/m2, inclusive
  • The ratio of your waist-to-hip circumferences is either >0.84 ("apple"-type body shape) or <0.77 ("pear"-type body shape)
  • You are willing to undergo a drug intervention for 16 weeks
  • You are willing to drink heavy water [similar to the ordinary water that is highly enriched in the naturally occurring stable (non-radioactive) form of hydrogen, deuterium; also called deuterium-labeled water] for 8 weeks before the beginning and during the second half of the drug intervention; you will need 24-hours access to a refrigerator for storage of the water.
  • You agree to use a double barrier method as a form of birth control to prevent pregnancy. Oral contraceptives (birth control pills) are not allowed in the study. Acceptable methods of birth control are condoms, spermicide, IUD (intrauterine device, must be hormone free - see list in clinic), diaphragm and abstinence. An example of a double barrier method would be condoms plus spermicide, etc.

Exclusion criteria

  • You have gained or lost more than 4.5 lb (2 kg) in the last 3 months
  • You have had significant changes in the diet or level of physical activity within the past month
  • You have a blood sugar of greater than 100 or a diagnosis of diabetes.
  • You have abnormal liver enzyme values from your blood work
  • You have a history of heart, kidney, lung, liver, and thyroid disease
  • You have an average blood pressure >140/90 at your screening visit
  • Have you had a positive test for human immunodeficiency virus (HIV), hepatitis B or hepatitis C?
  • You require chronic use of medications including diuretics, steroids, thyroid hormones, and adrenergic-stimulating agents (bronchodilators, nasal decongestants)

Treatment and study plan

pioglitazone

Drug

30mg per day for four months

Other names: Actos

Placebo

Drug

Primary outcomes

  1. In Vivo Adipose Cell Formation (Adipogenesis)

    Time frame: Change from baseline in adipogenesis at 16 weeks

    Following the consumption of water labeled with the stable isotope deuterium (2H2O; heavy water), adipose tissue biopsies from the subcutaneous abdominal and femoral (thigh) depots will be collected. The 2H from the heavy water is enriched into the DNA of newly synthesized cells. Measures of DNA synthesis (obtained via gas chromatography and mass spectrometry analysis of 2H-enrichment) denote new adipose cell formation, or adipogenesis. The primary outcome is to assess the change (from baseline) in adipose cell formation rates (i.e. adipogenesis) in response to 16-weeks of pioglitazone versus the control group.

Secondary outcomes

  1. Visceral Adipose Tissue (Percentage of Total Abdominal Adipose Tissue)

    Time frame: Change from baseline in visceral fat at 16 weeks

    The volume of fat tissue around the internal organs in the abdomen (visceral adipose tissue; VAT) and underneath the skin (subcutaneous abdominal adipose tissue; scABD) will be determined by Magnetic Resonance Imaging (MRI) of the abdominal region. VAT:total abdominal AT (TAT) reflects the percentage of abdominal fat that is VAT and is calculated as VAT/(scABD AT + VAT).

  2. Lipid Accretion in the Liver (Intra-hepatic Lipid; IHL)

    Time frame: Change from Baseline in intra-hepato-cellular lipid at 16 weeks

    Lipid accretion in the liver cells will be measured using 1H-MRS of the liver.

  3. Matsuda Index (Measure of Insulin Sensitivity)

    Time frame: Change from Baseline in Matsuda Index at 16 weeks

    Insulin sensitivity (glucose tolerance) will be assessed using an oral 75 g oral glucose tolerance test (OGTT) after an overnight fast. Blood samples will be collected at 0, 30, 60, 90, and 120 min after glucose administration to measure serum glucose and insulin. Insulin sensitivity was calculated using the Matsuda insulin sensitivity index [10,000/ √(glucose 0' x insulin 0') X (mean glucose OGTT x mean insulin OGTT)]. A higher value denotes increased insulin sensitivity.

Sponsors and collaborators

Lead sponsor

Pennington Biomedical Research Center

Other

Collaborators

  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Registry information

Acronym: Apple/Pear

Important dates

Study start
2011
Primary completion
2016
Study completion
2016
First posted
Dec 13, 2012
Registry last updated
Apr 30, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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