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Completed

NCT Number: NCT03951285

Nicotinamide Riboside and Mitochondrial Metabolism

Vitamin B3 has recently been found to be a potent modifier of energy metabolism, especially the function of mitochondria. Mitochondria power up all cells in our bodies, by generating fuel, ATP, for cellular functions. In previous studies, it has been discovered that mitochondrial biogenesis and oxidative metabolism in adipose tissue is severely impaired in obesity, already at a young adult age. Here the investigators describe a proposal where they use nicotinamide riboside (NR), a form of vitamin B3 naturally found in milk, to activate dysfunctional mitochondria, in particular the SIRT/NAD+ pathway, and to rescue signs of obesity-related diseases. The investigators use a unique human study design: monozygotic twins either discordant or concordant for obesity, to examine the effects of NR on mitochondrial function in muscle, adipose tissue and the metabolism of the whole body. The upcoming upcoming results are important for understanding the links between mitochondrial dysfunction and chronic metabolic diseases in humans, as well as for clarifying mechanisms of the novel nutritional therapeutic approaches.

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Key information

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • BMI >18.5 kg/m2 in both members of the twin pair
  • Agreed to maintain current level of physical activity throughout the study
  • Agreed to avoid vitamin supplementation or nutritional products with vitamin B3 14 days prior to the enrolment and during the study
  • Written, informed consent to participate in the study

Exclusion criteria

  • Unstable medical conditions as determined by the principal investigator
  • Clinically significant abnormal lab results at screening (e.g. AST and/or ALT > 2 x ULN, and/or bilirubin > 2 x ULN)
  • Subjects who have a planned surgery during the course of the trial
  • History of or a current diagnosis of any cancer (except for successfully treated basal cell carcinoma diagnosed less than 5 years prior to screening). Subjects with cancer in full remission more than 5 years after diagnosis are acceptable.
  • History of blood/bleeding disorders
  • Immunocompromised individuals such as subjects that had undergone organ transplantation or subjects diagnosed with human immunodeficiency virus (HIV)
  • Hepatitis
  • Blood donation in the previous 2 months
  • Anemia (hemoglobin <120)
  • Participation in a clinical research trial within 30 days prior to randomization
  • Allergy or sensitivity to study supplement ingredients
  • Individuals who are cognitively impaired and/or who are unable to give informed consent.
  • Any other condition, which in the principal investigator's opinion may adversely affect the subject's ability to complete the study or its measures or which may have posed significant risk to the subject.

Treatment and study plan

NR in BMI-discordant twins

Dietary Supplement

Water-soluble form of vitamin B3, nicotinamide riboside (NR) is used in this study. The NR product name is Niagen, produced by ChromaDex. NR does not cause the known side effects (vasodilation and flushing) of another vitamin B3, niacin.

Other names: Niagen, Nicotinamide riboside

NR in BMI-concordant twins

Dietary Supplement

Water-soluble form of vitamin B3, nicotinamide riboside (NR) is used in this study. The NR product name is Niagen, produced by ChromaDex. NR does not cause the known side effects (vasodilation and flushing) of another vitamin B3, niacin.

Other names: Niagen

Primary outcomes

  1. Mitochondrial biogenesis - mitochondrial DNA quantification

    Time frame: At baseline and 5 months after supplementation

    Change in amount of mitochondrial DNA in skeletal muscle and adipose tissue (mtDNA quantification)

  2. Mitochondrial biogenesis - mitochondria-related mRNA expression

    Time frame: At baseline and 5 months after supplementation

    Change in mitochondria-related mRNA expression in skeletal muscle and adipose tissue (qPCR)

  3. Mitochondrial biogenesis - electron microscopy

    Time frame: At baseline and 5 months after supplementation

    Change in mitochondria histology by electron microscopy evaluation of skeletal muscle

Secondary outcomes

  1. NAD+ and related metabolite levels in blood

    Time frame: At baseline and 5 months after supplementation

    Change in levels of NAD+ and related metabolites such as: NADP+, nicotinic acid adenine dinucleotide, nicotinamide, and nicotinamide mononucleotide in blood using high performance liquid chromatography-mass spectrometry

  2. Skeletal muscle mitochondrial oxidative capacity

    Time frame: At baseline and 5 months after supplementation

    Change in mitochondrial function in skeletal muscle by immunohistochemical respiratory chain enzyme analysis

Other outcomes

  1. Body weight and body composition

    Time frame: At baseline and 5 months after supplementation

    Change in body weight as well as fat mass and fat free mass measured with bioimpedance and DEXA scanning, fat distribution by magnetic resonance imaging

  2. Ectopic lipid accumulation in liver and muscle (in vivo)

    Time frame: At baseline and 5 months after supplementation

    Change in liver and skeletal muscle lipid accumulation measured with H-MRS in vivo

  3. Whole body insulin sensitivity

    Time frame: At baseline and 5 months after supplementation

    Insulin sensitivity as measured by oral glucose tolerance test (OGTT)-derived indexes

  4. Circulating inflammation markers

    Time frame: At baseline and 5 months after supplementation

    Change in circulating levels of IL-2, IL-5, IL-6, IL-12 and TNF-alpha will be measured by multiplex

Sponsors and collaborators

Lead sponsor

Helsinki University Central Hospital

Other

Collaborators

  • Finnish Institute for Health and Welfare
  • Göteborg University
  • University of Helsinki
  • University of Iowa

Registry information

Official study title

Vitamin B3 as a Novel Mitochondrial Therapy for Obesity

Acronym: VitaPower

Important dates

Study start
2016
Primary completion
2019
Study completion
2019
First posted
May 15, 2019
Registry last updated
Dec 24, 2019

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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