Skip to main content
OpenTrials
Recruiting

NCT Number: NCT06539078

Skeletal Muscle Mitochondria in Ageing

Healthy ageing is associated with the loss of muscle mass and physical function. As a result, older people are limited in their independence. The aging of muscles typically begins around the age of 30. From this age onward, muscle strength, muscle mass, and the maximum oxygen uptake of muscles decrease. The reasons for this are not entirely clear, but it seems to be partly related to how oxygen moves from our blood vessels to the muscles and how muscles burn energy. The precise role of age and physical fitness, as well as whether exercise can counteract the effects of ageing, is still unknown. Therefore, in this study, we aim to investigate the muscle function of both physically active and inactive young and middle-aged individuals. We hypothesise that endurance training can mitigate some of the effects of ageing.

Recruiting

Interested in participating?

Request Info

Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Vrije Universiteit Amsterdam

Amsterdam, North Holland, 1081HV, Netherlands

Location status: Recruiting

Location contact

Ellen Breedveld, MSc

CONTACT

[email protected]

+31636318844

About this study

Healthy ageing is associated with a loss of muscle mass and physical function. This loss of physical function is underpinned by reductions in characteristics such as muscle strength, power, and maximal oxygen uptake (V̇O2max; reflecting exercise capacity). However, the causal contributors to these age-associated impairments, and the role of exercise training status in mitigating them, remain poorly defined. Skeletal muscle mitochondrial function has been proposed to be a key contributor to age-associated effects on physical function, however many conflicting results are present in the extant human literature. Moreover, diffusion of oxygen from capillaries to mitochondria is a key determinant of V̇O2max, however, whether the skeletal muscle diffusive capacity for oxygen (DmO2) declines with age is unknown. A new technique utilizing near-infrared spectroscopy (NIRS) will enable the non-invasive assessment of skeletal muscle diffusive capacity in young and elderly subjects for the first time to resolve this issue. The primary aims of this study are therefore to 1) compare DmO2 derived via NIRS between young sedentary, young endurance-trained, older sedentary, and older endurance-trained subjects; 2) to compare non-invasive (i.e. with NIRS and 31phosphorous magnetic resonance spectroscopy [31P-MRS]) and invasive (i.e. measures of mitochondrial morphology and respiration obtained by skeletal muscle biopsy) markers of mitochondrial function between the same groups, and 3) to assess the relationships between DmO2, mitochondrial measures and assessments of capillarization with functional measurements of muscle strength, power, and V̇O2max.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

In order to be eligible to participate in this study, young sedentary participants must meet all of the following criteria:

  • Aged between 18-30 years
  • Male or female
  • Not currently engaging in any formal exercise training or competitive sports
  • No chronic health conditions likely to affect exercise tolerance or the physiological responses to exercise

In order to be eligible to participate in this study, young trained participants must meet all of the following criteria:

  • Aged between 18-30 years
  • Male or female
  • Currently engaging in formal training (at least 3 times per week) in competitive endurance sports
  • No chronic health conditions likely to affect exercise tolerance or the physiological responses to exercise

In order to be eligible to participate in this study, older sedentary participants must meet all of the following criteria:

  • Aged between 50-65 years
  • Male or female
  • Not currently engaging in any formal exercise training or competitive sports
  • No chronic health conditions likely to affect exercise tolerance or the physiological responses to exercise

In order to be eligible to participate in this study, older trained participants must meet all of the following criteria:

  • Aged between 50-65 years
  • Male or female
  • Currently engaging in formal training (at least 3 times per week) in competitive endurance sports
  • No chronic health conditions likely to affect exercise tolerance or the physiological responses to exercise

Exclusion criteria

  • Age that falls outside of 18-30 years (young groups) or 50-65 years (middle-aged groups)
  • Inability to provide informed consent
  • History of claustrophobia
  • Ineligibility to perform the exercise test described in this study protocol or follow instructions
  • Taking any medications known to interfere with the physiological responses to exercise, e.g. e.g. systemic corticosteroids, statins, SGLT2 inhibitors, GLP1 receptor agonists
  • Contraindication for MRI (e.g. pacemaker, claustrophobia)
  • Being under investigation for non-diagnosed disease at the time of investigation
  • Body Mass Index (BMI) >30 due to adiposity, since this is known to cause difficulties in obtaining muscle biopsies and NIRS measurements
  • Pregnancy
  • Are current smokers or have been a regular smoker within the last 12 months

Treatment and study plan

Maximal exercise test

Other

Participants will undertake an incremental ramp test on a cycle ergometer to determine maximal oxygen uptake (V̇O2max) and the gas exchange threshold (GET). Throughout the exercise test, muscle oxygenation and deoxygenation will be monitored by NIRS.

3D ultrasound

Other

Muscle volume and morphological characteristics will be assessed via 3D ultrasound imaging.

Dynamometry

Other

To determine the contractile properties of the knee extensors, participants will perform maximal isometric and isoinertial contractions of the knee extensors on a dynamometer.

Exercise test and occlusions

Other

Participants will perform a series of moderate-intensity constant power output exercise bouts on a cycle ergometer following which the recovery rates of muscle V̇O2 will be determined via a series of intermittent arterial occlusions. Throughout all tests, pulmonary gas exchange and ventilation will be determined and muscle oxygenation and deoxygenation will be monitored by NIRS.

Exercise test in MRI

Other

Exercise will be performed on a custom-built magnetic resonance-compatible cycle ergometer in supine position for determination of muscle phosphocreatine recovery kinetics using 31phosphorous magnetic resonance spectroscopy [31P-MRS].

Muscle biopsy

Procedure

A muscle biopsy will be obtained from the vastus lateralis using a modified Bergström needle technique with suction.

Primary outcomes

  1. Maximal oxygen uptake (V̇O2max)

    Time frame: Baseline (visit 1)

    ml/min/kg

  2. Muscle volume

    Time frame: Baseline (visit 1)

    cm^3

  3. Muscle strength

    Time frame: Baseline (visit 1)

    Newton-metre (Nm)

  4. Muscle power

    Time frame: Baseline (visit 1)

    Watt (W)

  5. Muscle diffusing capacity for oxygen (DmO2)

    Time frame: Baseline (visit 1) and visit 2-4. In total 4 weeks.

    Differences in recovery constant k (min-1) obtained under conditions of high, medium or low O2 availability

  6. Muscle mitochondrial fragmentation index (A.U.)

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks).

    Degree of fragmentation of the mitochondrial pool.

Secondary outcomes

  1. Gas exchange and ventilatory variables (gas exchange threshold, respiratory compensation point, maximal ventilation)

    Time frame: Baseline (visit 1)

    L/min

  2. (Peak) power output

    Time frame: Baseline (visit 1)

    Watt (W)

  3. Mean response time of the V̇O2 slope during ramp exercise

    Time frame: Baseline (visit 1)

    sec

  4. (Maximum) heart rate (HR)

    Time frame: Baseline (visit 1) and during visit 2-4 (max 4 weeks in total)

    beats per minute (bpm)

  5. Maximal O2 pulse

    Time frame: Baseline (visit 1)

    ml/beat

  6. Slope of ventilation (VE) versus carbon dioxide (VCO2) output during ramp exercise (i.e. ventilatory efficiency)

    Time frame: Baseline (visit 1)

    V̇E/V̇CO2 slope

  7. V̇O2/HR slope during ramp exercise

    Time frame: Baseline (visit 1)

    beats/L/min

  8. Maximal respiratory exchange ratio (RER)

    Time frame: Baseline (visit 1)

    RER = VCO2/VO2

  9. Maximal ventilatory equivalents

    Time frame: Baseline (visit 1)

    VE/VCO2 and VE/VO2

  10. Maximal end-tidal pressures for oxygen (O2) and carbon dioxide (CO2)

    Time frame: Baseline (visit 1)

    mmHg

  11. Capillary lactate concentration

    Time frame: Baseline (visit 1)

    mmol/L

  12. Maximal respiratory frequency

    Time frame: Baseline (visit 1)

    breaths/min

  13. Pulmonary oxygen uptake - baseline and steady state V̇O2

    Time frame: Baseline (visit 1) and visit 2-4 (max 4 weeks in total)

    L/min

  14. Pulmonary oxygen uptake kinetics - Phase II V̇O2 time constant and time delay

    Time frame: Visit 2-4 (max 4 weeks in total)

    sec

  15. Pulmonary oxygen uptake kinetics - Phase II V̇O2 amplitude

    Time frame: Visit 2-4 (max 4 weeks in total)

    L/min

  16. Concentrations of NIRS derived muscle oxy- and deoxygenated [haemoglobin + myoglobin] (HbO2, Hbb) and tissue saturation index (TSI).

    Time frame: Baseline (visit 1) and visit 2-4 (max 4 weeks in total)

    HbO2 and Hbb: % maximal value, TSI (%) = HbO2/(HbO2+Hbb) For all variables resting concentration, baseline cycling concentration, (sub)maximal exercise concentration will be reported.

  17. NIRS derived muscle oxy- and deoxygenated [haemoglobin + myoglobin] (HbO2, Hbb) and tissue saturation index (TSI) versus relative and absolute work rate.

    Time frame: Baseline (visit 1)

    HbO2 and Hbb: % maximal value, TSI (%) = HbO2/(HbO2+Hbb) versus relative (%max) and absolute power output (W) Relative and absolute work rates comparisons will be reported for all variables: resting concentration, baseline cycling concentration, (sub)maximal exercise concentration.

  18. Initial and secondary slope of increase during incremental exercise will be reported for NIRS derived muscle oxy- and deoxygenated [haemoglobin + myoglobin] (HbO2, Hbb) and tissue saturation index (TSI) versus relative work rate.

    Time frame: Baseline (visit 1)

    concentration[Hbb/HbO2/TSI]%/delta%peak power(W)

  19. Initial and secondary slope during incremental exercise will be reported for NIRS derived muscle oxy- and deoxygenated [haemoglobin + myoglobin] (HbO2, Hbb) and tissue saturation index (TSI) versus absolute work rate.

    Time frame: Baseline (visit 1)

    concentration[Hbb/HbO2/TSI]%/deltaW

  20. Muscle (de)oxygenation breakpoint during incremental exercise

    Time frame: Baseline (visit 1)

    Power output (W) and maximal oxygen uptake (L/min)

  21. Rate constant of mV̇O2 recovery kinetics under conditions of high, medium and low O2 availability

    Time frame: Baseline (visit 1)

    sec

  22. Muscle morphology - Fascicle length

    Time frame: Baseline (visit 1)

    cm

  23. Muscle morphology - pennation angle

    Time frame: Baseline (visit 1)

    degrees

  24. Muscle morphology - (effective) physiological cross-sectional area (PCSA)

    Time frame: Baseline (visit 1)

    cm2

  25. Muscle morphology - vastus lateralis specific force

    Time frame: Baseline (visit 1)

    N/cm2

  26. Muscle morphology - estimated muscle fiber number

    Time frame: Baseline (visit 1)

    PCSA/muscle fiber cross-sectional area

  27. Adipose tissue thickness at the site of NIRS measurement

    Time frame: Baseline (visit 1)

    mm

  28. Mitochondrial respiratory function (background, LEAK, N-linked respiration, OXPHOS, ETS, succinate (S) + rotenone (ROT)-linked uncoupled respiration, )

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks).

    pmol/s/mg

  29. Respiratory control ratios

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks).

    OXPHOS/ETS, LEAK/ETS, LEAK/OXPHOS, LEAK/NADH-linked, ROT+S/ETS, (OXPHOS-LEAK)/ETS, (OXPHOS-LEAK)/OXPHOS, (ETS-LEAK)/ETS, (ETS-OXPHOS)/ETS

  30. Intrinsic mitochondrial respiration (each respiratory state outlined below will be normalised to mitochondrial volume density)

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks).

    (pmol/s/mg)/mitochondrial area density (%) For: background, LEAK, N-linked respiration, OXPHOS, ETS, succinate + rotenone-linked uncoupled respiration

  31. 31P-MRS-derived mitochondrial bioenergetic function - resting and steady-state exercising concentrations and amplitude of exercise-induced changes of skeletal muscle Phosphocreatine [PCr], [inorganic phosphate] and pH

    Time frame: Visit 5 MRI

    mM pH = unitless

  32. 31P-MRS-derived mitochondrial bioenergetic function rate constant of PCr

    Time frame: Visit 5 MRI

    Rate constant of Phosphocreatine [PCr] on- and off-kinetics (sec)

  33. 31P-MRS-derived mitochondrial bioenergetic function - maximal rate of oxidative ATP synthesis

    Time frame: Visit 5 MRI

    mM/s

  34. Muscle fiber type distribution

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    Type I, IIa, IIx and hybrid fiber-type proportions (%)

  35. (mean) fiber cross-sectional area, also fiber type specific

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    um

  36. Weighted fiber cross-sectional area

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    um2

  37. Mean and fiber type specific succinate dehydrogenase activity

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    A660/um/s

  38. Integrated fiber succinate dehydrogenase activity

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    A660.um/s

  39. Mean and fiber type specific myoglobin concentrations

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    mM

  40. Muscle capillarization - capillary density

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    number of capillaries/mm2

  41. Muscle capillarization - capillary-to-fiber ratio

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    capillary-to-fiber ratio

  42. Muscle capillarization - mean number of capillaries surrounding a fiber (CAF)

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    number of capillaries

  43. Muscle capillarization - mean number of capillaries surrounding a fiber in relation to fiber area (CAFA)

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    number of capillaries/um2

  44. Muscle capillarization - capillary-to fiber-perimeter exchange index (CFPE)

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    CFPE (unitless)

  45. Muscle capillarization - length of capillaries relative to fiber perimeter (LC/PF)

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    percentage (%)

  46. Muscle capillarization - sarcomere length

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - staining within time window of 2 years.

    um

  47. Mitochondrial dynamics proteins (Mfn1, Mfn2, OPA1, Drp1, Parkin, PINK1, Fis1, MTFP1, NRF1&2, PGC1a, TFAM, OXPHOS protein content (complexes I-V and total protein content)

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - western blot within time window of 2 years.

    ug/mg loaded sample

  48. Physical activity status - pedometer

    Time frame: Baseline 7 days

    Number of steps per day

  49. Mitochondrial area density

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - electron microscopy (EM) within time window of 2 years.

    Percentage (%)

  50. Mitochondrial volume density

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    um3.um3.10^2

  51. Mitochondrial number

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    number/um2

  52. Mitochondrial area

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    um2

  53. Mitochondrial height, width, perimeter and maximal+minimal Feret's diameter

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    um

  54. Mitochondrial surface area-to-volume ratio

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    um/um^2

  55. Mitochondrial circularity

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    Circularity (AU)

  56. Mitochondrial roundness

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    Roundness (AU)

  57. Mitochondrial aspect ratio

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    Aspect ratio (AU)

  58. Mitochondrial cristae area density

    Time frame: Visit 6 muscle biopsy (+/- after 4 weeks) - EM within time window of 2 years.

    Percentage (%)

Study contacts

Contact information is provided by the study sponsor or research team.

Ellen Breedveld, MSc

CONTACT

[email protected]

+31636318844

Sponsors and collaborators

Lead sponsor

VU University of Amsterdam

Other

Registry information

Official study title

Exercise as a Countermeasure Against the Effects of Ageing on Muscle Mitochondria, Diffusive Oxygen Transport and Muscle Volume

Acronym: AGAMEMNON

Important dates

Study start
2024
Primary completion
2025
Study completion
2026
First posted
Aug 6, 2024
Registry last updated
Aug 6, 2024

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.

Published trials that share one or more normalized conditions with this study.