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Obstructive Sleep ApneaNCT02157844

Fat Metabolism in OSA and COPD

An observational study of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease, run by Texas A&M University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by an obstruction of the upper airways. The obstruction results in periods of intermittent hypoxia and re-oxygenation, which lead to increased oxidative stress, increased inflammation, endothelial dysfunction, and insulin resistance. Read more about this study

Who is it for?
Ages 30 years and olderHealthy volunteers can take part
How many people
62 participants
Where
1 siteUnited States
Study dates
Apr 2014to Dec 2017
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Subjects with OSA or COPD will be recruited when visiting a medical or pulmonary clinic in and outside the surrounding area of College Station. Patients and healthy subjects will also be recruited by responding to distributed flyers in the community in the College Station area; for example in hospital/clinic waiting areas, clinic rooms and bulletin boards at Scott \& White and the CSMC or any other hospital. Other general recruitment material in relation to the nutrition research that the research group performs at Texas A\&M can be placed on bulletin boards at Scott \& White and the CSMC.

Who may be able to join

  • Established diagnosis of OSA or COPD
  • Ability to sign informed consent
  • Ability to walk, sit down and stand up independently
  • Age 30 years and older
  • Ability to lie in supine position for up to 8 hours
  • Clinically stable condition and not suffering from a respiratory tract infection or exacerbation of their disease
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  • Willingness and ability to comply with the protocol
  • Inclusion criteria healthy normal weight and obese subjects:
  • Healthy male \& female according to the investigator's or appointed staff's judgment
  • Ability to walk, sit down and stand up independently
  • Age 30 years or older
  • Ability to lay in supine or elevated position for 8 hours
  • No diagnosis of OSA or COPD
  • Willingness and ability to comply with the protocol

Who cannot join

  • Established diagnosis of malignancy
  • Untreated metabolic diseases including hepatic or renal disorder
  • Presence of acute illness or metabolically unstable chronic illness
  • Presence of fever within the last 3 days
  • Any other condition according to the PI or study physician that would interfere with proper conduct of the study / safety of the patient
  • Use of long-term oral corticosteroids or short course of oral corticosteroids in the preceding month before enrollment
Show all 13Show fewer
  • Use of protein or amino acid containing nutritional supplements within 5 days of first study day 5 days of first study day
  • Failure to give informed consent or Investigator's uncertainty about the willingness or ability of the subject to comply with the protocol requirements
  • History of hypo- or hyper-coagulation disorders, including use of a Coumadin derivative, history of deep venous thrombosis (DVT), or pulmonary embolism (PE) at any point in lifetime
  • Currently taking anti-thrombotics and cannot stop for 7 days (i.e. medical indication)
  • Recent myocardial infarction ( < 1 year ago)
  • Current alcohol or drug abuse
  • (Possible) pregnancy

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Texas A&M University

    College Station, Texas, 77843

Other trials in United States

About this study

Official title: Fat Metabolism and Digestion in Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease

Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by an obstruction of the upper airways. The obstruction results in periods of intermittent hypoxia and re-oxygenation, which lead to increased oxidative stress, increased inflammation, endothelial dysfunction, and insulin resistance. Chronic obstructive pulmonary disease (COPD) is a lung disease that leads to poor airflow. This disease leads to systemic hypoxia, reduced oxidative capacity, and increased inflammation. The direct cause of OSA and COPD is unclear, but OSA and COPD may be linked to other comorbid conditions such as obesity and type II diabetes. Upon onset of OSA and COPD, metabolic disturbances associated with obesity and type II diabetes can be exacerbated.

Obesity is a condition characterized by an increase in visceral fat, elevated plasma levels of free fatty acids, inflammation, and insulin resistance. Although the effects of body fat distribution have not been studied in these patients, an increase in both subcutaneous and abdominal fat mass in non-OSA older women was shown to increase morbidity and mortality. Fat/adipose tissue is an active tissue capable of secreting proinflammatory cytokines such as tumor necrosis factor (TNF)-alpha and interleukin (IL)-6, reactive oxygen species and adipokines. Particularly, abdominal fat is a prominent source of pro-inflammatory cytokines, which contributes to a low grade, chronic inflammatory state in these patients. Additionally, an increased inflammatory state is associated with reduced lean body mass, and together with elevated circulating free fatty acids may increase the occurrence of lipotoxicity and insulin resistance. Thus, increased fat deposition is associated with a poor prognosis in OSA and COPD patients and therefore it is of clinical and scientific importance to understand the changes in fat metabolism and digestion as a result of OSA and COPD.

It is therefore our hypothesis that fat synthesis and insulin resistance is increased and whole body protein synthesis is decreased in OSA and COPD patients, leading to a poor prognosis.

Read the detailed description

This research study involves 3 visits for subjects and healthy controls. The first visit is the screening visit and includes review of the informed consent and a DXA scan and the second and third visit for the study days. For the first test day, 3 hours of the subjects time will be for urine and blood sample collection, and to stable isotope administration (deuterated water, isotopically labeled amino acids). Subjects are allowed to go home after and eat normally. On the second study day, subjects will arrive early that morning. For the duration of the study, subjects have to lie in the bed (except for bathroom privileges). They can watch tv or bring and use a book/tablet. The research nurse or study staff will be present in the human subject area to assist the subject if necessary. Subjects are not allowed to eat or drink during the second test day, except for the test drink (meal) and water. One IV catheter will be placed in a vein of the arm/hand for blood draws. The hand will be placed in a hot box during blood collection. Another IV catheter will be placed in the contra-lateral forearm for a primed and continuous infusion of isotopes (isotopically labeled amino acids and glycerol). Each day, a total of 80-100 ml of blood will be obtained. Stable isotopes will be ingested and infused on the first test day and added to the test drinks and infused on the second day. On the second test day, subjects will fill out questionnaires. After completion of the study, we will provide the subject with a meal.

Keywords
Obstructive Sleep Apnea, Chronic Obstructive Pulmonary Disease, Obesity, Hepatic fat metabolism, fat digestion, whole body protein synthesis, protein digestion, amino acid metabolism, adipose tissue fat metabolism, lipolysis
Medical subject headings
Sleep Apnea, Obstructive, Pulmonary Disease, Chronic Obstructive, Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02157844
Study groupRoleWhat they receive
COPD and OSASubjects with diagnosis of COPD and OSA
COPDSubjects with diagnosis of COPD
OSASubjects with diagnosis of OSA
controlsGender, age, BMI matched controls

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Hepatic triglyceride synthesis

    changes in hepatic triglyceride synthesis before and after a meal

    Measured: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion

  2. Hepatic de novo lipogenesis

    changes in hepatic de novo lipogenesis before and after a meal

    Measured: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion

  3. Adipose tissue triglyceride synthesis

    changes in adipose tissue triglyceride synthesis before and after a meal

    Measured: pre and 4 hours post meal

  4. Adipose tissue de novo lipogenesis

    changes in adipose tissue de novo lipogenesis before and after a meal

    Measured: pre and 4 hours post meal

  5. Adipose tissue lipolysis - glycerol rate of appearance

    changes in adipose tissue lipolysis before and after a meal. plasma enrichment of glycerol.

    Measured: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion

  6. Rate of appearance of ingested glucose

    determine changes in appearance of glucose rate in subjects

    Measured: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion

  7. Endogenous Glucose Production

    Determine whole body glucose production in subjects

    Measured: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion

  8. Glucose disposal

    Determine whole body glucose uptake in subjects

    Measured: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion

  9. Net whole-body protein synthesis

    change in whole-body protein synthesis rate after intake of meal

    Measured: 0, 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210 min post-meal

  10. Citrulline Rate of appearance

    plasma enrichment of citrulline

    Measured: Postabsorptive state during 2 hours

  11. Arginine turnover rate

    Arginine enrichment in plasma

    Measured: postabsorptive state during 3 hours

  12. Whole body collagen breakdown rate

    Hydroxyproline enrichment in plasma

    Measured: Postabsorptive state during 3 hours

  13. Tryptophan turnover rate

    Tryptophan enrichment in plasma

    Measured: Postabsorptive state during 3 hours

  14. Myofibrillar protein breakdown rate

    3methylhistidine enrichment in plasma

    Measured: 0,15,30,45,60,75,90,105,120,150,180,210 min post-meal

  15. Glycine rate of appearance

    glycine enrichment in plasma

    Measured: Postabsorptive state during 3 hours

  16. Taurine turnover rate

    enrichment of taurine in

    Measured: postabsorptive state during 3 hours

Secondary outcomes (5)
  1. Fat digestion and absorption

    defining fat digestion and absorption after a meal. Enrichment in palmitic acid and tripalmitin fatty acids in plasma

    Measured: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion

  2. Insulin response to feeding

    acute changes from postabsorptive state to postprandial state

    Measured: pre and up to 5 hours post meal

  3. Body composition

    body composition will be determined by dual-energy X-ray absorptiometry and by deuterated water dilution technique. Plasma deuterium enrichments will be determined.

    Measured: 1 day

  4. Physical activity questionnaire

    Outcome of physical activity assessment in breast cancer patients and healthy controls in relation to the fat metabolism

    Measured: 1 day

  5. Protein digestion after feeding

    Ratio enrichment free phenylalanine vs phenylalanine from protein spirulina

    Measured: 0,15,30,45,60,75,90,105,120,150,180,210, min post-meal

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jun 2014 (estimated)
  2. Study startApr 2014
  3. Primary completionDec 2017
  4. Study completionDec 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
62 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02157844
Sponsor's protocol ID
2013-0878F
Status last verified
Feb 2022
First submitted
4 Jun 2014
Last updated
4 Feb 2022
Results posted
No
Data monitoring committee
No

Publications

  • Huttl VN, Deutz N, Wierzchowska-McNew RA, Ruebush LE, Engelen M. Whole-body and intracellular arginine metabolism in hypertension: role of disease severity and sex. Am J Hypertens. 2026 May 18:hpag047. doi: 10.1093/ajh/hpag047. Online ahead of print.

    PubMed 42149813
  • Kang MC, Deutz NEP, Kirschner SK, Engelen MPKJ. Metabolic kinetics and muscle and brain health markers in older adults, and the role of age and presence of chronic morbidities: A large cross-sectional cohort study. Clin Nutr. 2024 Dec;43(12):36-47. doi: 10.1016/j.clnu.2024.10.015. Epub 2024 Oct 11.

    PubMed 39423760
  • Deutz LN, Wierzchowska-McNew RA, Deutz NE, Engelen MP. Reduced plasma glycine concentration in healthy and chronically diseased older adults: a marker of visceral adiposity? Am J Clin Nutr. 2024 Jun;119(6):1455-1464. doi: 10.1016/j.ajcnut.2024.04.008. Epub 2024 Apr 12.

    PubMed 38616018
  • Engelen MPKJ, Kirschner SK, Coyle KS, Argyelan D, Neal G, Dasarathy S, Deutz NEP. Sex related differences in muscle health and metabolism in chronic obstructive pulmonary disease. Clin Nutr. 2023 Sep;42(9):1737-1746. doi: 10.1016/j.clnu.2023.06.031. Epub 2023 Jul 26.

    PubMed 37542951

Questions about this trial

What is this clinical trial studying?

An observational study of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease, run by Texas A&M University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hepatic triglyceride synthesis (time frame: Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion). The study lists 16 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02157844, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2022.

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